HomeMy WebLinkAboutMiscellaneous - 7 LIBERTY STREET 4/30/2018 (2) I7 LIBERTY STREET
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LOT #-----._.._L.._..�.._.._'_......_....._. _ _
PARCEL # _ STREET
CON.STRUCT_I ON____APRROVAL
HAS PLAN REVIEW FEE DEEN PAID? E5 NO
PLAN APPROVAL.: DATE
DESIGNER: ///QJ I./ /fYI PLAN DA l"E Z
CONDITIONS
WATER SUPPLY: TOWN WELL
WELL PERMIT DRILLER._ /r76G/� .._. _._.._... ...
WELL TESTS: -
CHEMICAL DA 1 E APPROVED _%Zdq?_.
BACTERIA I Dfl1E (11"PRUVED
BACTERIA II DAIE APPROVED
COMMENTS:
FORM U APPROVAL: APPROVAL 1*0 ISSUE YES NO
DATE ISSUED
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID NO
WELL CONSTRUCTION APPROVAL _ NU
SEPTIC SYSTEM CONSTRUCTION APPROVAL ES NO
OTHER YES NO
ANY VARIANCE NEEDED ( YES NO
y
FINAL BOARD OF HEALTH APPROVAL: DA I E: /��/�-� BY : -�
. SEPTI__�.YSIE.M__�.►vS.T9.4.l,.Rt�..QN.
IS THE INSTALLER LICENSED? ES NO
_._. TYPE..OF CONSTRUCTION: LWREPA I R
NEW CONSTRUCTION: CERTIFIED PLOT PLnN REVIEW YES NO
CONDITIONS OF APPROVAL YES NO
(FROM FORM U)
,ISSUANCE OF DWC PERMIT AYENO
DWC PERMIT NO. 4:�11 INSTALLER:-1,M SP�v6&R_
BEGIN .INSPECTION YE NO:
EXCAVATION . INSPECTION: NEEDED:
PASSED } ����• BY
CONSTRUCTION INSPECTION: NEEDED:
AS BUILT PLAN SATISFACTORY: YES:
APPROVAL TO BACKFILL: DATE: BY__u --L �--_
FINAL GRADING APPROVAL: DATE BY
FINAL CONSTRUCTION APPROVAL: DATE: 13Y
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AMPAD NO.?3-176-400 SETS NO,23- 75 200 SETS
Commonwealth of Massachusetts r. ,�C '
City/Town of . REC '��
System Pumping-Record JUN 10�y
Form 4
.•••~ TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
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 your
local Board of Health to determine the form they use.The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Locatio LL /Rig �qfhhou4 Left
/Right rear of house, Left/right side of house, Left
Right side of builing, Left Sguilding, /
Left/Right rear of building, Under deck
Address
L6\0
City/Town State Zip Code
2. System Owner.
Name
Address(d different from location)
City/Town StaAe�&J
Telephone Number
3 i `
B. Pumping Record
1. Date of Pumping 2. ti Pumped:
Date p Gallons r
3. Type of system: ❑ Cesspool(s) ;_S__e�ptic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of stem:
/4
6.. System Pumped By:
Neil.Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Location ere contents-were disposed:
Lowell Waste Water
Sign 9t Haul Date
t5form4.docP 06/03 System Pumping Record•Page 1 of 1
r
NEW ENGLAND ENGINEERING SERVICES
G 'wt
July 7, Zoos RECEIVED
North Andover Board of Health JUL 112005
400 Osgood Street TOWN OF t4 TH ANDOVER
North Andover, MA 01845 HEALTH DEPARTMENT
RE: TITLE V REPORT: RE: 7 Liberty Street North Andover
Dear Sir or Madam:
Enclosed is a copy of the Title V report for the above referenced property. The system
PASSED our inspection.
If there are any questions please call me at my office, 686-1768.
Sincerely,
--2 C
Benjamin C. Osgood, r.
Certified Title 5 Inspector
60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099
t +
..............:. ...................
1 of 11
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT
SUBSURFACE SEWAGE DISPOSAL SYSTEM FO
PART A
CERTIFICATION
Y 1
Property Address: 7 Liberty Street North Andover,MA 01845 T�
JUL 2005
►NN
Owner's Address: 7 Libertyorth Andover,MA 01845 Owner's Name: Judy KasakowsldHEAo H PA tr�vT��
Date of Inspection: June 27,2005
Name of Inspector: (please print) Benjamin C.Osgood,Jr.Certified Title 5 Inspector
Company Name: New England Engineering Services Inc.
Mailing Address: 60 Beechwood Drive North Andover,MA 01845
Telephone Number: 978-686-1768
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,
accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the
proper function and maintenance of the on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section
15340 of Title 5(3 10 CMR 15.000).The system:
PConditasses
ionally Passes
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature: Date:
The system inspection shall submit a copy of this 4- ion report to the Approving Authority(Board of Health or DEP)within 30
days of completing this inspection If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and
the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system --
owner and copies sent to the buyer,if applicable,and the approving authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does
not address how the system will perform in the future under the same or different conditions of use.
i
2of11 i
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 7 Liberty Street North Andover,MA 01845
Owner's Name: Judy Kasakowski
Date of Inspection: June 27,2005
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
y ES 1 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 Conditional) Passes:
Y Y
One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,
upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits
substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a
complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the
tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health):
w--1
Broken pipe(s)are replaced
Obstruction is removed
Distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if
(with approval of the Board of Health):
Broken pipe(s)are replaced
Obstruction is removed
ND explain;
d I
3of11
OFFIML INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 7 Liberty Street North Andover,MA 01845
Owner's Name: Judy Kasakowski
Date of Inspection: June 27,2005
C. Further Evaluation is Required by the Board of Health:
Q Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect
public health,safety or the environment
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is
not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is
functioning in a manner that protects the public health,safety and environment:
The system has a septic tank and (SAS)Soil Absorption System and the(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 the SAS is within 50 feet of a private water supply well.
The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private
water supply well**. Method used to determine distance
**This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and
volatile organize compounds indicates that the well is free from pollution from that facility and the presence of
ammonia nitrogen and nitrate nitrogen is equal to or less than 5ppm,provided that no other failure criteria are
triggered. A copy of the analysis must be attached to this form. _
3. Other.
4of11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENT
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 7 Liberty Street North Andover,MA 01845
Owner's Name: Judy Kasakowski
Date of Inspection: June 27,2005
D. System Criteria applicable to all systems:
You must indicate"yes or No"to each of the following for all inspections:
Yes No
X 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 overload or clogged SAS or
cesspool.
X Static liquid level in the distribution box above outlet invert due to an overload or clogged SAS or cesspool
Liquid depth in cesspool is less than 6"below invert or available volume is less than'h day flow
�c 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
coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the
presence of ammonia nitrogen and nitrogen is equal to or less than 5ppm,provided that no other failure criteria are
triggered. A copy of the analysis must be attached to this form.)
Ala (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in
310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd.
You ndluindicate either"yes"or"no"to each of the following:
(The folio criteria apply to large systems in addition to the criteria above)
Yes No
The system is 400 feet of a surface g water supply
The stem is within 200 a tributary to a surface drinking water supply
system �y g
The system' ted in a nitrogen 'five area(Interim Wellhead Protection Area—IWPA)or a mapped Zone H
of c water supply well
If you answered"yes"to any question in Section E the system is consi a significant threat,or answered"yes"in Section D above
the large system has failed. The owner or operator of any large system coni a significant threat under Section E or failed under
Section D shall upgrade the system in accordance with 310 CMR 15.304. The syste owner should contact the appropriate regional
office of the Department.
6of11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 7 Liberty Street North Andover,MA 01845
Owner's Name: Judy Kasakowski
Date of Inspection: June 27,2005
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design) Number of bedrooms(actual): 3
DESIGN flow based in 310 CMR 15.203(for example: 110 gpd x #of bedrooms):
Number of current residents:_
Does residence have a garbage grinder(yes or no): ND .
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): "
Seasonal use:(yes or no): A/y .
Water meter readings,if available(last 2 years usage(gpd):..W CL L
Sump Pump (yes or no): /y 0 .
Last date of occupancy Grr-r-- '
COMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no)
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: P U M Q E D Z 9e-t&.5 A-taro FCA- o w Zvi a
Was system pumped as part of the inspection(yes or no): ,vo
If yes,volume pumped: eallons—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)
Tight tank Attached a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
07 yE�2s
Were sewage odors detected wen arriving at the site(yes or no):_ )
7of11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 7 Liberty Street North Andover,MA 01845
Owner's Name: Judy Kasakowski
Date of Inspection: June 27,2005
BUILDING SEWER(locate on site plan)
Depth below grade: b 1
Materials of construction. cast iron_c 40 PVC other(explain)
Distance from private water supply well or suction line: 20 '
Comments(on condition of joints,venting,evidence of leakage,etc.):
P b�rr.e-:r J,-
SEPTIC TANK: (locate on site plan)
Depth below grade:
Material of construction: Y concrete metal fiberglass polyethylene
Other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate)
Dimensions: L��c7 GALLONS
Sludge depth-
Distance from top of sludge to bottom of outlet tee or baffle:
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
How were dimensions determined:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet
invert,evidence of leakage,etc.):
GREASE TRAP:VA (locate on site plan)
Depth below grade:
Materials 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 sludge to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition structural integrity,liquid levels as related to outlet
invert,evidence of leakage,etc.
8of11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 7 Liberty Street North Andover,MA 01845
Owner's Name: Judy Kasakowski
Date of Inspection: June 27,2005
TIGHT OR HOLDING TANK. /t/A (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Materials of construction: concrete metal fiberglassyolyethylene other
(explain)
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alar present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: (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 evidnence of solids carryover,any evidence of leakage into or
out of box,etc.):
o,2 o t &Z sv c) c OL)u Reeoefte-,v c nan
o ie' A fL 1.5 ER - 6746i6)e.
PUMP CHAMBER.-.A/V-1 (locate on sire plan)
Pumps in working order(yes or no)
Alarms in working order(yes or no)
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
• 11
z
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100
A 3G`6 11
"
AA 3 _ w��
,� �� �-max _ L �
s = q , �
40 0-�,� � q 3' 3
DEPTH TO GROUNDWATER
depth to groundwater
bei ow k(---r jA bo S
method of determination or approximation: ous, `a�
Date.... .........................
NORTH
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
This certifies that ..
has permission to perform .....................
...... ............................................
wiring in the building of........... ................................................................
at..../......i.................... .......................................... .North Andover,Mass.
Fee...z..:......... ... Lic.No..............
ELECTRICAL INSPECTOR
Check #
Commonwealth of Massachusetts - - Official Use only
Permit No.
Department of Fire Services ' tC
�v
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leave blank
Occupancy and Fee Checked
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(M ),527 C700-11 12.00
(PLEASE PRINT IN INK OR TYPE AINF RMATION) Date:
City or Town of: L Nef To the Inspector o Wires:
By this application the undersign d gives notice of his or her int ntion to perform the electrical work described below.
Location(Street&Number) •
Owner or Tenant Telephone
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Installation of Security system
Completion of the ollowin table may be waived by the Inspector of Wires.
No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Lighting Outlets No.of Hot Tubs Generators KVA
No.of Lighting Fixtures Swimming Pool Above ❑ In-rnd. rnd. BatteryUnits,
❑ o.o , cy ig ing
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones
V No.of Switches No.of Gas Burners o.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons g
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:
No.of Devices or E uivalent
No.of Water KW No.o No.o Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify)
(Expiration Date)
Estimated Value of E ectric 1 Work: (When required by municipal policy.)
Work to Start: D� Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify, under th pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.: I
Licensee: John S. Bassett Signature Yd LIC.NO.: 1533C
(If applicable, enter"exempt"in the license number line) Bus.Tel.No.: 603 594 5928
Address: Alt.Tel.No.:
OWNER'S INSURANCE WAIVER: I am aware that the Li*see see does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's a ent.
Owner/Agent
Signature Telephone No. PERMIT FEE. $ ,
ILE4No. 546 04/01 '02 14:56 ID:ADT SECURITY JACK BASSET 781 278 1181 PAGE 1
Norwam), MA Oi06_%
Fire &
Security rere�rNmc: 7dJ•�7U ,+x7
Fax: 781-278.1,a.19r)_
ELECTRICAL INSPECTION
NOTIFICATION FOWA
This letter is to inform your office that all related work is complete and ready for your
(1na1 1nenecti011
Type of Install: Security hire❑ Access CCTV
Permit A
Date: -
Name:
r
Address:
City: '
Customer Contact Name:
Phone Number: ���-`� -
John S. Bassett
License H- 1533C
FORM 4 - SYSTEM PL7IPLNG REC
0
of NOOFH��Po�H
�ov� $oPRo 5
5FQ 2� \9g
Commonwealth of Massachusetts
Massachusetts
Aystem Pumping Record
-stem Owner Systern Location
�v
vf7 L)
Date of Pumping: Quantity Pumped: l ` 'gallons
Cesspool: No LTJ" Yes ❑ Septic Tank: No ❑ Yes
System Pumped b\-: _ License #:
Contents transferred to: - (-- -
Date Inspector
PLAN REVIEW CHECKLIST
ADDRESS ,�, , ENGINEER
GENERAL Or
3 COPIES ✓ STAMP LOCUS ✓ SCALE CONTOURS ✓
PROFILE t/ SECTION BENCHMARK L✓ ELEVATIONS SOIL
& PERC INFO ✓ WETS. DISCLAIMER ✓ WELLS & WETLANDS
WATERSHED DISTRICT DRIVEWAY i✓ WATER LINE DRAINS
RESERVE AREA ✓ SCH40SLOPE
SEPTIC TANK ,/
MIN 1500G. ✓/ . 17 INVERT DROP � GARB. GRINDER ND (+200% EDF)
25' TO CELLAR MANHOLE TO GRADE ELEV GW
D-BOX
# OUTLETS FIRST 2' LEVEL STATEMENT INLET -
OUTLET 17 (2" OR . 17 FT)
LEACHING /
100' TO WETLANDS ✓ 100' TO WELLS v 325' TO SURFACE H2O SUPP
351 TO FND & INTRCPTR DRAINS 4' TO S.H.GW 2% SLOPE
4' PERM. SOIL BELOW FACILITY - MIN 12" COVER FILL? (25' if
above natural elevation; 101if below)
TRENCHES
MIN 660 SLOPE (min . 005 or 6"/1001 ) >3 ' COVER? - VENT
SIDEWALL DIST. 2X EFF. W OR D .(MIN 61 ) t✓ IS RESERVE BETWEEN
TRENCHES?yam IN FILL? MUST BE 10' MIN.
BOT T� X LDNG + SIDE X LDNG = TOT
(L x W x #) (G/ft2) (DxLx2x#)
fw
Marchionda
&Associates, Inc.
Engineering and
Planning Consultants
June 10, 1992
North Andover Board of Health
North Andover Town Hall
120 Main St.
North Andover, MA 01845
RE: Variance Request to 310 CMR 15.03(7)
Lot 1 Liberty Street - No. Andover, MA.
Dear Members:
On behalf of Robert & Deborah Lurvy, I am requesting that the Board of
Health consider granting a variance to the specific requirements of 310 CMR
15.03(7) relative to downhill slope for a 3.29 Ac. lot at the corner of Sharpners
Pond Road and Liberty St.. The purpose of this request is to allow for the
construction of a four bedroom single family home.
The lot is bounded northerly by Liberty St.and westerly by Sharpners Pond
Rd.. The land slopes up steeply from the intersection to the top of a hill and
then down to a brook located to the rear of the property. Favorable soil for the
installation of a septic system was encountered in a relatively level area
between the top of the hill and Liberty Street. No ground water was encountered
during the spring in this area. However, less pervious soil was encountered
below elevation 93.0, approximately 8 to 11 feet below the ground surface. The
presence of this soil limits the depth at which the septic system can be placed
into the ground.
Due to the slope of the land in relation to the elevation of Liberty St.,
the downhill slope specified by the State Environmental Code under 310 CMR
15.03(7) cannot be met between Liberty St. and the proposed septic system
location. In all the other directions the downhill slope requirements of 310 CMR
15.03(7) can be met. This section of the regulation establishes a means of
providing a suitable amount of soil down slope of a septic system to prohibit
effluent from discharging to the ground surface. In order to provide a suitable
amount of soil between the proposed septic system and Liberty St., a retainning
wall to hold back the soil has been proposed. By the placement of a concrete
wall in the location and at the elevations proposed, the same degree of
environmental protection can be achieved without strict conformance with the
provisions of 310 CMR 15.03(7).
62 Montvale Avenue
Suite I
Stoneham,MA 02180
(617)¢38-6121
Fax(617)438-9654
Marchionda
W&Associates,Inc.
W'
t
,a Engineering and
__._` " Planning Consultants
Based upon the results of the soil tests conducted and the existing site
conditions, no other area of the lot is more suitable for the construction of a
septic system. Additionally, there are no areas on the lot to place a septic
system without the need of a variance. Therefore, failure to grant a variance to
this section of the regulations would cause this lot to be unbuildable which
would cause a substantial hardship for the owners.
Thank you for your anticipated consideration in this matter. Should you
have any questions or comments please do not hesitate to call.
Sincerely,
Michael J. Rosati
Marchionda & Assoc., Inc.
351-03.L62
i
Marchionda
&Associates, Inc.
Engineering and
Planning Consultants
June 10, 1992
North Andover Board of Health
North Andover Town Hall
120 Main St.
North Andover, MA 01845
RE: Variance Request to 310 CMR 15.03(7)
Lot 1 Liberty Street - No. Andover, MA.
Dear Members:
On behalf of Robert & Deborah Lurvy, I am requesting that the Board of
Health consider granting a variance to the specific requirements of 310 CMR
15.03(7) relative to downhill slope for a 3.29 Ac. lot at the corner of Sharpners
Pond Road and Liberty St.. The purpose of this request is to allow for the
construction of a four bedroom single family home.
The lot is bounded northerly by Liberty St.and westerly by Sharpners Pond
Rd.. The land slopes up steeply from the intersection to the top of a hill and
then down to a brook located to the rear of the property. Favorable soil for the
installation of a septic system was encountered in a relatively level area
between the top of the hill and Liberty Street. No ground water was encountered
during the spring in this area. However, less pervious soil was encountered
below elevation 93.0, approximately 8 to 11 feet below the ground surface. The
presence of this soil limits the depth at which the septic system can be placed
into the ground.
Due to the slope of the land in relation to the elevation of Liberty St.,
the downhill slope specified by the State Environmental Code under 310 CMR
15.03(7) cannot be met between Liberty St. and the proposed septic system
location. In all the other directions the downhill slope requirements of 310 CMR
15.03(7) can be met. This section of the regulation establishes a means of
providing a suitable amount of soil down slope of a septic system to prohibit
effluent from discharging to the ground surface. In order to provide a suitable
amount of soil between the proposed septic system and Liberty St., a retainning
wall to hold back the soil has been proposed. By the placement of a concrete
wall in the location and at the elevations proposed, the same degree of
environmental protection can be achieved without strict conformance with the
provisions of 310 CMR 15.03(7).
62 Montvale Avenue
Suite I
Stoneliam,MA 02180
(617)438-6121
Fax(617)438-9654
f
MarcWonda
&Associates,Inc.
WEngineering and
Planning Consultants
Based upon the results of the soil tests conducted and the existing site
conditions, no other area of the lot is more suitable for the construction of a
septic system. Additionally, there are no areas on the lot to place a septic
system without the need of a variance. Therefore, failure to grant a variance to
this section of the regulations would cause this lot to be unbuildable which
would cause a substantial hardship for the owners.
Thank you for your anticipated consideration in this matter. Should you
have any questions or comments please do not hesitate to call.
Sincerely, ,s
Michael J. Rosati
Marchionda & Assoc., Inc.
351-03.L62
t
Town of North Andover, Massachusetts Form No.s
BOARD OF HEALTH
r c� 19�
h w
A
• t s
DESIGN APPROVAL FOR
s�CHus t�
SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant_ �Y(1 /VL .� -A-�-k� ` Test No.
: Site Location
Reference Plans and Specs. nA�� .A•�r�� w�J Y r �l��.r ,
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
OU
: Fee Site System Permit No—5,3r,
-- -- �-^ - ....-,,.•:•:. .fi...�:>-^:-.,,;• ,•YS,-,.�r,;�s•�a�-?sem-Fnrn�c�,:-xr.��.�.'►?",�,rs...._ .. ... _�.. -,_�?"+*a ra+-rKeu•
Town of North Andover, Massachusetts Form No.3
of MoDrM BOARD OF HEALTH
• 3?e.T. °..'e O
A v. 2 3
-
9 19
�'�s' "'•t� DISPOSAL WORKS CONSTRUCTION PERMIT
SACHUSE
Applicant —7-1/P7
NAME
�� ADDRESS
Site Location -S��OT / �,6� J- �j TELEPHONE�
Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil
Sewage Disposal System as shown on the Design Approval S.S. No. �_ Absorption
-9 8
C AIRMAN, BOARD OF HEALTH
Fee `�W
D.W.C. No. lo//
f.
7hoatemiew ,ea oeatoe ane.
66 LITTLETON ROAD WESTFORD, MA 01885 (408) 692.8396 FAX508) 692.0023
• �•800.649•TflrT
Repcirt: Number-: C—wps-6802 Report Date: tiiepLember J8,1992
Cl i��nt:; Sample Taker, At:
Wilmington Pumr, Supply Inc. Flintlock
P.O. Box 517 L.ot. #1
Wilmington, MA 01.887 #7 Liberty 5t ,
N. Andover, nk
Sample Taken By. WPS Staff On: September 17,1.992
CERTIFICATE OF ANALYSTS
TEST PARAMETER: EPA Max RESUT,TS UNITS
'Cot:al Coliform (P) 0 *0 I'Cr 100ml
Calcium No Limit 23.4 1118/L
Copper. (5) 1 .3 0.09 1118/1,
Iron (10 0.3 0.19 mg/F.,
Magnesium No Limit- 4 .8 mg/L
Manganese (U) 0.05 0.04 mg/1'
Sodium " 20 10.2
mg/Ja
Potassium (S) No Limit 0.8 mg/L
Alkalinity (S) No Limit: 112 rtig/L,
Ammortia No Limit. O.OG nig/L
Chloride (S) 250 9.2 mg/L
CM-Ovine (total ) Not Spec <0.02 mg/I.,
Color (4i) 15 5 CPU
Conduat;ivity No Limit 255 umbos/cm
1IHrdnesf: No Limit. 78 mg/L
Ni.trates(as N)(P) 10 0.05 mg/L
N.itrites(as N) 1 <0.01 mg/L
PH (S) 6.5-8.5 7.9 St;
Odor (:;) 3 0 TON
Sulphates ( ) 250 13.3 mg/1,
Turbidity 5 2.2 NTU
Sediment pos/neg neg
N'"Not Tested, #:=Value Exceeds F-PA STDTNTC=Too Numerous to Count
*=Background Bacteria Noted, "--EPA Advisory Limit
=Exceedb EPA Advisory Limit
(F);-Primary EPA Standard, (S)=Secondary EPA Standard (may affect
aesthetics of drinking water i .e. t'.asLf,, calor, etc. )
This wator sample, as tc-hied, meets or exceeds LPA health standards
for the parameters lisLed above. The quality of r.his water is
accepted a;; POTABLE according to EPA Standards.
NIa stac.hushtts Stata Ctirtified "1it:h:ac1 l'. Gar.lson, for
Tc�::;t:ing Laboratory #MAO/i8 Thorstensen Laboratory Inc .
T WN OF NORTH ANDOVER/
BOARD OF HEALTH
7� AUG 17 1995
SUBSURFACE SEWAGE DISPOSAL SYSTEM I/�l]S,�PECTION FORM
Address of property v_,-, ��► Q f�� ' "&U�/ `Q- 0Owner's name C, �IIjQ�-k �u - eco
Date of Inspection
PART A
CHECKLIST
Check i the following have been done:
Pumping information was requested of the owner, occupant, and Board of
�Hth.
G
None of the system components have been pumped for at least two weeks
and the system has been receiving normal flow rates during that
peri d. Large volumes of water have not been introduced into the
s em recently or as part of this inspection.
As built plans have been obtained and examined. Note if they are not
a�lable with N/A.
r//Th facility or dwelling was inspected for signs of sewage back-up.
e
Th�site was inspected for signs of breakout.
All system components, excluding the SAS have been located on the
Y P � 9
te.
The septic tank manholes were uncovered, opened, and the interior of
the septic tank was inspected for condition of baffles or tees,
material of construction, dimensions, depth of liquid, depth of
sludge, depth of scum.
Ll The size and location of the SAS on the site has been determined based
existing information orapproximated by non-intrusive methods.
The facility owner (and occupants, if different from owner) were
provided with information on the proper maintenance of SSDS.
8
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION
FLOW CONDITIONS
If residential
3 number of bedrooms
number of current residents
IeO
garbage grinder, yes or no
laundry connected to system, yes or no
0 seasonal use, yes or no
If nonresidential, calculated flow:
Water meter readings, if available: W-Ql� wCt-�g'4--
Last date of occupancy
GENERAL INFORMATION
Pumping records and source of information: _
eY1 V
Oc u Y\e.s
es System pumped as part of inspection, yes or no
if yes, volume pumped IS-0D Gja(�o S
Reason for pumping:c,, t -�
Q,v� VJ�V� v v ,v1 � C4.-tom lic-
r,4��
ee_
T pe f 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)
Other (explain)
Approximate age of all components. Date installed, if known. Source of
information: 9 '/d QwrS — �a �� �� — as
NO Sewage odors detected when arriving at the site, yes or no
9
DISPOSAL SYSTEM SUBSURFACE SEWAGE DIS EM INSPECTION FORM T
PART B
SYSTEM INFORMATION continued
SEPTIC TANK:-
(locate
ANK:(locate on site plan) tQA C'puQ�
A-��, kv c cA c ; vim ' " C)v.-t �CrxJ� q`
depth below grade: 8Y\ CPV��C��C a P
material of construction: concrete metal FRP other(explain)
dimensions: xSJK �� _ lSdolC'(�t��UhS
sludge depth
„
a � distance from top of sludge to bottom of outlet tee or baffle
' scum thickness
70 distance from top of scum to top of outlet tee or baffle
distance from bottom of scum to bottom of outlet tee or baffle
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles,
depth of liquid level in relation to outlet invert, structural integrity,
e 'd�e�nce oleaka recommend�atnioien for repfirs, c. )e esOk O�
CC 2 ueC V L rcc O wsl�G�
u ' vt o CK ►G
'Lv\ SI o+)S
DISTRIBUTION BOX:
(locate on site plan)
C/ depth of liquid level above outlet invert
Comments:
(note if level and distribution is equal, evidence of solids carryover,
evidence of leakage i to or pu.t. of�box, recomm n ation fo repairs, at
.
PUMP CHAMBER:
(locate on site plan)`-' V
pumps in working order, yes or no
Comments:
(note condition of pump chamber, condition of pumps and appurtenances,
recommendations for maintenance or repairs,etc. )
10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued
SOIL ABSORPTION SYSTEM (SAS) : Z
(locate on site plan, if possible; excavation not required, but may be
approximated by non-intrusive methods)
If not determined to be present, explain:
Type
leaching pits and number
leaching chambers and number
leaching galleries and number
leaching trenches, number, length
leaching fields, number, dimensions
overflow cesspool, number
Comments:
(note condition of soil , signs of hydraulic failure, level of ponding,
condition of vegetation, reom endations for aintenance ;gr. yepairs,etc. )
� k%C_V\ v\_of V\1% , lu v S 1 vt 5
C> ��
CESSPOOLS (locate on site plan) : 'hov\.e
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 (cesspool must be pumped as
part of inspection)
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding,
condition of vegetation, recommendations for maintenance or repairs,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, recommendations for maintenance or repairs,etc. )
I
12
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
FAILURE CRITERIA
Indichte yes, no, or not determined (Y, N, or ND) . Describe basis of
determination in all instances. If "not determined", explain why not)
N Backup of sewage into facility?
NDischarge or ponding of effluent to the surface of the ground or
surface waters?
Static liquid level in the distribution box above outlet invert?
Liquid depth in cesspool <6" below invert or available volume< 1/2 day
flow?
Required pumping 4 times or more in the last year?
number of times pumped
NSeptic tank is metal? cracked? structurally unsound? substantial
infiltration? substantial exfiltration? tank failure imminent? ti
Is any portion of the SAS, cesspool or privy:
below the high groundwater elevation?
► V within 50 feet of a surface water?
►v within 100 feet of a surface water supply or tributary to a surface
water supply?
within a Zone I of a public well . .
within 50 feet of a bordering vegetated wetland or salt marsh
(cesspools and privies only, not the SAS) ?
, " within 50 feet of a rivate water supplywell?
P
/ U less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis? If the well
has been analyzed to be acceptable, attach copy of well water analysi
for coliform bacteria, volatile organic compounds, ammonia nitrogen
and nitrate nitrogen.
13
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART D
CERTIFICATION
Name of Inspector
Company Name ?� '�
Company Address ���
Certification Statement
I certify that I have personally inspected the sewage disposal system at
this address and that the information reported is true, accurate and
complete as of the time of inspection. The inspection was performed and
any recommendations regarding upgrade, maintenance and repair are
consistent with my training and experience in the proper function and
manitenance of on-site sewage disposal systems.
Ch one:
I have not found any information which indicates that the system fails
to adequately protect public health or the environment as defined in
310 CMR 15. 303 . Any failure criteria not evaluated are as stated in
the FAILURE CRITERIA section of this form.
I have determined that the system fails to protect public health and
the environment as defined in 310 CMR 15. 303 . The basis for this
determination is provided in the FAILURE CRITERIA section of this
form.
Inspector's Signature
Date
Original to system owner
Copies to:
Buyer (if applicable)
Approving authority
ar � Department of Environmental Management/Division ofVters, es
P1, ,
l �.r
WATER WELL COMPILE
WELL LOCATION /_7-- EOG ESCRIPTION
Address f� S E W of
f/F (feet l ./tet (circle)
City/Town/ 0 N �l"
Well owner 'L U7LOGK � - (ro 1
Address 0' � S 1 /V N S(DW of
*O/)-T- 4,4"g LT iL1e '1 0/,Y A15 (m 1.in tenths/ �^ (circle)
Board of Health permit: yes 9 no E] ersec w/J 41{ �'
qtr fro !
WELL USE WELL DATA �j
Domestic Vublic❑ Industrial ❑ Total well depth
Monitoring❑ Other De tit to bedrock 767 ft.
��.��� Water m-bearr inconsolidated material:
Method drilled
U� ?i
Description—
Water-bearing
Date drilled Description CJ
Water-bearing zon s:
CASING 1) From� s To—
Type
o Type 2) From To
Length #0 ft. Dia(I.D.) in.
3) From To
Length into bedrock Z O ft.
Gravel pack well: dia.
Protective well seal: �y)V16 Screen: dia.
Grout.❑ Other .S� Slot$ length from_to
STATIC WATER LEVEL
Static water level below land surface �C> ft, Date 4
WELL TEST 141
Drawdowt�y ft. -Biter-p�vivit & hr. min.at gpm
Ho measured Recovery ft. after hr. min.
LOG of FORMATIONS COMMENTS
0
q
Materials From To
Driller ,
GAP Mass. Registration#
Firm �`��l�.yL/, 6s v uVS
/S Address vv i AG7DR ILIA
City/Town
— _Izel 27s
r nature supervising r i red well driller `
Please print firmly BOARD OF HEALTH COPY i
id v ri o is n Y A i i v IW�a i rpt h M. . •r•.. _- y _. ____ry___ �,,.. .. _
NORTfl
own o o b . Andover 7
No. v ►-
JAY ENTRY PERMIT --�----� No th�Ant� ver, Mass., X19
PERMIT
�
BOARD OF HEALTH
THIS CERTIFIES THAT. Zvi( •••• ••• *4 ' ••••
�' �.� BUILDING ISPECTOR��
has permission It; �
ect .$ �� � ildings on .......... .�.. Ro„gh/'`1 tl�(: rald
® Chimne,
to be occupied as :./AlelP•AANZ &r Final
provided that the person accepting this permit shall in every respect conform to the terms of the application on file m
PLUM ING SPECTOR
this office,and to the provisions of the Codes and By-Laws relating to the Inspection;Alteration and Construction of ,� 677
Buildings in the Town of North Andover. PERMR FOR FOUNDATION ONLY Fina
REQULATEO BY PAiill, 114.8-& B.C.
VIOLATION of the Zoning or Building Regulations.Voids this Permit.
PERMIT E`TIRES If\j 6 MONTHS ELECTRICA cTOR
DA � PND Des ��U�� Rough �'
ll_ESS CONJTRUCTION S I � Service
PERMIT FOR FRAME/ '
BU1Lb`�
Final
DATE; !� FEE PAI •, .o . . -6i
GAS INSPECTOR
BUILDING INSPE
Occupanc i, Pere,rt Required to Occupy Bu l�'ing Dough
—`�--�-- i - – Final
Display in a Conspicuous Place on the Premises
FIRE DEPT.
Do Not Remove Burner
No Lathing to Be Done Until Inspected and Approved by Smoke Det.
�, �, ���� Building Inspector
MaircWionda
&Associates, Inc.
wu � Engineering andPlanning Consultants
June 10, 1992
North Andover Board of Health
North Andover Town Hall
120 Main St.
North Andover, MA 01845
RE: Variance Request to 310 CMR 15.03(7)
Lot 1 Liberty Street - No. Andover, MA.
Dear Members:
On behalf of Robert & Deborah Lurvy, I am requesting that the Board of
Health consider granting a variance to the specific requirements of 310 CMR
15.03(7) relative to downhill slope for a 3.29 Ac. lot at the corner of Sharpners
Pond Road and Liberty St.. The purpose of this request is to allow for the
construction of a four bedroom single family home.
The lot is bounded northerly by Liberty St.and westerly by Sharpners Pond
Rd.. The land slopes up steeply from the intersection to the top of a hill and
then down to a brook located to the rear of the property. Favorable soil for the
installation of a septic system was encountered in a relatively level area
between the top of the hill and Liberty Street. No ground water was encountered
during the spring in this area. However, less pervious soil was encountered
below elevation 93.0, approximately 8 to 11 feet below the ground surface. The
presence of this soil limits the depth at which the septic system can be placed
into the ground.
Due to the slope of the land in relation to the elevation of Liberty St.,
the downhill slope specified by the State Environmental Code under 310 CMR
15.03(7) cannot be met between Liberty St. and the proposed septic system
location. In all the other directions the downhill slope requirements of 310 CMR
15.03(7) can be met. This section of the regulation establishes a means of
providing a suitable amount of soil down slope of a septic system to prohibit
effluent from discharging to the ground surface. In order to provide a suitable
amount of soil between the proposed septic system and Liberty St., a retainning
wall to hold back the soil has been proposed. . By the placement of a concrete
wall in the location and at the elevations proposed, the same degree of
environmental protection can be achieved without strict conformance with the
provisions of 310 CMR 15.03(7).
62 Montvale Avenue
Suite I
Stoneha►n,MA 02180
(617)438-6121
Fax(617)438-9654
•
MarcMonda
&Associates,Inc.
17, I".nriiieering and
. t
111anniligConsultants
Based upon the results of the soil tests conducted and the existing site
conditions, no other area of the lot is more suitable for the construction of a
septic system. Additionally, there are no areas on the lot to place a septic
system without the need of a variance. Therefore, failure to grant a variance to
this section of the regulations would cause this lot to be unbuildable which
would cause a substantial hardship for the owners.
Thank you for your anticipat; d consideration in this matter. Should you
have any questions or comments please do not hesitate to call.
Sincerely,
Michael J. Rosati
Marchionda & Assoc., Inc.
351-03.1,62
• SENDER: Complete items 1 and 2 when additional services are desired, and complete items
3 and 4.
Put your address in the"RETURN TO" Space on the reverse side. Failure to do this will prevent this card
from being returned to you.The return Mei t fee will provide you the name of the person delivered to and
the date of delivery. For additional fees the following services are available. Consult postmaster for ees
and check box(es)for additional service(s) requested.
1. E Show to whom delivered, date, and addressee's address. 2. ❑ Restricted Delivery
(Extra charge) (Extra charge)
3. Article Addressed to: 4. Article Number
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Type of Service:
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Always obtain signature of addressee
or agent and DATE DELIVERED.
5. Sit — Add ssee 8. Addressee's Address (ONLY if
x requested and fee paid)
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X II
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PS Fn..., 3811 A— IQRQ .usr.Pn 14AQ_9,AR_p15 nnMFCTlr RFTIIRN RFCFIPT
UNITED STATES POSTAL SERVICE
OFFICIAL BUSINESS
SENDER INSTRUCTIONS
Print your name,address and ZIP Code
in the space below.
• Complete items 1,2,3,and 4 on the -
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RETURN Print Sender's name, address, and ZIP Code in the space below.
TO ASO
�. 4: /oAC X04 S G
&z 11,wrtl4k 46 5, 1�
.�lF, h .�1-14 oz/80
Marchionda
W1`
&Associates,Inc.
Engineering and
Planning Consultants
June 10, 1992
North Andover Board of Health
North Andover Town Hall
120 Main St.
North Andover, MA 01845
RE: Variance Request to 310 CMR 15.03(7)
Lot 1 Liberty Street - No. Andover, MA.
Dear Members:
On behalf of Robert & Deborah Lurvy, I am requesting that the Board of
Health consider granting a variance to the specific requirements of 310 CMR
15.03(7) relative to downhill slope for a 3.29 Ac. lot at the corner of Sharpners
Pond Road and Liberty St.. The purpose of this request is to allow for the
construction of a four bedroom single family home.
The lot is bounded northerly by Liberty St.and westerly by Sharpners Pond
Rd.. The land slopes up steeply from the intersection to the top of a hill and
then down to a brook located to the rear of the property. Favorable soil for the
installation of a septic system was encountered in a relatively level area
between the top of the hill and Liberty Street. No ground water was encountered
during the spring in this area. However, less pervious soil was encountered
below elevation 93.0, approximately 8 to 11 feet below the ground surface. . The
presence of this soil limits the depth at which the septic system can be placed
into the ground.
Due to the slope of the land in relation to the elevation of Liberty St.,
the downhill slope specified by the State Environmental Code under 310 CMR
15.03(7) cannot be met between Liberty St. and the proposed septic system
location. In all the other directions the downhill slope requirements of 310 CMR
15.03(7) can be met. This section of the regulation establishes a means of
providing a suitable amount of soil down slope of a septic system to prohibit
effluent from discharging to the ground surface. In order to provide a suitable
amount of soil between the proposed septic system and Liberty St., a retainning
wall to hold back the soil has been proposed. By the placement of a concrete
wall in the location and at the elevations proposed, the same degree of
environmental protection can be achieved without strict conformance with the
provisions of 310 CMR 1.5.03(7).
62 Montvale Avenue
Suite I
Stoneham,MA 02180
(617)438-6121
Fax(617)438-9654
Marchionda
&Associates, hic.
9
• � pit.
4y
1.
F.ngin�`eriug and
�.�llrSc' Plaimiiig Consultants
Based upon the results of the soil tests conducted and the existing site
conditions, no other area of the lot is more suitable for the construction of a
septic system. Additionally, there are no areas on the lot to place a septic
system without the need of a variance. Therefore, failure to grant a variance to
this section of the regulations would cause this lot to be unbuildable which
would cause a substantial hardship for the owners.
Thank you for your anticipat, d consideration in this matter. Should you
have any questions or comments please do not hesitate to call.
Sincerely,
Michael J. Rosati
Marchionda & Assoc., Inc.
351-03.1,62
PLAN REVIEW CHECKLIST
ADDRESS / ENGINEER
GENERAL
3 COPIES STAMP f/ LOCUS SCALE CONTOURS
PROFILE c/ SECTION BENCHMARK L-- ELEVATIONS --�� SOIL
& PERC INFO WETS. DISCLAIMER_LZ WELLS & WETLANDS
WATERSHED?-j2b DRIVEWAY WATER LINEJ� DRAINS
SCH40 SLOPE
SEPTIC TANK
MIN 1500G. C--' .17 INVERT DROP GARB. GRINDER(+200% EDF)
25' TO CELLARMANHOLE TO GRADE / ELEV GW
D-BOX
SIZE # LINES FIRST 2' LEVEL STATEMENT /-- r
INLET - OUTLET (2" OR . 17 FT)
LEACHING /
RESERVE AREA ✓ 4' FROM PRIMARY? `' 100' TO WETLANDS &, 2% SLOPE
100' TO WELLSI,/ 325' TO SURFACE H2O SUPPN/� 35' TO FND & INTRCPTR
DRAINS ✓ 4' TO S.H.GW 4' PERM. SOIL BELOW FACILITY MIN
12" COVER !/ FILL? x (25' if above natural elevation; 10'i below)
TRENCHES
MIN 660 gpd L/ SLOPE (min .005 or 611/1001 ) -�>3' COVER? - VENT 4--`
SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) Ll---- IS RESERVE BETWEEN
TRENCHES? IN FILL? MUST BE 10' MIN. ---� 4" PEA STONE? "—
BOT -'3�0 X LDNG710& + SIDE 466 X LDNGTOT
(L x W x #) (G/ft2) (DxLx2x#)
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: �)/aim//. ���`/' Phone a/-
LOCATION: Assessor's Map Number Parcel
Subdivision 2/4� Lot(s)
Street �i`' r S� St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
-q I& Date Approved �Z-
Conservation Administrator Date Rejected
Comments
Date Approved
T wn Planner Date Rejected
Comments
_ -� Date Approved 9 X�) IC
Health Agent ` Date Rejected
1
Comments
Public Works - sewer/water connections MI � M�
- driveway pe it 44
Fire Department
Received by Building Inspector Date
Commonwealth of Massachusetts
City/Town of
a
System Pumping Record
Form.4
DEP has provided this form for use by local Boards of Health b N � , b , but the
information must be substantially the same as that provided check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Locaf -Left front ofhous �ight front of house, left side of house, right side of house, Left
rear of house, right rear of house, left side of building, right rear of building, under deck.
n L,-,� r
CityfTown State Zip Code
2. System Owner: ^
Name
Address(if different from location)
City/TownSt Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping 2. QuantityPumped:p g D e p Gallons
3. Type of system: ❑ Cesspool(s) 0 Septic Tank ❑ Tight Tank
❑ Other(describe): _�
4. Effluent Tee Filter present? ❑ Yes ❑'No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System: 4
6. System Pumped By:
Neil J. Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc.
Company
7. Locatio w ere contents were disposed:
G.L.S.Q owell ste ter
o,
Signafurg Olt
f auler Date
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