Loading...
HomeMy WebLinkAboutMiscellaneous - 66 STERLING LANE 4/30/2018 J�6 Sterling Lane _. T 1 I 1 r P _�.�_--_ �� :/ ,2 �� !/� �`� ._ ` �----- � ��� �. _-� �� V \, . ���� �� �i n� � { i ���'` ��� �� �� 1 I North Andover Board of Assessors Public Access Page 1 of 1 NORTH Hoath Andover Board of Assessors Of+•�•n a 7H0 ••�r.o .SSNCHUBE roperty Record Card Click Seal To Return Parcel ID :210/106.C-0033-0000.0 FY:2010 Community :North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales F .. ��. Summary 1 Residence o Detached Structure 1-1 Li Condo 66 L-3 STERLING LANE 'J Commercial Location: 66 STERLING LANE Owner Name: GREENE,ROBERT A. GREENE,MELISSA W. Owner Address: 66 STERLING LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 8-8 Land Area: 0.99 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 3614 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 776,500 831,400 Building Value: 546,800 604,700 Land Value: 229,700 226,700 Market and Value: 229,700 Chapter Land Value: LATEST SALE Sale Price: 900,000 Sale Date: 05/02/2006 Arms Length Sale Code: Y-YES-VALID Grantor: GOODMAN,ROBERT Cert Doc: Book: 10163 Page: 235 http://csc-ma.us/PROPAPP/display.do?linkld=1519146&town=NandoverPubAcc 5/6/2010 9 Commonwealth of Massachusetts Title 5 Official Inspection FormMAY 11 ?010 Subsurface Sewage Disposal System Form -Not for Voluntary AssessFents T R 66 STERLING LANE Property Address WY Robert and Mellissa Greene Owner Owner's Name information is North Andover MA 01845 4/27/10 required for every page. Cityrrown 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. b Important: A. General Information When filling out forms on the computer,use5 only the tab key 1. Inspector: to mored not Benjamin C. Osgood, Jr.curs use the return Name of Inspector key. none Company Name 16 Hillside Avenue, Unit 3 Az Company Address Amesbury MA 01913 City/Town State Zip Code 508-328-4633 870 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 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 ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority [22, G a j 4/27/10 Ins ctoes nature 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. t �. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ( 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Cityrrown 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)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. ❑ Y 0 N ❑ ND(Explain below): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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 ElN ❑ 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Cityrrown 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 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 must 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 ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Cityfrown 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. 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. 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 ❑ ® Y 9 ❑ ® 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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owners Name information is required for North Andover MA 01845 4/27/10 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 by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built 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? ® ❑ 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: ® ❑ 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): 4 Number of bedrooms(actual). 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current 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: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Fall 2009 per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® 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): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 � every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Built 2000 per Board of health records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.5 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipe looks new in basement Septic Tank(locate on site plan): Depth below grade: 1 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: 1500 Gallons Sludge depth: 2" t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. Cityrrown 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 28" Scum thickness 2" 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 16" How were dimensions determined? Measure Stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank in good condition. pvc tees in good condition Grease Trap(locate on site plan): Depth below grade: feet 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: Date Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address P Y Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. City/Town 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.): 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 0 No N Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �( 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is North Andover MA 01845 4/27/10 required for every page. Cityfrown 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.): Box in good condition. Distribution equal. No evidence of soilids carryover or leakage in or out. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 2 -50'trenches ❑ 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.): Area of leach field looks normal. No evidence of ponding, damp soil, or unusual vegetation. 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 ❑ No Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every 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.): Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yY 66 STERLING LANE Property Address Robert and Mellissa Greene Owner information is Owner's Name required for North Andover MA 01845 4/27/10 every page. Q r own 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 r f I -I-FQCL+ �A taJ7 SG � ry 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �( 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is North Andover MA 01845 4/27/10 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 5 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® 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: usgs maps You must describe how you established the high ground water elevation: System built in an area which was raised between 4 and 5 feet above old existing ground System constructed 4 feet above ground water Before filing this Inspection Report, please see Report Completeness Checklist on next page. • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 66 STERLING LANE Property Address Robert and Mellissa Greene Owner Owner's Name information is required for North Andover MA 01845 4/27/10 every 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 Town of North Andover NORTH OFFICE OFQ?0 ' •,�o COMMUNITY DEVELOPMENT AND SERVICES p 30 School Street North Andover,Massachusetts 01845 `°••��°..•'��y WILLIAM J. SCOTT Ss�cNuse Director December 10, 1997 Mr. Steven D'Urso -- 22 Lilly Pond Dr. Boxford, MA 01921 Re: Lot 93 Sterling Lane Dear Mr. D'Urso: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. Distances to dwelling, wetlands, etc. from tank-and leach area not shown on site plan (N.A.803. - 2. No benchmark within 75' of system (310CMR 15.220(q)). 3. Missing map and parcel (N.A.8.02a). 4. Note 93 of material notes to agree with 310CMR15.255. .If you have any questions, please do not hesitate to call the Board of Health Office at the number listed below. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp cc: George Farr William Scott , Director, P&CD File CONSERVATION-(978)688 9530 • HEALTH-(978)688-9540 • PLANNING-(978)688-9535 *BUILDING OFFICE-(978)688-9545 0 *ZONING BOARD OF APPEALS-(978)688-9541 • *146 MAIN STREET STEVEN J. D'URSO �5 Environmental Designs 22 Lilly Pond Road W. Boxford, MA 01921 DATE QQ (��/508)) 3]52-9872 ATTENTION {,{,�/,'/��/' TO Lew ew RE IV > WE ARE SENDING YOUAttached /Prints rider separate cover via the following items: ❑ Shop drawings ❑ Plans ❑ Samples S p ❑ Specifications flcations ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION Bgra 'trxv Ag THESE AREZpproval MITTED as checked below: ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS 7DL Aw COPY TO_ SIGNED: Town of North Andover f 40RT" OFFICE OF 3�°.t"`° '°•X40 COMMUNITY DEVELOPMENT AND SERVICES ° � . 30 School Street ' t WII LIAM J. SCOTT North Andover,Massachusetts 01845 �9SSgc►+us�t<5 Director April 2, 1998 Mr. Steve D'Urso. 22 Lily Pond Dr. Boxford, MA 01921 Re: Lot 3 Sterling Lane. N. Andover, MA 01845 Dear Steve: This is to inform you that the proposed plans for the site referenced above 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 S S/rel cc: George Farr ,File r BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Iniitialls A. Bottom of Bed 1. Excavation to proper depth 2. With trenches,sides of excavation are beneath B horizonl'// 3. Edge of excavation specified distance from foundation,etc. Comments: B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed 3. Wall minimum 10'to leaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" ✓ 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8"per foot minimum 6. Pipe properly set on compact firm base 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change 10. 10' minimum offset to water line Comments: D. Septic Tank ^ n 1. Level [/ 2. 1,500 gal minimum �' 31;31 l^ 3. Gas baffleP resent on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20"manholes t/ 7. Inlet tee minimum 12"under invert 8. Outlet tee minimum 14"under invert 9. Outlet line cemented 10. Air space 3"above tees 11. 2"-3"drop from inlet to outlet 12. Pipe set 13. Compact base with 6"of 1/4"crushed stone under tank 14. Tank is watertight, Comments: I Yes NO E. Pump Chamber 1. If separate from ,compact base with 6"of 1/4"stone underneath 2. Minimum 2"pipe to -box if gravity system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specs cation 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum 0.1 T'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution 5 5. Compact base with 6"of stone beneath box 6. Box is watertight jr 7. All lines cemented with hydraulic cement 44, 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-3/4"- 1 '/�" -pea stone Bucket test done? 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property;if not,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') _sem 3. Width of trenches agree with plan-Minimum 2%maximum-4'. 4. Vent present if<50 feet or specified 5. Distance between trenches minimum 4'and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". Yes NO E. Pump Chamber 1. If separate from ,compact base with 6"of 3/a"stone underneath 2. Minimum 2"pipe to -box if gravity system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specs cation 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum O.1 T'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution 5. Compact base with 6"of stone beneath box 6. Box is watertight ' 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-3/4"- 1 '/z" -pea stone Bucket test done? 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') s� 3. Width of trenches agree with plan-Minimum 2';maximum-4'. 4. Vent present if<50 feet or specified 5. Distance between trenches minimum 4'and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". 1 Yes NO 9. Pipes set on stable base. Comments: 1. Leach Field 1. Maximum length of fielNd 2. Pipe slope minimum 0.00'3. Separation between pip 4. Pipes connected at end 5. Separation between adjacent fields 10' inimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to st line 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: J. Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12"and 48" e 4. Access manholes on each pit 5. Pipes cemented with hydraulic cemen Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 ✓ 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" ✓ 4. Grading slopes away from dwelling ✓ 5. No areas over system that may pond ✓ PLAN REVIEW CHECKLIST ADDRESS 2 ,1:3 ENGINEER GENERAL 3 COPIES STAMP L/ LOCUS v� NORTH ARROW ��� SCALE CONTOURS ✓ PROFILE-Z(Sc) SECTIONy BENCHMARK SOIL_ & PERCS ELEVATIONS WETS . DISCLAIMERy WELLS & WETS _WATERSHED? DRIVEWAY L"" WATER LINE 1/ FDN DRAIN L---- M&P, SCH40 L,---- TESTS _CURRENT? 04 SOIL EVAL SEPTIC TANK M-IN 1500E .17 INVERT DROP L� GARB. GRINDER/)—(2. comps +200) --- 10 ' TO FDNy MANHOLE ELEV GW # COMPS.-j - GBy -- D-BOX SIZE ## LINES FIRST 2 ' LEVEL STATEMENT INLET /36, OUTLET /A,/- 67 = (2" OR . 17 FT) TEE REQ'D? A0 LEACHING , / MIN 4.40 GPD? V RESERVE AREA `" 4 ' FROM PRIMARY? Ll� 2o SLOPE 100 ' TO WETLANDS ✓100 ' TO WELLS c/' 4 ' TO S .H.GW (51 >2M/IN) 20 ' TO FND & INTRCPTR DRAINS 400 ' TO SURFACE H2O SUPP 4 ' PERM. SOIL BELOW FACILITY ✓ MIN 12" COVER Z-- FILL? ( 15 ' ) BREAKOUT MET? (- TRENCHES / MIN 440 gpd `' SLOPE (min . 005 or 6"/100 ' ) SIDEWALL DIST . 3X EFF. W OR D (MIN 6 ' ) ( -- - RESERVE BETWEEN TRENCHES? `' IN FILL? MUST BE 10 ' MIN.. L---. '3:' PEA STONE? L,-- VENT? ( >3 ' COVER; LINES >50 ' ) BOT ��� + SIDE 76 ? X LDNG TOT -4(-16 �-44o ( L x W x #) (DxLx2x##) (G/i t2) Copyright C 1996 by S.L. Starr a IW ix Sy 4, .oto �j LOS. Q EL=14,LQ' LOT 4 FOUNDAnOM DUMP 20NE 1 i 0 ti l REFERENCE PLAN. N0. Bois FOUNDA710N LOCATION PLANo � w_ CjgMr. COOUDW C Nsr WTON CO., INC' +� 7W CCWff=r= X. A tem_ nix mm=a or w om LM nuc ,w A#q' � ANM is �OF w LOCATM. NORTH ANDOVER lu ox,y Sr f'= 60' a#m 12128 CHR3STIANSEN &SERGf LAND AWCOW O MN or r?JLNWWAM Al mm m N /I!S MAR -' 9 ; 'I �. 0 R T#.4 0VM Of O dUV16;;L �® ra �Fa Nofh i ndover, Mass., a. BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System iR ' ... BUILISING INSPECTOR THIS TOR THIS CERTIFIES THAT ©AR �� V.577,,, ....,.. ...,. ... ...... ................................................. Foundation 414x f # �.. . 4S. .. � has permission to erect........................................ buildin s on ... ....... ......... �...... .....�/1.�+. ..... !� Rough/yl�✓� � A� to be occupied as../4)....po .M....4�...8A4 rh �� J� N id tel` ey p , .., :.....................t�...................:............ ,....... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMB G INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. R � - JD b ELECT AL•INSPE � i � c , A ,� �0� Service BUILDING INSPECTOR px'7 't, s:'� GAS INSPECTOR Display in a Conspicuous Place on the Premises Do Not Remove .m i No Lathingor D Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. . Smoke Det. ,• Q " SEE REVERSE SIDE FORM U - LOT RELEAFORM j. INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having.jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ***********'t*****************APPLICANT FILLS OUT THIS APPLICANT PH0NE�;1��'D/Olt' LOCATION: Assessor's Map Number ���C� -�D�.3 PARCEL SUBGIV1Si0N �A/</Cil `p,�C�% !—� LOT (S) _ ST. NUMBER U S c RECOMMENDATIONS OF TOWN AGENTS: a CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS i II TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS 7' FOOD INSP CTOR-HEALTH DATE APPROVED DATE REJECTED EP IC I SPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS i PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm I FORM 11 -SOIL EVALUATOR FORM Page 1 of 3 No. Date: Commonwealth of Massachusetts Massachusetts Soil Su ability Assessme r On- t e&wage D wosd Performed By: Date: 5he)AS Witnessed By: Location Address or Owner's Name Lot# ,,: Address and ' Telephone# U New Construction Repair Office Review Published Soil Survey Available: No Yes Year Published Publication Scale V �7 r Soil Map Unit Drainage Class 4olQ Soil Limitations Surficial Geologic Report Available: No ® Yes Year Published Publication Scale Geologic Material(Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No Yes >O Within 500 year flood boundary No `>o Yes Within 100 year flood boundary No Yes Wetland Area: National Wetland Inventory Map(map unit) Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month Range: Above Normal Normal Below Normal Other References Reviewed: DFP APPROVED FORM-17!07/95 w�levalsam FORM 11 -SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. L� (2a - Site Review Deep Hole Number Date3r? ? Time g Weather C12aA, Location(identify on site plan) Land Use . Slope(%) C Surface Stones s Vegetation Landform �y j Position on landscape(sketch on the back) Distances from: Open Water Body oy feet Drainage way feet Possible Wet Area7 l) feet. Property Line S� ' feet l/9 Drinking Water Welfeet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency,% Gravel) 33 jDO =SL - P rer �1 � E/E r ,o zS -MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA C� Parent Material(geologic) t e �,L Depth p o Bedrock: Doth tD Qroundwaten Standing Water in the Hole: go Weeping from Pit Face: Estimated Seasonal High Ground Water: 36 i DEP APPROVED FORM-IL°1/95 wilevtl um FORM I I -SOIL.EVALUATOR FORM Page 31 of 3 Location Address or Lot No.. Determination for Sreasnnal g& Water T'abte Method Used. aDepth observed standing in observation hole inches aDepth weeping from side of observation hole inches Depth_to soil mottles ,j4 inches- Ground-water adjustment: feet Index Well.Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring PerviQm Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,.what-is the depth of naturally occuring pervious material? e � rtification. I certify �� , that on (date) I have. passed. the soil evaluator examination approved,by the Department of Environmental Protection and thatthe. above analysis was performed by me_. consistent with the. required training, expertise and experience described in 310 CMR.15.017. Signature ed J Date h7 DFS APPROVED FORM-17/07/95 soilevd.um FORM 12 - PERCOLATION TEST W3Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS 14, A., , Massachusetts Percolation Test* Date: 7 ZZ s 9Z Time: Observation Hole# 4_Z L Depth of Perc Start Pre-soak /Z; 09 End Pre-soak - 2,4 Time at 12 Time at 9" Time at 6" 2 -3 3 Q Time (9"-6") 3 Rate Min./Inch / D H/ l , *Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed Fl 0 Performed By: Witnessed By: Comments: DEP APPROVED FORM- 12/07/95 PerctatSAM i i I NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT DATE / //6 FEE: PERMIT # QS¢ DATE RECEIVED A9 APPLICANT �C�6�'6� '` 'e'� MAP PARCEL ADDRESS /GN 3V M0 AJ. A . LOT ## STREET ## ENG. 7r-VE I 'Le,56 STREET Ll . ENGINEER' S ADD. �� L/GG yob BUDJ PLAN DATE �i��9� REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED REASONS FOR DISAPPROVAL - 411 ISAPPROVAL:4J �i GrJ�L L/iV G G!J ETG ANDS , �T� �'20I1iI (TJA ?,,��,j --l- /VO% 514 �� Mass A) NrH P 'I- --i 9,Ce�6 . �j�/,�J g.Oaa� �07"E 0(,A4,g7le1,9& /VGS TO �2E� GL�f 3/O CM 2 T � 3 No. COMMONWEALTH OF MASSACHUSETTS Board of Health,A &d- , MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct's Repair O Upgrade O Abandon O-X Complete System ❑Indvidual Components Location ,�`Q�y� Owner's Namely y Map/Parcel# Address Lot# 07- Telephone# G� Z Installer's Name Designer's Name Address Address -27 0� Telephone# Telephone# /� Type of Building: Lot Size'003S `'sq/.ft. Dwelling-No.of Bedrooms ey re Garbage grinder( . v 4 Other-Type of Building No.of persons Showers( ), Cafeteria( ) Other Fixtures Design Flow(m) , r quired) 4j4Q gpd, Calculated design flow Design flow provided e it Plan:Date h 0 97 umber of sheets Revision Date TitleLYA2ZZ— -y Description of Soil(s) � 'ti Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation S � DESCRIPTION OF REPAIRS OR ALTERATIONS I The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to pla c-p4heAystem inn erap tion until a Certificate of Compliance has been issued by the Board of Health. Signed P Date��-17, 7 11�Inspections DEP APPROVED FORM 5/96 No. Fee COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed O, Repaired O, Upgraded O, Abandoned() by: at has been installed in accordance with the provisions of 310 CMR 15.00(Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow _(gpd) Installer Designer: Inspector Date The issuance of this permit shall not be construed as a guarantee that the system will function as designed. DEP APPROVED FORM 5/96 No. Fee COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No._,dated Provided:Construction shall be completed within three years of the date of this permit. All local conditions must be-met. DEP APPROVED FROM 5/96 Date Board of Health No. COMMONWEALTH OF MASSACHUSETTS Board of Health,A &W4V e t , MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Consttuct''4A Repair()Upgrade()Abandon()-!`Complete System ❑Indvidual Components Location dy� Owner's Name Map/Parcell! Address t Lot# 07- Telephone# Installer's Name Designer's Name Address Address 4-sy Telephone# Telephone# :? Type of Building: /" Lot Size'003S sq.ft. Dwelling-No.of Bedrooms 40r fz: Garbage grinder( AIV Other-Type of Building No.of persons Showers( ), Cafeteria( ) Other Fixtures Design Flow m uired) e g ( q gpd, Calculated design flow Design flow provided gpd Plan:Date l— 0 g'7 umber of sheets Revision Date Title Description of Soil(s) c 't✓ Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation S � DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to plac a ystem in operation until a Certificate of Compliance has been issued by the Board of Health. Signed _ ` Date �// Inspections I DEP APPROVED FORM 5/96 No. Fee COMMONWEALTH OF MASSACHUSETTS Board of Health, CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed O, Repaired O, Upgraded O, Abandoned() by: at has been installed in accordance with the provisions of 310 CMR 15.00(Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow _(gpd) Installer Designer: Inspector Date The issuance of this permit shall not be construed as a guarantee that the system will function as designed. DEP APPROVED FORM 5/96 No. Fee COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No._,dated Provided:Construction shall be completed within three years of the date of this permit. All local conditions must be met. DEP APPROVED FROM 5/96 Date Board of Health : Town of North Andover, Massachusetts Form No.2 f NORTH BOARD OF HEALTH O't� o • 3:'" W. 1996 DESIGN APPROVAL FOR C"�56` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM • Applicant Test No. : Site Location 4l-D;r Reference Plans and Specs. • 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 Feey6b Site System Permit No. Town of North Andover, Massachusetts Form No.3 e AORT"1 BOARD OF HEALTH 0 ' F S �''�•,,.o.�'`�x DISPOSAL WORKS CONSTRUCTION PERMIT ,SSACNUSEt / Applicant AME ADDRESS TELEPHONE Site Location Permission is hereby granted to Construct (v)/or Repair ( ) an Individual oil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN, BOARD OF HEALTH Fee ��1 ` D.W.C. No.