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HomeMy WebLinkAboutMiscellaneous - 70 BROOKVIEW DRIVE 4/30/2018 (2) 70 BROOKVIEW DRIVE 210/105.A-0032-0000.0 J2 i II J I L I JI � II I� i i II I w i ` I 1 MAP # LOT # PARCEL # STREET CONSTRUCTION APPROVAL HAS PLAN REVIEW FEE BEEN PAID?? / YES NO PLAN APPROVAL: DATE 7/ ff(�7 APP. BY DESIGNER: `���QcS/� � PLAN DATEb'Z �7 CONDITIONS WA R SUPPLY: TOWN WELL WELL PERMIT_ DRILLER WELL TESTS: GI�EMICAL DATE APPROVED BACTERIA Z DATE APPROVED BACTERIA II APPROVED PLUMBING SIGNOFF WIRING SIGNOFF COMMENTS: FORM U APPROVAL: APPROVAL TO ISSUE K--J NO DATE ISSUED BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: BY: 1 SEPTIC SYSTEM INSTALLATION IS THE INSTALLER LICENSED? NO TYPE OF CONSTRUCTION: REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW NO- CONDITIONS OF APPROVAL YES (FROM FORM U) ISSUANCE OF DWC PERMITYE NO DWC PERMIT PAID? YES! NO DWC PERMIT NO.- S' INSTALLER: BEGIN INSPECTION DYENO: EXCAVATION INSPECTION: NEEDED: PASSED fl BY CONSTRUCTION INSPECTION: NEED D: AS BUILT PLAN SATISFACTORY: YES•��_2�� APPROVAL TO BACKFILL: DATE: ;/ / BY�z /! FINAL GRADING APPROVAL: DATE I BY FINAL CONSTRUCTION APPROVAL: DATE:G BY 5 6 ;^ Town of North Andover HEALTH DEPARTMENT $ICHUSf CHECK#: © DAT / LOCATION: `f H/O NAME: ' CONTRACTOR NAME- Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Tithe 5 �nspector $ LJ'^Fitle 5 Report $ ❑ Other. (Indicate) $ r Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Massachusetts RECLSI ED Title 5 Official Inspection Foro1i Subsurface Sewage Disposal System Form-Not for Voluntary Ass ssmen (r� TOWN OF NORTH ANDOVER b' 70 Brookview Drive HEALTH DEPARTMENT Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town. State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your Neil James Bateson cursor-do not Name of Inspector use the retum key. Bateson Enterprises Inc. Company Name 111 Argilla Road Company Address Andover MA 01810 Citylrown State Zip Code 978-475-4786 S115 Telephone Number License Number B. Certification I certify that 1 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 ❑ Nee Further Evaluation by the Local Approving Authority 9/14/2011 Inspec or s Signature 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 tha approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. l5ins•11/10 Title 5 Official Ins lion Form' pe .Subsurface Sewage Disposal System Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �. 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 N ❑ ND(Explain below): t5ins-11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Passes B) System Conditionally P ass (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water ' supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal 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 El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ N 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 Y2 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts i w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w„ 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA_ 01845 9/14/2011 every page. Cityrrown 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. El ® 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 welll 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. EJ ® 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 ❑ 0 the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply 11 Elthe 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, j 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. I t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town 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 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Yes 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: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 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: Pumped May 2011, 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 UA system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-11/10 Title 5 Official Inspection Fond:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 13 years old, 4/21/1998, as built plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): 4" PVC thru wall, 3" PVC in house, no leaks visible 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: 10'x 5'x 4' Sludge depth: 0 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 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 27" Scum thickness 0" 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 21" How were dimensions determined? Tape Measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet tee ok. Outlet tee ok. Depth of liquid at outlet invert. No evidence of leakage. 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 70 Brookview Drive Property Address Nicholas Lambo Owner Owners Name li information is North Andover MA_ 01845 9/14/2011 required for every page. Citylrown 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 ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box level&distribution equal . No evidence of leakage. Evidence of light solid carryover. D-box cover broken, replaced it. 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: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. Cityfrown 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 trenches 75' long ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil ok. Vegetation ok. No sign of ponding to surface. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. CityrFown 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.): T 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, ( 9 Y p 9, egetat on, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form • Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 every page. City/Town 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 14 W� �CkA--,c- L 9 G " x t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form • Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 70 Brookview Drive Property Address Nicholas Lambo Owner Owner's Name information is required for North Andover MA 01845 9/14/2011 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: '4 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: 4/30/1996 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Design plan ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test pit data on design plan shows water @ 7'deep Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 4 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 70 Brookview Drive Property Address Nicholas Lambo Owner Owners Name information is required for North Andover MA 01845 9/14/2011 every page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems) completed E System Information^Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 1 Summary Record Card generated on 9/19/2011 12:35:45 PM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-105.A-0032-0000.0 v Parcel Id 16909 70 BROOKVIEW DRIVE LAMBO, NICHOLAS 70 BROOKVIEW DRIVE NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1.11 Acres FY 2011 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until LAMBO,NICHOLAS Payor 70 BROOKVIEW DRIVE NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 1771 .0-70 BROOKVIEW DRIVE Last Billing Date 7/13/2011 3170377 03 Cycle 03 Active UB Services Maint. Account No.3170377 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 514.23 /1 UB Meter Maintenance Account No.3170377 Serial No Status Location Brand Type Size YTD Cons 35341119 a Active ERT HH b Badger w Water 0.63 0.63 715 Date Reading Code Consumption Posted Date Variance 6/21/2011 0 n New Meter 0 324% 6/21/2011 771 sReset meter 4 324% NEW ERT 6/21/2011 767 m Manual estimate 100 7/20/2011 211% MSG 3/7/2011 667 a Actual 27 4/13/2011 42% 12/8/2010 640 a Actual 16 1/12/2011 -90% 9/24/2010 624 a Actual 195 10/15/2010 76% 6/22/2010 429 a Actual 124 7/15/2010 497% 3/9/2010 305 a Actual 18 4/14/2010 -52% 12/8/2009 287 a Actual 39 1/12/2010 -66% 9/4/2009 248 a Actual 105 10/15/2009 128% 6/8/2009 143 a Actual 44 7/20/2009 131% 3/16/2009 99 a Actual 22 4/29/2009 -18% 12/9/2008 77 aActual 25 1/20/2009 -69% 9/10/2008 52 a Actual 52 10/10/2008 -100% 7/14/2008 0 n New Meter 0 10/10/2008 -100% 7/14/2008 3358 r Replacement 82 10/10/2008 368% 6/6/2008 3276 a Actual 42 7/16/2008 61% 3/7/2008 3234 a Actual 25 4/11/2008 -54% 12/11/2007 3209 a Actual 60 1/22/2008 -76% 9/5/2007 3149 a Actual 198 10/12/2007 87% 6/19/2007 2951 a Actual 130 7/20/2007 530% 3/15/2007 2821 m Manual estimate 20 4/16/2007 -30% 12/12/2006 2801 a Actual 26 1/19/2007 -95% 9/18/2006 2775 a Actual 509 10/20/2006 2116% a FORM U - LOT R=ASR FOM 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***************** APPLICANti T: DV ' /f' /J��ni S Phone P� S .S S LOCATION: Assessor' s Man Nu.-nber ��9 t���''9 Parcel 3 �` r Subdivision ) / Tr� Lots; / S S t r e e'- j ���` t<<C'L.> ����• St. N u7j--e r *** i:e**�eie*fie ** eic*7Fic*** i�c*Qf^1.Cyal Use M"� 'IIATIOP S OF TOWN AGENTS: Date Ancroved Ad-_. stratcr Date Rejected Cc=ents L t�f7Y1�,1C M. I Y1 Date Approved Town Planner Data Rej egad Cc:�.::.er.t_ Data Anmroved Fccu Date Re-iectc- -vDate Approved 7' 1nstec_ `-:ea_-}^ Date Re. ec==- C'O __. se-.:er waz=_r connections - driveway per-zit Fi--e Decar-menz Recsived by Build 4na Instector Date arCbIo11da d[E TFEM OF �OQa��fl44Q[� Associates,L.P. Engineering and `•;`t- Planning Consultants T DATE, (617)438-6121 2 FaxATTENTIC (617)438.965.1 G RE- TO ��oi�l/'l ri► 57- -=-- WE ARE SENDING YOU %QAttached C3 Under separate cover via the following items: O Shop drawings G Prints =l Plans O Samples Specifications Cl Copy of letter Cl Change order COPIES I DATE I fJ O. I DESCRIPTION �-s . Town of North Andover Massachusetts Form No.2 THESE_ARE , NORTq BOARD OF HEALTH F - '-�- DESIGN APPROVAL FOR [. SSACMUSE� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM E: L: Applicant--- Test No. REMARKS Site Location_ (017 I5 121 • Reference Plans and Specs. ENGINEER DESIGN yyt� s ATE Permission is granted for an individual soil absorption sewage disposal Ko he Installed in accordance with regulations of Board of Health. CHAT AN,BOARD OF HEALTH : Fee Site System Permit No. COPY-TO APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# LOCATION: 07— /s fJ l'0 i. (11 e_Gc�_ LICENSED INSTALLER: A-7-CZ— SIGNATURE: -7CZ—SIGNATURE: ���� y�--� TELEPHONE# 6 7 2 7-Y '- CHECK LY "CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE-ATTACH FOUNDATION AS-BUILT. Administrative Use Only �� �� 7 $75.00 Fee Attached? Yes 1// No Foundation As-Built? Yes No Floor Plans? Yes No Approval Date: g `�1 r rcbioxida `�. _ 22 D.QG� Du�pC� a £�associates,L.P. 4�1�� 0� �� J�Gvt] Engineering and Planning Consultants t DATE, EOBNO. (617)438-6121 -• �--�'� r��-?r� . Fax(61/)438.9654 - ATTENTION G TO lifG'� RE: CCC/J/ b11,4 the following items: WE ARE SENDING YOU NQAttached D Under separate cover via ElShop draveings U Prints D Plans O Samples El Specifications E3 Copy of letter D Change order DATE I '.'O. I DESC:IPTtCN CCP-FS .. THESE ARE TRANSMITTED as checked below: ! + O For approval O Approved as submitted _ O Resubmit copies for?pproval I - _ )<'For your use O Approved as noted D Submit copies for distribution O As requested D Returned for corrections O Return - corrected prints C3 For review and comment O 0 FOR BIDS DUE 19 D PRINTS RETURNED AFTER LOAN TO US ' REMARKS v�1117 an S Se �' 40/_ 71Z COPY-To SIGNED: i if enclosures are not is noted.APnC/y notify us it once. : Town of North Andover, Massachusetts Form No.2 f NORTIy BOARD OF HEALTH °� ) DESIGN APPROVAL FOR "5`` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM • Applicant Test No. Site Location Lor Lt- i Reference Plans and Specs. - -�',st yQ �r-9-d�.�=t✓ ENGINEER DESIGN 15ATE Permission is granted for an individual soil absorption sewage disposal 33temst�be Installed in accordance with regulations of Board/of Health. CHAI AN,BOARD OF HEALTH Fee �� Site System Permit No. �-� I ELEV.=137.29 �. ,69 50 R L=8.92' 0 �� 5 00 ' =51 .98' 1� � R�12 64 — — — _ L=60 R-125 . ()0 ep � �00L=28.54' L=21 .01 ' 00 � R=1 7 5 L=g5 . 2 6 i ' 15 48,422 S.F. 1 .11 Ac. S.F. TOP FND 'A 0 00 �I N EL=132.9' i ow i i t ss°i TA O z � 8ch1 � Z �dW � 299.24 I 512°3g� � N d N N Ln N O �C n N X- 000 N 0000 0-0 OF AjjqS WE HEREBY CERTIFY THAT WE HAVE EXAMINED } f o STEPHEN M. ® THE PREMISES AND THAT ALL APPARENT a v MELESCIUC �' EASEMENTS AND ENCROACHMENTS ARE LOCATED THIS PLAN IS INTENDED FOR ZONING No. 39049 v AS SHOWN. THE STRUCTURE SHOWN CONFORMS PURPOSES ONLY. IT WAS PREPARED �s A90FFSS\O�PQ TO THE ZONING LAWS OF THE MUNICIPALITY FROM EXISTING PLANS AND RECORDS l O WHEN CONSTRUCTED. ALSO, ACCORDING TO THE WITH THE STRUCTURES SHOWN LOCATED qN� U v�y F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP, BY AN INSTRUMENT SURVEY. THIS PLAN COMMUNITY PANNEL NO. 250098 0009 C i ' SHOULD NOT BE USED FOR PROPERTY DATED 6/2/93 THE STRUCTURE IS NOT LOCATED LINE DETERMINATION. g ('�I�{b IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE. k r CERTIFIED PLOT PLAN 1 LOT 15 BROOKVIEW DRIVE MARCHIONDA & ASSOC. , L. P . NORTH ANDOVER, MASS. ENGINEERING AND PLANNING CONSULTANTS E PREPARED FOR R OKVIEW COUNTRY HOMES 62 MONTVALE AVE. B SUIT-0 � P.O. BOX 531 STONEHAM, MA. 02180 (617) 438-6121 NORTH ANDOVER, MASSACHUSETTS SCALE: 1 "=30' DATE: 3/2/98 Town of North Andover, Massachusetts Form No.3 t MoRTH BOARD OF HEALTH o t. do X19 to DISPOSAL WORKS CONSTRUCTION PERMIT ,SSACMuSEt Applicant � � 1, 97-7 y NAME ADDRESS TELEPHONE Site Location >s !U Permission is hereby granted to Construct Kror Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. 51 CHAIRMAN, BOARD OF HEALTH w9219 Fee D.W.C. No. JOIN -- 1 T - 98 WED 14 : 0 !5 P . 0 1 FROM FLINTL,CKF INC. PI-ONE NO. 19786934430 ?tin. 17 1998 01:40PM P3 TOWN OF NORTH ANDOVBR SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The mdolqpod hemby reify that the Sewage DiSPOW Systom,(�)con ctod; ( }r,—*ed. by e I G 8,emm located to t 'm� 4�[ e��'� �Ia(" Y, w-as installed in confot as&-Eee with the North � AAdover Board of Health approved plea,Syste= fJcsipts permit �4f®dated 3l-2 6/`�7 ,with,an approved desigj611ow of ° + _ gallorts per day. T-ho materiels used were in xnforanarce with those&pcci5;:d of the approved plan;the system was iratalled in accordance with the provisions of 314 CNIl`c 15.000,'Title 5 Und local regulations,arca tho 6zal VAd4v agrees Substantially with the approved pian. All wort;is Rcqumtely t4pr4sented on the As-built which has been submitwd to the 1 okll of,Herlth. ZBed inspection daft: I— q pias ect -- P Final inspection date; Etl or' . tnstsd]cr sic.4: Date: 6f(, 1�t Design Engineer: Date: ��1 � Add ress Zd./3 Q&o ky,,a ou , p 2 Title of File Page of Date File Open: Date File closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes: action Document/ document/ Num. Action Department ------------- Board of Appeals — Board of Health Planning Board — Conservation Commission — Buil-din DepartnlerRt — ---- OR- -_ V And r/y Town O overf o No. - - * 0 - . dover, Mass., __ 19 �O _'9�'CsLAK OCHICNE WICK '9 AOA'4TED�PP`y '`J S BOARD OF HEALTH Food/Kitchen rERMIT T Septic S e BUILDING INSPECTO THIS CERTIFIES THAT................................... �.. .�?..�.r ....0 �.tYr. .......... Q.kl.I111 .�!....... .. . .f.s F atio ................. buildings on ......7.0.....sko..Q. ...0.l..F. ........�., ,.(.uL. ou has permission to erect..................... 9 ��X� to be occupied as................................................ .1... .�-.1-F................ 1... . ,.....:................,........................ Chimney provided that the person accepting this permit shall in every respect conform to the t sof the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Ins,pectio , Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSP CT VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELEC IC INSPE S CONSTRUCTION START. � '''� UNLESS �� � .................................................... ....... ... ....................................... BUI ING INSPECTOR / Occupancy Permit Required to Occupy Building As s CYOR ay kh4 Display in a Conspicuous Place on the Premises — Do Not Remove 4 �, , L r. YeN No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner ,,5 N�`;-`��+� �- Street No. V QSmoke Det. Form No, 4 Town of North Andover, Massachuseti, BOARD OF HEALTH June 22 19 98 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed (X ) or repaired ( ) by Peter Breen I INSTALLER at Lot 15 Brookview Drive, N. Andover SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 940 dated March 2619 98 I The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD F 0 HE.- LTH ENGINEER i s Office Use Only top Permit Na Occupancy 8 Fee Checked:J?g/� ar .�c�r��e Sa6cry BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12: (Please Print in ink or type all information) Date To the In pector of Wires: To"of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number lgr T IS— * 70 1:51e6-, X, Ut Owner or Tenant Q0 O 0\,--�_ Owners Address C) Q b ry, S-3 i Is this permit in conjunction with a building permit Yes gl--- No ❑ (Check Appropriate Box) Purpose of Building /i-le,✓ Utility Authorisation No. 76 yl�r 7 Existing Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters New Service old U Voits Overhead ❑ Undgmd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electncal Work Total No.of Lightling Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimminq Pool gmd ❑ gmd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Oioosal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Soace/Area Healing KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Si ns Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremenlits of Massachusetts General taws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = have submitted valid proof of same to the Oftic YES NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please pacify) (Expiration Date) Estimated Value of I Work$ 6—J0 U //� - Work to Start - Inspection Date Reaquested 7 `�7/fly Rough ° Final Signed under the as of/perjury: �— ��� L1C.NO. d Cl FIRM NAME iWlG/d ffC Al C/h/ l�-^ j Lac, / Licensee Slit/2 t-�C. Signatures �/ \C C.NO. Bus.Tel No. 97Y VJ l& Address,<Jl, (}2�, 7 L. Alt Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Teiephone No. PERMIT FEE (Signature of Owner or Agent) 15445 4 4 Date... :a ............ 1 1 NORTH S TOWN OF NORTH ANDOVER 3j •`,� °� p PERMIT FOR WIRING .....<z� - ' This certifies that ................................................... ....�;�:?.. Lv- has permission to perform .. ...... .. .. .. -c............... .................... wiring in the building of.. � '........:................. .. at.....' n... ' `''` ' ` . ......... ,North Ando er.Mass. F&;�P/.... ....... Lic.No. ............................................................ / ELECTRICAL INSPECTOR 04/24/98 09:21321.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer WFAMA :914iii 'hl 01 I- 1-1 �i1i NEON; ial 1 ::. _ ; �. II; 1 illii���) ol on ■cM1. =� NMI1 0, it ft�l 01 ;ilk willOmni III �f- ���i!% f��i Nil ! � ii� �� � ! .yl �[El ! � � ■�! Emmaus Soli -- ��G� =wasp -- NEI aUMiuz A- _ 00 o i � H�KiTIE7-1 XG1 8 8 i B=r gurej -.tw D4i1 '� st, + T I 0. 3h I. oil Ar _4 i rt�L i..nz FL HAWL-�Fs-• I vor F1LC2 �+a O L - uF-.— M& L�L— _} tI P - 151 ell PI First Floor I ,tet/��/✓'/ L 1938 SF r. -au .- *vrz:;;v- -- - -- - _ 1 A;4 0 1 i u�Sv av-.9riord Cam TV �nl t6 r mono I en nu LA ,t# .,t. . 1 — ,,� LOT 15 BROOKVIEW ESTATES d a ti gmP, PO, HJT VFWT CEgdr. `.51DIUP __.. . L_._._..- At. ! PATIO AeB44 I r ELEV, R4H LOT 15 BROOKVIEW ESTATES Lbw FLagHi�+Cf E( E /ENT ~IFit . V9--_. _ i o o . . -r Lot 15 BROOKVIEW ESTATES BUYER: LAMBO ro CO►1G �2A P e1DC.�E. VffI4 - - GED.+ 5iDI�,.t� � Y [z:)LA �4 LOT 15 BROOKVIEW ESTATES rGENERAL NO=S '1. SMUCTURAL A. DZSI07 LOADS 1. n=x 1. LIVZHC SPACE. 10 p.s.t. live/1Q p.s.t. dead 2. rLOOR 1 SLEEPING SPACE 30 p.s.t. lits/10 p.s.l. dead '3. ROOr 30 p.s.t., lits/10 ps.t. dead Z. Ait.OlfAs1.S MWLZ=ON (nom) - .-• 1. WITS• GPPSUK CZZLING ZELOW• I/360 - - 2. NO GTPSUM CZZLZM ZZZCW C. BOIL ZZARIXG CAPACITZ 2000 p.s:l. ROTEt mml= LOADS AND SITE.COHDITZOHS SBGUI.D BE VERITIED WZTB LOCAL AUILDINC CODES AWD OrFZCX=.BPECIAL COXDxTXCNS Sl= AS SRISHIC, zwx,WZHD OR grmto; mc.LQADZ3to MAT XBgUXd PROFESSIONAL AL ZW-COMMETE ' 2� A ON ORROX-3000 p.s.L. (28 DRAT MRS ON 40 A= OR GRAVEL TXLL WITS US 110 MZLMW.WIRE idea. Z. FOUM=ZOX MR= i Z'OOTM.MS-3000 P.M.L. (28 W Ste) 3. A. FOOTINGS SBALL ZZ PLACED On UNDISTURBED of zm=NRZM FILL TO A DEPTH ZZWIRZD By LOCAL ZUZZ,DZNG CODES AHD rtOaT CDQIDZ?ZO>lE. Z. UNREZ>Tro== M=j SSALL SUPPORT A N&=Mm 0'r 71-0• UMZALAACZD r3ZL C. DAHPFROGYM (BASZKMM)-M COATS Or ASPBALTZC COATM =WOUND D. MATLRPROOFIXG (BABITASLN SPACES WMM GRADE)'-T= PLT BOT N PPZD TELT KMUMUZ NATZRPRDOrZNCL • Z. YOUADATIOM ORAIZ-INSTALL A i• PERFORATED MA331 TILE AT PJMXMXwER Or BASEHENT.TOPS Or JOZM TO ZE COVERED W/130 FELT AND A MINIMUM Or 18- COURSE STORE OR ¢RAVZL.amx 1'ZL$ 3/16• FM rwr TO POINT_Or DZSCEARGE. Ir. TZRHXTZ PROT=TZON-As REQ9Z1iZD BY LiOCAL aria" a. ANCEoA IOUs-Q-z12` ASCBOR BDUS 1 B'-0. O.C. t. 1 A. ALL STRUCTURAL STZZL SUM REET ASTM A-36 Z. UNLESS OTHERMZSE NOTED,PZOY DZ A 20- NOM. HOOD SILL OF APPROPRIATE WXDTH BOLTED .T0 TBE TOP rLAX= Or ALL STS. =AM WITS 3/80 DIA BOLTS STAGGERED AT 21-0- O.C. tZGID?.Y TASTLN ALL Oa HERS AND JOISTS. r 5. C RPP=q _ A.. rR71MM 111MBs>Z - - 2. SMS-0 3 OR •STUD• BADE 2. JOISTS a NAMMS-E-1,200,000 p.s.i./lM-1,130 p.s.i. 3. BZW(S 4, QZR25-S-1,200,000 p.s.i./P8-i3Osa R.s.f `- B. STAIR 222ZNQstsT-! L ORADs, S. UNLESS OZBZNa1ISN•NOm,PtOVIDst - a)Do Am EZADElt JOISTS i 2Rnoom 1 Ai.L rLOOR OPZMMS. b)DOUBLM JOISTS MDZR ALL PARALLEL PA3t'l=ONS• s)lz3 CROSS ZRIDGZlliO.! SACH JOIST BAZ . B.. FLOOR CONSTltDC2ZCN " -": ' �:•.."" - - 1. GENERAL FLOORS-1/2• lL2WOOD "(C-a 12/16 ZRf APA W/XXT. GLUE) UNDER 1/20 PLYWOOD UNDERLiIYldniT INT APA) WZT3 Br"..DZNG PAVER BZTWEEN. 2. (SATS A.'20S.Z2/ AZUN .-OSE mxaz RESISTANT PS.YWOOD ��tLAYMEb1T.0=C PLUGGED EXT-APA. . C. Z3TZRZO3t SZZAZ:zNa 1.0 MR=-1/2• PLYWOOD tC-D 24/0f D!l Alti.9/EX?. QLQi) (•OPTZOBALj 1/20 INSULATION BOARD WITS DZAGOUAL ltr CORNER ZRACINQ IN FRANZ. 2. Roar-1/2. 3�LYI�OOD (C-0.24/a nr,AYA;1r/Ssl. dL=) O. XXTmoz rZNZi>1 I. MMFALr-UNLEss o"Mmazz nmICATM,ALL. nmxxaR WALLC S CEILINGS ARE:TO BE COVBAZD HITS 1/2- gnSt[ NQARa,a►Z'i'8.MVM CORNER "r REINFORCZNG,=M i SANDED. t*OPTIORAL 1/2•: •ZLVE BOARD- Wm Tx3mzR PLASTER SYSTEN). 2. SA23 i 20=T AMXM U9 $ MATER RZSXSUW WFSVM BOARD. A.. UNLESS OTS MWM NOTED"PRoV=2 i. ZNsvt.AT = R-l9 111 ALL ZXZZRION WALLS • t--iP IN rLOm OVER UNEUM SPACES "N-30 M CATEEDRAL CXXLMlQS AlmrACMM DZRELTLZ'TO ROOr It-30 ZS TOZ FLOOR CZZLMcs 2. VAPOR DAxXXZR-ZNSTA= A 2'mm.'pOZvwpvl a VAPOR BARRIER on THE WARM"SIDE OT ALL ZNSIILATION. 3. Naris-OOUBLE nU=ATXM GLA.4s' AT ALL EXZZRZOR GLASS AREAS - TL}dERED. mAss IN ALL SLZD=a =Am DOORS a WZNDORs Lsss TSAR 30- ABOVE TSE lLOOR.CEZCE LOCAL COD38 rOR GLAZING MuzRL2O:=. Form NO. 4 f{ Town of North .Andover' %'1assachusetts f BOARD OF HEALTH ± June 22 19 98 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed (X ) or repaired ( ) by Peter Breen INSTALLER at Lot 15 Brookview Drive, N. Andover SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 940 dated March 26 19 98 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD OF HEALTH ENGINEER �> w ? ti f .l ♦ 1 i T.FND. 33.4' i t ELEV.=137.29 , _ x,69 . 500 , L=8.92' 00 25 . 0 0 100 �i 1 1 .98' ��� R'__49 . 64 ' =60 . 0 L 0 0 R=125 . 00L=21 .01 'ep X00' L=28.54' 45' 00 R=17 5 6' — 15 G L=85 2 _ / 48,422 S.F. / / H 1 .11 Ac. / // / // 12.1 EX. VENT 23 D TOP FND / N I EL-132.9' B 11 EX. 3' X 75' TRENCHES d- E m EX. �j EX. 1500 GAL. D-BOX � A SEPTIC TANK p; 100.7� � � M 100 FT, WETLAND BUFFER LINE EX- � 299.24 f / 2 L 1 N ELEVATIONS TAKEN AT TOP OF PIPE SWING TIES TOP OF FOUNDATION: SEE PLAN ►se••• �� COMPONENT COR A COR B COR C PIPE ® DWELLING: 128.52 �',, NOF qS�' - SEPTIC TANK 53.0 16.2 (CENTER) D-BOX 77.8 30.3 (CENTER) TANK IN: 127.99 p m► END PIPE: D 21.3' 40.1' TANK OUT: 127.71 1IL �� END PIPE: E 422' 70.2' D-BOX IN: 127.40 ',s N o . �Q� D-BOX OUT: 127.25 (ALL) � s G1 E END PIPE: F 105.2 112.6,a� END PIPE: G END PIPE - G: 126.78 ►; ALN END PIPE - H: 126.78 END PIPE - F: 126.77 AS-BUILT SEWAGE DISPOSAL MARCHIONDA & ASSOC., L.P. SYSTEM PLAN ENGINEERING AND PLANNING CONSULTANTS LOT 15 BROOKVIEW DRIVE 62 MONTVALE AVE., SUITE I STONEHAM, MA. 02180 NORTH ANDOVER, MASS. (617) 438-6121 PREPARED FOR BROOKVIEW COUNTRY HOMES SCALE: 1=30' DATE: 4/21/98 P.O. BOX 531 NORTH ANDOVER, MASSACHUSETTS M & A FILE No.: 351 — 22 J i ?0 SEPTIC PLAN SUBMITTALS LOCATION: /��✓r��� �/ �d� NEW PLANS: $60.00/Plan REVISED PLANS: YES $25.00/Plan DATE: S.� 1-7 DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary NORTH ANDOVER BOARD OF HEALTH ` DESIGN REVIEW REPORT DATE (D ���� FEE: PERMIT ## 94-� DATE RECEIVED APPLICANT JD U& MAP PARCEL ADDRESS LOT ## /C5- STREET ## ENG. "-FOS 47-/ STREET -,5,eG0,CfJ/C� ENGINEER' S ADD. / PLAN DATE V5-A6/9 7 REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED REASONS FOR DISAPPROVAL: l z oP�E-s ENC# A21G Moi' 75-1 •�°o�/ Y s �-� �y . �� c iS 2 za C >) Ev/gr,1o, --5 ��. 7 . V6A)7 A4 6 PLANT REVIEW CHECKLIST ADDRESS /� �.eGY>.C�IJ/�G2J -ENGINEER dSPT-/ 3ENERAL 5)6 - 3 )G .3 COPIES STAMP LOCUS NORTH ARROW S SCALE :ONTOURS PROF ILE_L::::�Sc) SECTION L,---' BENCHMARK�Lor" SOIL & ?ERCS V ELEVATIONS WETS . DISCLAIMERWELLS & WETS /� JATERSHED? NO DRIVEWAY WATER LINE S FDN DRAIN L,--- M&P 3CH40_1Z"�TESTS CURRENT? L� SOIL EVAL ,' IC OSAfi/ SEPTIC TANK lIN 150OG L--' . 17 INVERT DROP �" GARB . GRINDERkl ( 2 comps +200 ) 10 ' TO FDN_ Z MANHOLE ELEV C/ GW # COMPS ._L GB D-BOX SIZE # LINES FIRST 2 ' LEVEL STATEMENT_ INLET / ./ - OUTLET /,�76/ _ 17 (2" OR . 17 FT) TEE REQ' D? /Ud LEACHING MIN 440 GPD?b/"' RESERVE AREAy/ 4 ' FROM PRIMARY?.le 20 SLOPE 100 ' TO WETLANDS L--__100 ' TO WELLS 4 ' TO S ,H . GW EJ( 5 ' >2M/IN ) 20 ' TO FND & INTRCPTR DRAINS L/-' 400 ' TO SURFACE H2O SUPP 4 ' PERM . SOIL BELOW FACILITY MIN 12" COVER FILL? x( 15 ' ) BREAKOUT MET? y TRENCHES MIN 440 gpdy SLOPE (min . 005 or 6"/100 ' ) l/ SIDEWALL DIST . 3X EFF . W OR D (MIN 6RESERVE BETWEEN TRENCHES? L—SIN FILL? 'MUST BE 10 ' MIN . 4" PEA STONE?y VENT?-,\--/ _ ( >3 ' COVER; LINES >50 ' ) BOT + SIDE 76- _ v`r� X LDNG r 3-3 = TOT 4—�,c5 _744'0 ( L x W x # ) (DxLx2x# ) (G/ft2 ) Copyright 0 1996 by S.L. Starr June 23, 1997 Mr. Mike Rosati Marchionda& Associates 62 Montvale Ave., Suite#1 Stoneham, MA 02180 I Re: Lot #15 Brookview Estates Dear Mike: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: If new plans satisfactorily>addressing all the following issues are submitted to the Health Department by 7/ 7 , then approval for the plans should be given by C,4" Only two (2) copies of plans submitted. 4,-127 No signature. (00. Benchmark more than 75 feet from system. (310 CMR 15.220(q)) i v.4. No perc elevations. L-,5:- Manhole to be within 6 inches of final grade. 4,,&, Reserve not 4 feet from primary. �, . Vent missing. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S. Health Administrator SS/cjp i Town of North Andover of SNo 0 e,tioo OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES A 146 Main Street . o North Andover, Massachusetts 01845 �,'p�4,r.o.P•`�h WILLIAM J. SCOTT 9SSACHU Director July 8, 1997 Mike Rosati Marchionda & Associates 62 Montvale Ave., Suite 1 , Stoneham, MA 02180 RE: Brookview Circle Dear Mike: This letter is to inform you that the proposed septic plans for Lots 14 and 15 Brookview Circle have been approved. If you have any questions, please do not hesitate to call the Board of Health office at the number below. !r` Sincerely, X Sandra Starr, R.S. Health Administrator A cc: Wm. Scott, Dir. CD&S File Dave Kindred BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i - - - - -- - --..- .-- --- - it SEPTIC PLAN SUBMITTALS LOCATION: e� c� / S '`6z� ✓7e. w �;�c NEW PLANS: YES 560.00/Plan REVISED PLANS: YES 525.00/Plan y DATE: �� 4 7 DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary Town of North Andovert 40RTH , OFFICE OF 3�o�t«ao e.ti00t COMMUNITY DEVELOPMENT AND SERVICES ° . A 30 School Street North Andover,Massachusetts 01845 •'`cy WILLIAM J.SCOTT 9SSACMUS�t Director June 23, 1997 Mr. Mike Rosati Marchionda& Associates 62 Montvale Ave., Suite#1 Stoneham, MA 02180 Re: Lot #15 Brookview Estates Dear Mike: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: If new plans satisfactorily addressing all the following issues are submitted to the Health Department by July 7, 1997, then approval for the plans should be given by July 16, 1997. 1. Only two (2) copies of plans submitted. 2. No signature. 3. Benchmark more than 75 feet from system. (3 10 CMR 15.220(q)) 4. No perc elevations. 5. Manhole to be within 6 inches of final grade. 6. Reserve not 4 feet from primary. 7. Vent missing. If you have any questions, please do not hesitate to call the Board of Health Office at the , number below. Sincerely, QJ6 Sandra Starr, R.S. Health Administrator SS/cjp CONSERVATION 6RR-9530 HEALTH 688-9540 PLANNING 688-9335