The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 61 GRANVILLE LANE 4/30/2018 GRANVILLE LANE fi'2lD9Q6jCtOO52--0000.0 1. i Q 1 � L 1 � � o Bk g 116B ' Ps 2.13" 97 5 DEED RESTRICTION Pursuant to 310 CMR 15.000 Title 5, and as a condition of septic plan approval by the North Andover Board of Health notice is herebygiven that real estate located at 61Granville gi Lane, North Andover, Essex County, Massachusetts (Assessor's Parcel ID No. 210/106.0-0052- 0000.0), as described in a deed from Farr Better Homes, Inc. to Built Best Construction, LLC dated January 21, 2009 and recorded with the Essex North District Registry of Deeds at Book 11435, Page 20, is the subject of a variance from the Town of North Andover Minimum Requirements for the Subsurface Disposal of Sanitary Sewage A1.05 and C9.01(4). Said variauuce limits the maximum number of bedrooms at this dwelling to 3 bedrooms. This variance is within the jurisdiction of the North Andover Board of Health. Signed and sealed this 8th day of July, 2009. B IL &EN UCTION, LLC By. Walter K. Eriksen, Jr., Manager COMMONWEALTH OF MASSACHUSETTS Essex, ss. On this 8th day of July, 2009, before me, the undersigned notary public, personally appeared Walter K. Eriksen, Jr., Manager of Built Best Construction, LLC, proved to me through satisfactory evidence of identification, which was personal knowledge, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose on behalf of Built Best Construction, LLC, a Massachusetts limited liability company. ee�s: Notary Public My commission e �=' s SCOTT JOHN ER(KSEN:. .. Notary public Commonwealth of Vassachusetts My Commission Expires .— November 2,2012 {NEW\NEW\A0204105.1} i pORTy q O �t�E' 0 ti 1'6'6 OOL FILE ®P� T 0 [OC.IM[lwKl y1 ATED �SSACHUS�� PUBLIC HEALTH DEPARTMENT Community Development Division March 2, 2009 Walter Erickson 315 Middlesex Road Tyngsborough, MA 01879 RE: Subsurface Subsurface Sewage Disposal System Plan for Lot 4 Granville Lane,North Andover, System Plan for Lot 4 Granville Lane,North Andover, MA Dear Mr. Erickson, Variance: Pleases be advised that a regularly scheduled meeting held on February 26, 2009,the North Andover Board of Health approved the following variance to the already approved plan for the property listed above. A. Dr. MacMillan made a motion to allow the variance request to "Allow the use of a segmental block retaining wall in lieu of a poured concrete wall as required by the Town of North Andover Minimum Requirements For the Subsurface Disposal of Sanitary Sewage Section 9.02." B. In addition,the engineer,Mr. Benjamin Osgood,Jr., shall approve the type of block chosen, and submit a detailed drawing of the wall plan. Mr. Fixler seconded the motion. All were in favor. Installation: The time table for installation will not change from the previously approved date of February 1 2008. In accordance with local subsurface disposal regulations "Acceptable plans and any variances shall expire two years from the date approved unless construction on the lot has begun" During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. Waiver: This approval includes a Board of Health waiver obtained at a regularly scheduled BOH meeting held on January 24, 2008. The waiver is to the local regulation's minimum design specification that requires all systems to be designed to serve a minimum of four bedrooms. This waiver to allow a 3-bedroom design is approved with the restriction that the deed restriction, limiting the use to a three bedroom, maximum seven-room home,is placed on the deed of the 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com g PART D CONSTRUCTION SECTION 10.00 , GENERAL CONSTRUCTION REQUIREMENTS 10.01 Pipe: All piping shall be a minimum of Schedule 40 PVC. SECTION 11.00 BUILDING SEWERS IN UNSEWERED AREAS 11.01 Distances: The minimum distance between the building sewer and a water supply line shall be ten feet. The minimum distance of a building sewer from a private well shall be at least fifty feet. 11.02 Material: The building sewer shall be constructed completely of cast-iron or schedule 40 P.V.C. with watertight joints. 11.10 Compliance: All building sewers shall be constructed in accordance with the State Plumbing Code, 248 CMR 2.00. SECTION 12.00 DOSING CHAMBERS AND PUMPS 12.01 General: All pumping systems must be equipped with a check valve, bleeder hole, alarm on a separate circuit and a manual operating switch. SECTION 13.00 SOIL ABSORPTION SYSTEMS 13.01 Minimum design: All soil absorption systems designed to serve a single dwelling shall be designed to serve a minimum of four bedrooms unless a waiver by the Board of Health permitting a deed restriction limiting use to three bedrooms is granted for sites where the larger system cannot be installed. 13.02 Vehicular traffic: No driveway, parking or turning area or other impervious area shall be located above a soil absorption system. 13.03 Cover Material: The soil placed as backfill over the system shall be a minimum of nine inches, excluding topsoil which shall be a minimum of three inches, placed in lifts and sufficiently compacted to prevent depressions-due to settling which may intercept or collect surface water runoff above the system. Backfill material shall be clean and free of stones greater than six inches in size. Tailings, clay or similar materials are prohibited. Septic Regulations TOWN OF NORTH ANDOVER, MA X North Andover Board of Assessors Public Access Page 1 of 1 b � r 1 N°RT„ Forth Andover Board of Assessors OWL 9SSAC.HU t roperty Record Card Click Seal To Return Parcel ID :210/106.C-0052-0000.0 FY:2010 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales Summary � n Residence = —-- Detached Structure Condo 61 GRANMLLE LANE Commercial Location: 61 GRANVILLE LANE Owner Name: BUILT BEST CONSTRUCTION,LLC C/O SCOTT ERIKSEN Owner Address: 61 GRANVILLE LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:6-6 Land Area: 1.01 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2240 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 177,500 2,300 Building Value: 48,900 0 Land Value: 128,600 2,300 Market Land Value: 128,600 Chapter Land Value: LATEST SALE Sale Price: 0 Sale Date: 12/31/1976 Arms Length Sale Code: N-NO-OTHER Grantor: Cert Doc: Book: 01281 Page: 0465 http://csc-ma.us/PROPAPP/display.do?linkld=1519165&town=NandoverPubAcc 10/19/2010 i r F L GRADE INSPECTION Date: S Address: C) LOAMED? SEEDED? COVER PER PLAN? Other: North Andover BoaTd of Assessors Public Access Page 1 o � ' s pORly Town Qi. q0 V" F, = 9 X Ac Property Record Card Return to the Home page click on logo l Parcel ID:210/106.C-0052-0000.0 Community: North Andover SKETCH PHOTO New Search Sales No Sketch No Picture . Summary Residence Available Available Detached Structure Condo Commercial +� �'�� ' �� Comparable Sales Location: GRANVILLE LANE Owner Name: FARR BETTER HOMES Owner Address: P O BOX 35 City:NORTH ANDOVER State:MA ZIP:01845 Neighborhood:6-6 Land Area: 1.01 acres Use Code: 132-RES-UDV-LAND Total Finished Area: 0 sqft i ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 2,300 2,400 Building Value: 0 0 Land Value: 2,300 2,400 r Market Land Value:2,300 Chapter Land Value: LATEST SALE Sale Price:0 Sale Date: 12/31/1976 Arms Length Sale Code:N-NO-OTHER Grantor: Cert Doc: Book: 01281 Page: 0465 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&LinUd=1181554 1/24/2008 f i i Cf NORTH,� 711 4 � 9 Town of North Andover HEALTH DEPARTMENT SwCHU`+E CHECK#: DATE: LOCATION: t H/O NAME: Vv CONTRACTOR NAME: ., Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type. $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ Title 5 Inspector $ Title 5 Report $ JW ❑ Other. (Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' „ 61 Granville Lane Property Address r Scott Erickson L ;� Owner every Owner's Name required for ej information iNorth Andover Ma 01845 6/5/15 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:When A. General Information RECEIVED filling out forms on the computer, JUN q use only the tab 1. Inspector 17 2015 key to move your cursor-do not Fred Perrault TOWN OF NORTH ANDOVER use the return Name of Inspector HEALTH DEPARTMENT key. Borough Sewer Service "Q Company Name PO Box 111 AX Company Address Tyngsboro Ma 01879 Citylrown State Zip Code 978 649 6297 S15036 Telephone Number License Number B. Certification 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 s_ewa a dis osal s stems: 1"am a DEP a roved s stem ins ector _ursuantto Section 15.340 of`� 9 P _—y _PAL__ P P _— __ Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6/8/15 1pec"oed SI ature Date 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. ""*"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. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 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. -- J Cfieck�ie�for"yes', no or -f-d--r—tined'�(Y l�"1VD�f�ttfe fottowir�gatatement tf >�ot---- 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. ❑ Y ❑ N ❑ ND (Explain below): I i t5ins•3113 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is North Andover Ma 01845 6/5!15 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I N 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal failure criteria are triggered. A co of the analysis must to or less than 5 m provided that no other fa gg copy Y ppm, P be attached to this form. 3. Other: D) 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins-3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts --- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. City(rown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® 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 fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. 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:Ther --. --- —system-owner-shouWcontact-the-Board-of-Health-to-determine-whatwitt-bL---- 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. 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 ❑ ❑ 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owners Name information is North Andover Ma 01845 6/5/15 required for every page. Cityrrown State Zip Code Date of Inspection C. Checklist 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 b the owner, occupant, or Board of Health ❑ P P Y ® 9 ❑ ® 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 plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ 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? a ---�— ® — 1:1 Wa�th�fadlit"wrierfarrd�ccupants fidiffereritfrom-owner)pn3vidert witty------ — 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: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 3 x110 i t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is Ma 01845 6/5/15 required for every North Andover State Zip Code Date of Inspection page. CitylTown D. System Information Description: 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No current Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 7 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: current Date Other(describe below): General Information Pumping Records: Source of information: owner Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Reason for pumping: inspection Ty—peoffs of m- —-- --- --- -- ® 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y< 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 9/09 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1' Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): -- -� Septic Tank(locateonsite plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: — t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments + 61 Granville Lane Property Address Scott Erickson Owner Owner's Name required for is every North Andover required for eve Ma 01845 6/5/15 ' page. &Wrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 36" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 4.1 Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Dip tube Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet&outlet tees ok Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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: Date - t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Owner has pumped tank every 2 years. 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 per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts _ -- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D/box clean no carryover Pump Chamber(locate on site plan): i Pumps in working order: ❑ Yes ❑ No* Alarms in working order: _ _ �❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Granville Lane Property Address Scott Erickson Owner Owner's Name information is North Andover Ma 01845 6/5/15 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yy� 61 Granville lane Property Address Scott Erickson Owner Owner's Name information is required for every North Andover Ma 01845 6/5/15 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information—Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 I I OCUMA M MAJOC SILL ELEV.105.W 1 2 :;tom::. 1C4w : 100'BUFFER ZONE SEPTIC TANK 'DRNEWAY, O ,. D-BOX 1a' 37 f A ,,+�-� fiJ T BOXWATT,. .;;::,:.: 3r SE .....: R=213,2,4 b ` SECiINQrTAt BLOCK WALL.TOP ELEv.1al.00- .. ... ..... - 1 F • .. ................ ... . .................. ................... ......... .... V r .... ................. ........................... . ........................... ....... . ..... .............. .......................... ............ ...... .................. SYSTEM TIES 1 TO TANK IN 17.1' 2 TO TANK IN 320' 1 TO D BOX 20.3' 2TODBOX 45.3 1 TOA 44.0' 1 TO D 40.5' 2 TOA 78.T 2 TO D 24.0' 1 TO B 25.0' 1 TO E 48.8' 2 TOB 49.T 2 TO E 37.P 1 TOC 24.8' i TO F WAY 2 TO C 45.3' 2 TO F 54.0' OBSERVATION FORTS 1 TO OP-1 37.1' 1 TO OPS 45.0' 2 TO OP-1 71.9' 270OP-3, 39.3' 1 TO OP-2 340- 2 TO OP-2 27.0' s g LEGEND ` NORTH aa.• Y` O cx.`wi i�wcw 1• * � 9 SACHUS�� PUBLIC HEALTH DEPARTMENT Community Development Division RTI,,c r r 0 rr(F O F C09V1101-IA�VCYE As of: September 11 , 2009 rihis is to cert that the individuafsu6surface duposa(system received a SA`I7S OTORTlYSTECYI1'OYof the: Construction of a 9 (ezv ;K On Site Sewage �DisposaCSystem B Peter Breen At: 61 (aka Got 4) Granville Lane 911 ap-106.C; Parcef-52 North Andover, WA 01845 The Issuance of this certificate shad not 6e construed as a guarantee that the system wilt func ', `sat' actoril . t Michele Grant Public-Vealth Inspector 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com I COMPLETE SEWER SEPTIC SERVICE �cvst c" BIS adwa R_L 2€i. Salem ,NH 03079 IrtvblcE 7 N. u Y )r a C t1 er+M-Q NAM AIA. Niv� v. 800w 41-9379 t .. u. inTr ziw Ptton�E: Come, visrt'us at";' �,• JOR,A[lDRE-11S 11=LLtt FFRI?NT l'HM BILLING ADDRESS $ '�. :At1n14 `. STATE ZlP WWW.Soucysewle-MOM DESCRIPTION OF-WORK. � II r to VACUUM PUMP p SEPTIC TANK GA!_S p CESSPOOL .R O OVERALL SYSTEM p BASEMENT;. p FAILED SYSTEM .d T- L-j,DRYWELG >, COMMENTS n.4 a .. F _ �4 "� J 't t � TYPE OF SE � '�n TAx ExeMPT TERMS OF PAYMENT RES/COMM' TAX CASH d f4 INDUSTRIA ' TOTALS GH-CK-i7� CHARGE`0 ��{ PLUMBING❑ � `": ,�' � }'JOB"COMPLETION -s z C com lehon of t ie ahoV� ��s been doC►e to Myr! We vinit assume no responsibility for any damage An :# mrof.payMen pr by the n customer constitutes a bindingsignature of this This is to acknowledge "bush;drivewaY�x orwalCnNaY, Y or_reasar�able:at{omey fees o outstanding balances, made ta'sprinkler.{av�m. . nsibibty far payment in fu1l:jalon4,wtt►64 oo a 6° assumes all re5po . invoice and w . J �, t" w , r SERVICEMAN AME-! ` CUSTOMEfSfGN1T HATE } r —: `,g��a ., ...—LAL 4 Summary Record Card generated on 6/17/2015 10:24:47 AM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-106.C-0052-0000.0 Parcel Id 17687 61 GRANVILLE LANE SCOTT & SOOJIN ERIKSEN 61 GRANVILLE LANE NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1.01 Acres FY 2015 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until SCOTT&SOOJIN ERIKSEN Owner 61 GRANVILLE LANE NORTH ANDOVER,MA 01845 FARR BETTER HOMES Previous Customer Inactive 7/30/2010 C/O BUILT BEST CONSTRUCTION 262 WESTFORD STREET TYNGSBORO,MA 01879 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 22356.0-61 GRANVILLE LANE Last Billing Date 4/16/2015 3170666 03 Cycle 03 Active UB Services Maint. Account No. 3170666 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 87.10 1/1 UB Meter Maintenance Account No. 3170666 Serial No Status Location Brand Type Size YTD Cons 36185613 a Active ERT HH b Badger w Water 0.63 0.63 455 Date Reading Code Consumption Posted Date Variance 6/8/2015 481 a Actual 26 17% 3/9/2015 455 a Actual 22 4/28/2015 5% 12/9/2014 433 aActual 21 1/15/2015 -43% 9/10/2014 412 a Actual 38 10/15/2014 55% 6/9/2014 374 a Actual 24 7/16/2014 33% 3/10/2014 350 a Actual 18 4/11/2014 -1% 12/9/2013 332 aActual 18 1/17/2014 -34% 9/10/2013 314 a Actual 28 10/15/2013 32% 6/10/2013 286 a Actual 21 7/24/2013 8% 3/11/2013 265 aActual 16 4/22/2013 32% 12/26/2012 249 aActual 17 1/9/2013 -50% 9/12/2012 232 a Actual 31 10/15/2012 39% 6/8/2012 201 a Actual 20 7/16/2012 24% 3/14/2012 181 a Actual 18 4/14/2012 -34% 12/9/2011 163 aActual 25 1/17/2012 33% 9/12/2011 138 a Actual 21 10/13/2011 13% 6/6/2011 117 a Actual 17 7/20/2011 11% 3/8/2011 100 a Actual 15 4/13/2011 -12% 12/10/2010 85 aActual 18 1/12/2011 -16% 9/8/2010 67 a Actual 22 10/15/2010 26% 6/4/2010 45 a Actual 16 7/15/2010 10% 3/8/2010 29 a Actual 15 4/14/2010 11% 12/7/2009 14 aActual 14 1/12/2010 9/4/2009 0 n New Meter 10/15/2009 pORTF4 d TS Q�,�4 LEO ,6q� • .s 0 0.ti 1 O � c � eb COCMl C 1WKM V �9SSAC HUS�� PUBLIC HEALTH DEPARTMENT Communify Development Division CERVEICA�E OF C0�1�1-1 ..GJ--I-L E As of: September 11 , 2009 This is to cert that the individual subsurface disposal system received a SAr17S FAC70R2'1XYPECrI70Y of the: Construction of a New On Site Sewage osaCSystem By• Teter Breen At: .61 (aka-Lot 4) Granvifie' Gane Map-106.C; Farrel—52 North Andover, WA 01845 die Issuance of this certificate shall not 6e construed as a guarantee that the system will "satactortl. Michele Grant lr''uffic Yfealth Inspector 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 1C\ Commonwealth of Massachusetts City/Town of NORTH ANDOVER Certificate of Compliance Form 3 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. This is to Certify that the following work on an On-Site Sewage Disposal System Important: When filling out ❑ Construction of a new system forms on the ® Repair or replacement of an existing system computer,use ❑ Repair or replacement of an existing system component onlythe tab key Y to move your cursor-do not Has been done in accordance with Title 5 and the Disposal System Construction Permit(DSCP): use the return key. DSCP Number DSCP Date rah Facility Owner LOT 4 GRANVILLE LANE Street Address or Lot# NORTH ANDOVER MA 01845 City/Town State Zip Code Designer Information: BENJAMIN C OSGOOD JR. Na Name of Company 9-9-09 gnatur Date InAaller Information: am Name of C mpa y Signature Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc•06/03 Certificate of Compliance•Page 1 of 2 NORTF4 �t 6E6 OO Q �~ M �y � e^ •M ATED T � COCM CMIwKw y1' �9SSACHUS��y PUBLIC HEALTH DEPARTMENT Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: Lot 4 Granville Lane MAP: 106C LOT: 52 INSTALLER: Peter Breen DESIGNER: Ben Osgood PLAN DATE: 11/6/07 BOH APPROVAL DATE ON PLAN: 2/1/08 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 7/23/09 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: New construction, no abandonment needed SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base N/A Cleanouts per plan ® 1500 gallon tank has been installed H-10 loading mono construction ® Water tightness of tank has been achieved by Visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (effluent filter) 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 NORTH qw- O �tteD 6'6'Y 0 O to ° CONIC�WKM y1. Esq A°A�rEp �P``,�qy SSAC HUSfc PUBLIC HEALTH DEPARTMENT (ommunity Development Division ® 24" inch cover to within 6" of final grade installed over one access port, must be to grade and over outlet of tank if effluent filter is present ® Hydraulic cement around inlet & outlet Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM (General) ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Retaining wall not built at time of final inspection. SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Infiltrator Chamber Standard Quick 4 ❑ Number of chambers per row: 8 ❑ Number of rows (trenches): 3 Comments: 24 Chambers total 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fox 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2006 I pORTH + Q��tVao 6g1rO Q t, , a O ro LAK ORATED �SSAC HUS�� PUBLIC HEALTH DEPARTMENT (ommunity Development Division BM = 105.50 HR = 0.82 HI = 106.32 SYSTEM ELEVATIONS ROD ELEVATION AS-BLT INVERT ELEV DESIGN INVERT ELEV Benchmark Building Sewer OUT 4.55 101.42 101.35 Septic Tank IN 4.78 101.19 101.15 Septic Tank OUT 4.93 101.04 100.90 Distribution Box IN 5.14 100.83 100.75 Distribution Box OUT 5.31 100.66 100.56 Lateral 1 TOP 5.40 Lateral 1 INVERT 100.57 100.47 Lateral 2 TOP 5.48 Lateral 2 INVERT 100.49 100.47 Lateral 3 TOP 5.43 Lateral 3 INVERT 100.54 100.47 Top Chamber 5.40 BED BOTTOM ELEV. 99.92 99.80 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 pORT14 « O�tttID O `O Z. r ,R T �9AORATED I.Pa` �y 9SSACHUS�� PUBLIC HEALTH DEPARTMENT Community Development Division CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck,on footings, etc 5 10 -- ® Waterline 10 10 101 ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh,Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib.to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot.Area ® Reservoirs 400 400 ® Drains(wat. supply/trib.) 50 100 ® Drains(intercept g.w.) 25 50 ® Drains (Other)Foundation 10(5) 20(10) ® Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form lune 2008 �r • 1 s 1} Y J •' } +�k �3"^'a ��'�,^5�4�•'��'� ��r C'' T`.- �►. ',• F- � ti ti � te ?k�«R ?fix `•? w .e I � T a � Baa ` - ,/ •' r�r. "'� r��Cb Ewt` C±-�" r`i "{'�„� � 7 't r�, �,y � -y G * e.:- •�4 ��. j �q'A�k.�; 's.# tid='r r�"w6` Y� �� •��*w �Aa' � ,,°�• �' v,•. -�"a _ a V ♦ 'i^i�4 .._ '`+y r• ``�1� !h�ll�� - e a��..i•1at.��.��•p� .�,a�` s '.+{• '�, 1�. � v,,�R�S„��' .,ry- .1 � �. i+. � i e. ira•.1 t !4+ .!�'_ N •� '�. � •yJl -y,” �� . t ` •+, b a."" �.r •r, �,.�, �� ,� �•s� sR�s{� art � 1 �" a •• .` t s'a - T j dR >(ti it4 �i .� �.i '�;r s. 1_'` '} s r rt - '' '_ D '... ¢ w �,��d^y •'� pi � .n 1 ;..`�, �'4,d,.t p`�'•7.t+•, •3� a xy ba .�,. !,t 7.�•'R��. r• t + m '�3c.�N`a _ � � � -, - �� "'"r'_`s s',� o,�•'�,� a,, �t *w�-i, ' +.'�xi}i�y� •t�`.��ti,h„��, ��_ �r i�` 4Y � .. . � }�- 'r a �'', �_.y Syrr-�H�t� ,r y ��'.'!-;�jt"+E•�a� r �� Y� 1� ��-i�_ � ,� y�a�_ , fl `' a fi • . }- � l t..y�. ,i �•„,a` • <j., ,, _ x..t• 2�1 +C� �,'�! ,�*...��*, �•u F� ' t 'h„ .."3•t° :a 4's^^i�`.#� � a.� .t �d�".a•'t. 4w, � �. *� r+'ii !f. 1 �� ' � y� •`n {x ',� • -a fir- � a. '; _ ' '� •; •�'• Jr.�i�� j `:}�' _ :�'4•••. � tti,, r -', M , C ��,-j _ }� t�..t "�'Y •�� v��e"' .��'X"' . � •• t� V ;, � li •fir ( .� i ». { 1 �' ��' j"st ; ^3+i _ -��•tr Jr V�,� � y 1 K ''�• _� � n.3; �• `• �,� �� ,.5# � 1•(4 1 't"�;f '� �d *�'l X ..h7 �• 1-. �, iii '� 'J'--.�;^- - ` 49•-'y`r n. �-.Gf t`� a.^ -!!! t�� 4.�«F:'k�•Ty �• M:'} '�",.•t`i�. Y•.:'� t `5'x��,�•. ,+�s• � S � ''t1. �-�" s (b":a . . �.. 5! � '� t t-"4:`•. � 1,,a 4tf�j�' .t ltt 7J..}:� 4 ` 1' 'Y.. • !" �, - w i 't t .+- •• Y�. S „r.� i ' i� A' t'. �.�^v. �a�J��' !� ,M1,�,' �. ti��,n`,� ^`¢-� ��i ��.. •r V �'�',�� ' 4• � t F'� ,� `� ,lit, �� - � ��,ti°!�•+.�" 9 p,..�"�.'�-Oy'�'� '�. - - '�: :t 4e � ; • h.a '.CV"�ZjIF -a �.- ��+ 'y^i ,r. � _R y tT • ...� s t,"'ryx t y t ., YY-f 1 �°�,. •. ry.�N is � r' �.f ft„ ��.�c . r adz �� '•'` `��4 ,1�t� i•. + FF�7I�' �f '1 .�•!t r'+�. . u !� .��Stha11,! 'Y� Ora" � a� �� `.��,� •!Y r.,, ' ; "fit'`•":ti• �• ' '• ti �, `Y ,1`:+ �, Sit "�''+"z'^•�at5. •_y..,. � "� '�•�. 1' � l'). �` �Ti�„_{�•7 r,N, 1 14'A y,} y r ,,,i(,•w,,y, � �$S� �,a � j ,;i_ •' s ';. ` ,�.. IA _r�.L.ar.•,a�. {[ • 'I, +�1, �� C'+'4 •�`~t �• 11 �� v y rte f i f L ' r + ...:'�4 - �� ' �Vis. �'• ,, �`fr,•�� 1a .. 1 _ P 9•l' 1 1 �.itt �Y�r, •�.yp .. +•� ( r`A�, * �., �,•, y>.. - � �#`. l y\� grid; s 112.1 r a L �r L ra Lw j} '�^d"`.� :•�l .;', ! i � r�mlyltf��'.. t • f { y '.;• ! 2 � ;�r�; r: U I r r ,,kit � ", w � �✓ '} y`K' •« � �t' !� t r�`:.�„"i� �,k el 't :R� � � C '�t� i. � I,�t �,..t .... "`� q i •> *AWA ,,, ,P r ' ♦ s_ r r r� y aM*' a•cat ,. a , '� .�. "#11;-.,.'��#�� : i� � t -�,_� �i �"i• "amu �} �.# � •s ,,�� ICs •..•y,(t ;. .V 6,;�� !* �� • 4 N 2 • 7 e r�5g� .r `rl t i r. ROME,111 ElIl" ♦ u ' ` MEN ar_ - ^4. , - X � � ,'t ��' ♦ - ~'''yam•.-_ a' .• ��.. ,> 'Z �{ ax �t yam••• �° '!Sim e� t .a ay', T w ,y'• -^ " i �� ^ •� -:v 1 �._-�'+moi �` ,� _ `ti` _ •y1 R � � f +. �0: `iK,�•�ti•r+ � " " t,�K`��'Sy"4Rr� i'y.�'S#'��kR t'• � . ,'t � � • 'xi ai. t w ..' V ^. 'T�`�^. `_. i. 1. __{`-P..FY� iY.�,. ,.^1• i tilt`l""` .. ac- "' -\� L k :��.q-t'i '�` i thy.. �• i. t '' "" e�.`- ti � �`•: •�+ `� '�" �l•�. ,t... a 4�;�-"�'.t.'s'�4�'•.t;x :5..�•t i�"�-..,x.12. L w•Yc gb ti ' L:� ;.. {,•� •h,:k-V -h� '-' .• .. x•s'i.`,.['2. �....,.• � ` •�\.t Q. "�. `.`.`4J C v. ww ` �.. 4y r • +:_ 3,•.. ,y y •, 5, " ,c Y,.,: x +�..M' ,s -. �• .i.-"y1t+�•y .'7�! .F�, ,,�^ �� •;`4- �•'•' `sr � ,'ti,' ti` b'_ �� ',\ �" _,y,. 't �- �" `♦ �'mss:li - " .4 �,;� �+.� .-c..� .w C\7• � •w,....r... �'+ .�+•l,.•. t ..t,.si - ,.`..,w. �. .�t '? "'j '�'�' --.:, �. �',t .+ `+. . .L., .,,.t. �_ �' ,c"+} 'i •'� '�.-4 y 4k'S+-t. Z� ��xy�x �. ,y --'•.. \., �:. >lF- ,,. a - 1 `4, x �_'� �,a�. 1 ..� _�• •.�•t: -7 � .•'lam; •,y...•iu�, • �� ,fit ,. ,. .. .-.• .,,.._ ,, ..yY;� x� Yx:..� e...♦; t. T3.1. 't xy. ,T; .. .�z- 7`y,' T.. �•. .4. '\ i''i.:a�+.x.- AC ^� ] .�+. w-.F-, r,..l.1. � ��..\ +��_ �RL'.Psy; y�:''Y ♦ � � R - �a�. '`, \.. "1.s :.:a. `��.1'�ci• � �`� �'�. �� '�i � - . .��,:. a►.: c y a`. '�`1.. •'�.,r:•d .ry -.S � x t,{,9,. r i`�� ♦•i t�T.. �.`. 'wA � ` Lw.'t Y• x' n an`.. .-\, aZ�.' '�� •� � ..� ��.. �' - T �' •�'r, !r � x'. .i.'A� a � ��'- 4. •d'-\+� "�.`4 S- 'Ja � a i'',��a+:t,•ai��'a > 4_�r `-�� .\C` � - [ i- '_i '1 �.� "e! -.` s.ice'- i•,ti •P ! '.^:J, t+.,.a'�*w y � Oy �RZ.�.j ��1 ,r.`� F`. •R`�1 .A..~,��t_ � f.,;. •� _ ��.; L• � � ��.- ""�•.: 1.''� �. �. :w� S . y. .aZ '.Fc+.�;�y. � t `\ -` .w �. .x �hta,�•. rt„ �` $. �`x i• r -•t �. ;'�"4`.11�'� i Z �x �• i.t � ��}4i. ]x' 4 �'• 3 ti.{• 3�'-�`` :�"^�.l�r'S'^ �� .� !.�• �„ti�f �'i,. .,J,�T� +�, � •�„�'y�e �`i`,r;. �. ....�-+•.'' ,K.,�ia;. �..�. �<' ��' 'Av��-- .c��-c�'t.".5;,_ _ -- r >. V-w��'�` ..0. a� �- '�R ]'. � a _t-i`,i� x, •1 ,'j�'1 ;��,- t Zyr.QY X14 `1r^ ;']i;-:��.��.-. Y��' ,.��. �•\4;' '•7 ~'l � � >;♦ �,_ Z��. Lytti,. ? ^;'. �'�,w. 1'��• , •R xt - w• •it7 1r 1 �,y7'�ti.a �,.� �y •,y .''Y� z' :.'R - er!" �. Aw �� n3�wltajt.' '? i�' Y`L ' ', .;;' .�` r..-l�♦ . .�`�.”! tr. � �•r`H�a, ' *\, *... 12!�?`� �,' +. �\ i .t c i� �.� �\. .v^-'�.a �y��.. t�-.,' '., �'N�•'1 R- ...t .r+ •ayypq w ': .v�.1m! ,. 7�� , . x";�'r .: f'ec�. J -• ,. `,•�.',-' ��` '� �..r.` -f. ��: _�', k"I,� y .,:�`�r'?�� }.y"'•1• ��:� !, Fr, +C. i ,��7i!1S/'}fie- ,� ., 'ie ,.a, x.- -,.. DelleChiaie, Pamela From: Sawyer, Susan Sent: Thursday, July 09, 2009 2:02 PM To: Osgood, Benjamin C. Cc: DelleChiaie, Pamela; Grant, Michele Subject: RE: Lot 4 Granville Thanks Ben, I spoke with Walter and Peter.The permit may be signed off by today. I told Walter that I want a deep hole during the bottom of bed. I don't know if you have seen the site, but they did not protect the system. I want to have Peter dig down to the bottom of bed and then have you and Michele or I present. Dig one or two areas down 5 feet to make sure that there is no fill mixed in and it is true parent soil. No other documentation is needed. I just think the area looks like they dug out and put fill in, but I can't tell how deep they filled. Susan From: Osgood, Benjamin C. [mailto:BOsgood@Pennoni.com] Sent: Wednesday, July 08, 2009 2:04 PM To: Sawyer, Susan Cc: DelleChiaie, Pamela; Grant, Michele Subject: RE: Lot 4 Granville Susan, I assume the building inspector has a certified foundation plan at the same scale as the original plan on file. If he does not have a copy I can get one. The house plans will have to come from Walter. The deed restriction should probably come from Walter's attorney. I believe The wall block is specified on the revised plan. If it was not it should be Vertica Pro by Anchor Wall Systems. In regards to the soil in the area of the septic system. He stumped the lot and left the soil in the area of the septic system and piled the spoils from the excavation over the septic system area. I think it would be overkill to excavate another deep hole but if you want one I suppose on could be done. Ben From: Sawyer, Susan [mailto:ssawyer@townofnorthandover.com] Sent: Wednesday, July 08, 2009 12:18 PM To: Osgood, Benjamin C. Cc: DelleChiaie, Pamela; Grant, Michele Subject: Lot 4 Granville Hi Ben, Peter Breen has submitted the application to install Lot 4 Granville. I have a call into him to gather some items. Before issuing the permit I will tell him we need; Foundation as-built to same scale as plan Floor plans of house draft deed restriction 1 i i info about the wall as well.What type of block is being used? And also I have been by the site.They did not protect the septic location, so I have determined that we need verification that the area is still useable. I would like a soil test at the location of the system.We can do it as part of the bottom of bed, but I want you there to verify the parent soil with me. Thx Susan 2 z ✓V�-1 _ -_-�_ �V �� f" i � � �� s� ____--� ___-- �----- Application for Septic Disposal Svstem 4 Tob SD TE pConstruction Permit - TOWN OF 41 " °'• ORTH ANDOVER, p MA 01845 CNUS $250.00—Full Repair 1� ' « C $125.00-Component 1SgAk� Important: Application is hereby made fora permit to: When filling out forms on the � Construct a new on-site sewage disposal system* computer, use ❑ Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component—What? cursor-do not _ use the return key. A. Facility Information Address or Lot# -- ---- — --- Iq City/Town 2.- *TYPE OF SEPTIC SYSTEM*: ❑ Pump O'Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ Conventional System (pipe and stone system) O'Infiltrator or Biodiffuser(Gravel-Less) (Attach a copy of your,certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D-Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D-Box Present) S.A.S. 2. Owner Information �co Name Address(if different from above) City/Town State Zip Code Telephone Number 3. Installer Information Pct- - Name Name of Company 7 ?y J&YAJAd 5 j7y max �, rLo� 57— Address Cityrrown State Zip Code 9770-272 /?� Telephone Number(Cell Phone#if possible please) 4. Designer Information e Gtr ell0' La,40C =slS P/t1LL�+d s� �flL UCG ✓L Name Name of Company Add ress �d44&w7 1A ,g- City/Town State Zip Code 5? Y-6 F6 -/ �67 ` Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 r Application for Septic Disposal System pConstruction Permit - TOWN OF TODAY'S DAT * t ' Full Repair ORTH ANDOVER MA 01845 $255.00- 9SS�cHusE� $125.00 - Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Building:.iesidential Dwelling or❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. 6"tw�k' ?, 4�6 Name Date Applicati Approved B . (Board of Health Representative O m Date Application Disapproved for the following reasons: For Office Use Only: 1. FeeAttacbedP Yes No 2. Project Manager Oblitro a ' n F 1 g g orm Attached. Yes No / 3. Pump S sy tem? Ifso,Attach copv ofElectrical Permit Yes No 4. Foundation As-Built. (new construction ronly); Yes NoL/ (Same scale as approved plan) 5. Floor Plans? new construction only): Yes ( Y) No Application for Disposal System Construction Permit•Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: rq (-address of septic system) For plans by62,Q/1110�- t (Engineer) Relative to the application of �e_%�/Z �� And dated D (Installer's name) /a� l rngina date) Dated lecl, �j D D o ay s ate — With revisions dated L/`�T (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer, I must call for any and all inspections. If homeowner, contractor,project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection,without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against me and/or my company. a. Bottom of Bed–Generally, this is the first (Vs inspection unless there is a retaining wall,which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection–Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OK (or e-mail to: healthdept&townofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade–Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board ofHealth staff or consultant. d. Installation of tank, D-Box,pipes, stone, vent,pump chamber,retaining wall and other components. 6. As the installer, I understand that I am solely responsible for the installation of the system as per the a.12roved plans No instructions by the homeowner,general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer: 2L704 (Today's Date) cc—C ,C�— � 6re_, (Name–Print) ame–Signed) f t►ORTy qw. O169 "•O Z.O � "o ay � O4 COON Kw`y1' �Ssgc Hus�t PUBLIC HEALTH DEPARTMENT Community Development Division February 1, 2008 George Farr, Sr. PO Box 35 North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for Lot 4 Granville Lane,North Andover, MA Dear Mr. Farr, The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property. These plans dated November 6, 2007, final revision date of January 10, 2008,have been approved for a three (3) bedroom, maximum seven-room home. Please note the conditions#2 below. In accordance with local subsurface disposal regulations"Acceptable plans and any variances shall expire two years from the date approved unless construction on the lot has begun". During this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. This approval includes a Board of Health waiver obtained at a regularly scheduled BOH meeting held on January 24, 2008. The waiver is to the local regulation's minimum design specification that requires all systems to be designed to serve a minimum of four bedrooms. This waiver to allow a 3-bedroom design is approved with the restriction that the deed restriction, limiting the use to a three bedroom, maximum seven-room home, is placed on the deed of the property. This deed restriction shall stay in force with the life of the home unless the property is connected to a municipal sewer system in the future. This approval is subject to the following conditions: 1. Prior to issuance of a disposal works construction permit, a draft deed restriction, with conditions as stated above, must be submitted to and approved by the Health Department. 2. A foundation plan, at the same scale as the septic plan,must be submitted prior to the issuance of the DWC. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com 3. A complete set of floor plans for the dwelling must be submitted prior to the issuance • of the DWC. ' 4. Prior to the issuance of the Certificate of Compliance proof of recording of the approved deed restriction must be submitted to the Health Department. 5. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 6. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board,Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you may have. Sincerel Susan Y. Sawyer, REHS/ S Public Health Director Encl: list of licensed septic system installers Cc: New England Engineering Services 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com NEw ENGLANDENGiNEEPdNG SERVICES, INC. 1600 Osgood Street Building 20 Suite 2-64 North Andover, MA 01845 Tel: (978) 686-1768 • Fax: (978) 327-6138 www.neengineeringinc.com November 7, 2007 Project# 1401 Ms. Susan Sawyer,Health Agent North Andover Board of Health RECEIVED 1600 Osgood Street North Andover,MA 01845 NOV 13 2007 Re: 4 Granville Lane,North Andover TOWN OF NORTH ANDOVER Local Health Bylaw Variance Request HEALTH DEPARTMENT Dear Ms. Sawyer, The purpose of this letter is to request that the above referenced property be included in the upcoming Board of Health meeting agenda to discuss the following variance: Local Health Bylaw Variance Request 1 1. Section 9.01: Min 440 GPD Capacity required,330 GPD approved. 2. Section 9.01: Min 900 sq.ft. adsorption field required,630 sq.ft.provided 3. Section 9.04: Reserve area to be min 4 ft from preliminary leach area, proposed reserve area adjoins primary area. If you have any comments or questions please do not hesitate to contact this office. Sincerely, /Z C Benjamin C. Osg d,Jr. P.E. President I ' NEw ENGiANDENGINUMNG SMUCES, INC. 1600 Osgood Street Building 20 Suite 2-64 North Andover, MA 01845 'WI: (978) 686-1768 • Fax: (978) 327-6138 ----- www.neengineeringinc.com December 14,2007 NEES Proj #1401 EHrE�ALTHNOIRTH E► Ms. Susan Sawyer 20(1l North Andover Board of Health 1600 Osgood Street g A '20V MFNTERNorth Andover,MA01845 Re: Lot 4 Granville Lane No.Andover Local Health Bylaw Variance Request Dear Ms. Sawyer, The purpose of this letter is to request that the above referenced property be included in the upcoming Board of Health meeting agenda to discuss the following variance: Local Health Bylaw Variance Request Section 9.01: 440 GPD Capacity required, 330 GPD Provided. If you have any comments or questions please do not hesitate to contact this office. Sincerely, nJamin C. Ohlood,Jr. P.E. President Commonwealth of Massachusetts City/Town of North Andover Percolation Test Form 12 �M Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important: A. Site Information When filling out forms on the computer,use Mr. George Farr Sr. only the tab key Owner Name to move your Lot 4 Granville Lane, Assessors Map 106C, Lot 52 cursor-do not Street Address or Lot# use the return key. North Andover MA 01845 City/Town State Zip Code Ben Osgood, PE 978-686-1768 Contact Person(if different from Owner) Telephone Number B. Test Results 10-11-07 2:00 10-11-07 3:00 Date Time Date Time Observation Hole# P-1-07 P-2-07 Depth of Perc 40"+ 18"=58"(52" @12"mark) 48"+18"(60" @ 12" mark) Start Pre-Soak 1:50 2:35 End Pre-Soak 2:05 2:50 Time at 12" 2:05 2:50 Time at 9" 2:25 3:37 Time at 6" 2:57 4:33 Time(9"-6") 33 56 Rate(Min./Inch) 15 20 Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Timothy Mallette Test Performed By: Randy Burley, Mill River Consulting Witnessed By: Comments: Loamy sand parent material t5form12.doc•06/03 Perc Test•Page 1 of 1 I Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal MassDEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information George Farr, Sr. Owner Name Lot 4 Granville Lane Street Address Map/Lot# North Andover MA 01845 City State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 2. Published Soil Survey Available? ® Yes ❑ No If yes: 2007 1:15,840 73AYear Published (compilation) Soil Map Unit Winsor loam high groundwater Soil Name Soil Limitations 3. Surficial Geological Report Available? ❑ Yes ® No If yes: Year Published Publication Scale Map Unit Geologic Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No Within the 500-year flood boundary? ❑ Yes ® No Within a velocity zone? ❑ Yes ® No 5. Wetland Area: National Wetland Inventory Map U Upland Map Unit Name Wetlands Conservancy Program Map Map Unit Name TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information (Continued) 7 6. Current Water Resource Conditions (USGS): Month/Oct./20000 Range: E] Above Normal ® Normal E] Below Normal 7. Other references reviewed: n/a C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: T-1-07 10-11-07 1:00 Overcast Date Time Weather 1. Location Ground Elevation at Surface of Hole: 98.6 Location (identify on plan): See Sketch 2. Land Use Existing Residential Lot Few 0-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) Wooded Ground Moraine Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body n/a Drainage Way 105+ Possible Wet Area 101+ feet feet feet Property Line 12 feet Drinking Water Well feet Other feet 4. Parent Material: Basal Till Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: n/a n/a Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 40 95.3 inches elevation TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: T-1-07 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Structure Consistence Other Depth Color Percent Gravel Cobbles&Stones (Moist) 0-3 A 10 YR 2/2 LS Granular Very Friable 3-10 Bw 10 YR 4/4 FSL Granular Very Friable 10-42 BC 10 YR 5/4 SL 20 StrNoure Friable 42-52 C2 2.5 Y 5/4 40 7.5 YR 10 Medium 15 Single Loose 5/8 Sand Grain 52-120 C3 6/10 Gley 1 Loamy Sand 10 Massive Firm Additional Notes: TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts u= City/Town of North Andover - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: T-2-07 10-11-07 1:30 Overcast Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): Refer to Sketch 2. Land Use Residential Few 0-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) Wooded Ground Moraine Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body n/a Drainage Way 105 Possible Wet Area f 00feet + na Property Line feet Drinking Water Well eeet 12+ et Other feet 4. Parent Material: Loose Ablation Till Unsuitable Materials Present: El Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ® Yes ❑ No If yes: 88 n/a Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 27 95.4 inches elevation TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal w„ C. On-Site Review (Continued) Deep Observation Hole Number: T-2-07 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist Munsell (USDA) Structure Consistence Other y (Munsell) Depth Color Percent ) Gravel Cobbles a (Moist) Stones 0-3 A 10 YR 2/2 LS Granular Very Friable 3-15 Bw 10 YR 4/4 FSL Granular Very Friable 15-38 C1 5Y 6/2 27 5Y 7/2 10 LS 0 . Single Loose 7.5 YR 5/8 Grain 38-96 C2 2.5Y 6/4 SL 10 Single Loose Grain Additional Notes: TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B. inches inches ® Depth to soil redoximorphic features (mottles) A. 40 B. 27 inches inches ElGroundwaterin Groundwater adjustment(USGS methodology) inches inches 2. n/a n/a n/a Index Well Number Reading Date Index Well Level n/a n/a Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 15 inches inches boundary: 96nes TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. 10-11-07 Signature of Soil Evaluator Date Timothy S. Mallette#2965 06-28-05 Typed or Printed Name of Soil Evaluator/License# Date of Soil Evaluator Exam Randy Burley North Andover(Mill River Consulting) Name of Board of Health Witness Board of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to the designer and the property owner with Percolation Test Form 12. TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: * T6 GLo5�5.7. 6. ��n C2C-�ot2 (tv�F Fe-kCAVA-Ttvn� G, w ETLFtjj f ' � CA x 7x 6�24A %11 vt E L AAJC ST TITLE V FORM 11-T1-T2.doc•rev. 10/07 Form 11 Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 q�!U i TOWN OF NOR T H ANDOVER ,•ooIr Office of COM MUN!TY DEVELOPMENT AND SERVICES o� e` . •'� HEALTH DEPARTMENT 1600OSGOOD STREET: BUILDING 20: SUITE 2-36 NORTHANDOVER. MASSACHUSETTS01845 �� "• �``g sS�LNUgE Sus?n Y. Sawyer, REHS, RS 978. 688.9540 __Phone Public Health Director 978.688.8476 FAX heal thde t c o\,vnofnorihandoi er.com --— ---- www.to%,vnofnorthandover.com APPLICATION FOR SOIL TESTS DATE: C(• 7, Zoos MAP& PARCEL: 10�(- 572_ LOCATION O SOIL TESTS: �O� LJ VI IK. Ar7(1ytfe OWNER vorat rarr2f. Contact#. APPLICANT: Smc Contact#. ADDRESS: �o go X 357 MQ • kh au 1 ENGINEER: 1n C i% I_Contact#. CERTIFIED SOIL EVALUATOR: ASA (� CJI' Intended Use of Land: Residential Subdivision SingieFamiIy Home Commercial IsThis: Repair Testing: Undeveloped Lot Testing: V Upgrade for Addition: In the Lake Cochi the M ck Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THISFORM Proof of land ownership(Tax bill, or letter from owner permitting test) ➢ 8.5_x 11-Plot plan& Location of Testing(please indicate test pit sites on the plan) ➢ Fee of$425.00 per lot for new construction. This coversthe minimum two deep holes and two percolation tests required for each disposal area Fee of$360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluatorsmay perform deep hole inspections. ➢ Only Mass. Registered Sanitari ans and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BON representative. ➢ Full payment wil I be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, ascaledplan(nosmdlerthan1=100�shallbesubmittedtotheBoardofHealth showi ng the I ocati on of al I tests(i nd udi ng aborted tests). ➢ Withi n 60 days of testing soil evaluation forms shall be submitted. Please Do Not Wr ite Below T his L ine N.A. Conservation Commission Ap al D O Signature of Conservation Agent: , Date back to Health Department: (stamp in): /f(n A Pi;eO 6 TO Loe CtAK94q haS a Rvl (a ck)? r� �r►r 1 Commonwealth of Massachusetts Map-Block-Lot 106.00052 Permit No j. �q Board of Health Permit No North Andover BHP-2009- -- BH---------------0 ------- P.I. FEE ssAcIw � F.I. $250.00 ---------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Peter Breen to(Construct)an Individual Sewage Disposal System. at No LOT 4 GRANVILLE LANE as shown on the application for Disposal Works Construction Permit No. BHP-2009-063 Dated July-10,2009 ----------- Issued On:Jul-10-2009 ILL �ON �� Board of Health of &QRTH Commonwealth of Massachusetts Map-Block-Lot °a; 106.00052 o p Board of Health ----------------------- North Andover .,,,9•k'" CERTIFICATE OF COMPLIANCE � 3ACHLX�a¢ti THIS IS TO CERTIFY,That the Individual Sewage Disposal System (Construct) by Peter Breen Installer at No LOT 4 GRANVILLE LANE ---------------------------------------------------------------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. BHP-2009-063 Dated July__10,2009 ----------------------- ------- ---------- Printed On: Jul-10-2009 ---------------------------------------------------------------- Pri - - n: - 0 Board of Health !�ls`�� Sln�� 15 'a SUna,le� �a„� (--.� �� ose�Q �5e �— �'�5 �4 0' �v� ��- �4 a' 7 sJP`L> TOWN OF NORTH ANDOVER ,TORT!{ Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT A 1600 OSGOOD STREET;Building 2-36 «" NORTH ANDOVER MASSACHUSETTS 01845 �'9s''^°''EZts � Sac"us Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: MA LOT: INSTALLER _ DESIGNER: PLAN DATE: `j s r7 1.5G9--f BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: b K DATE OF FINAL GRADE INSPECTION: t l a3 SITE CONDITIONS ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANK Bottom of tank hole has 6" stone base (� 0(�� Weep hole plugged � 1500 gallon tank has bee install d H-10 loading onolithic construction ❑ Watertightness of tank as een achieved j (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent S filter is present y ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page 1 of /� D TOWN OF NORTH ANDOVER 4 NORrk q Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT til 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER MASSACHUSETTS 01845 ��Ss °"`��h � NCHUS Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX Comments: PUMP CHAMBER Bottom of tank hole has 6" stone base R'\Weep hole plugged ❑ Cmbo Tank installed. Size: El 10 gallon Pump Chamber installed H- 0loading Mon lithic construction) ❑ Inlet to installed, centered under access port ❑ Pump(s) stalled on stable base ❑ Alarm float rking ❑ Pump On/Off ats working ❑ Separate on/off ats ❑ Drain hole in press a line ❑ 24" inch cover to with 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing 1 ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECH LOGY ❑ Typof treatment device: ❑ Installed r manufacturers requirements ❑ All compon is working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 TOWN OF NORTH ANDOVER f �lORry Office of COMMUNITY DEVELOPMENT AND SERVICES �ro`,I,.o '°� HEALTH DEPARTMENT p 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 M9Ss„�H„S�s{h Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director978.688.8476-FAX D-BOX ❑ installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan -� -t-zb 1 ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed JI -P ❑ Laterals installed and ends connected to header S �� ❑ Laterals vented if impervious material above �`` �� 5 ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and y location as per plan 'Crow-_ �- -' ❑ Elevations of laterals installed as on approved plan w� ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: ss � Wastewater System Documentation—Feb 2006 Page 3 of 6 r TOWN OF NORTH ANDOVER F NORT{{N Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 "SS cH„E�h Susan Y. Sawver,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OF NORTH ANDOVER µOR7k Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 � . ,P.' NORTH ANDOVER,MASSACHUSETTS 01845 sacN„S�t�h Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot.Area ❑ Reservoirs 400 400 ❑ Drains(wat. supply/trib.) 50 100 ❑ Drains(intercept g.w.) 25 50 ❑ Drains (Other)Foundation 10(5) 20(10) ❑ Drywells 20 25 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES 0?�6,;� � °�oA HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 �9isACHUSE��h Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN. Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6 'MFt a � l COMMONWEALTH_OF MASSACHUSETTS _ TOWN OF: NORTH ANDOVER SYSTEM PUMPING REPORT ACTION KING ENTERPRISES,INC REPORT FOR THE MONTH OF MARCH 2012 Y CONTENTS CONDITION OF DATE NAME ADDRESS GAL _TYPE TRANSFERRED TO SYSTEM _ 3/12/2012 JOE FISH RESTAURANT1120 OSGOOD ST _ 2,000 GREASE CORRE_NCO 3/22/2012 SCOTT ERIKSEN— 61 GRANVILLE LN _ — 1,500 SEPTIC WELL WWTP VER -- ---- ----- — ---- _ -HEAL-TH-Ire.=<: M NT — --- This report contains CONFIDENTIAL AND PROPRIETARY information and is for regulatorypurposes only. �. I y