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Miscellaneous - 730 WINTER STREET 4/30/2018 (2)
LAW B 12682 Pg146 #26482 vg' I OL ,K50L.0- 1, A�0' 4— QUIT CLAIM DEED Deutsche Bank National Trust Company, as Trustee of the lndyMae INDX Mortgage Loan Trust 2004,1 K Mortpgo Pass -Through Csrtfcaies, Sarkis 2D04 -ARS under tM Pooling and Servicing Agreement dated August 1. 2004„ having a rnaftq address of 1761 E. St. Andrew Place, Sams Ana CA 9270.5 the full consideration paid In the amount of M HUNDRED NINETY EIGHT THOUSAND FIVE HUNDRED DOU.ARS AND 00 CENTS ($298,540.00) grants to Willem E f9orftN as trustee for Diamond Resity Trio% , It* land with bull its thereon situated in North Artdaaer Massachwatta and commonly k wm as 730 Winter Street SAID PROPERTY BEING MORE PARTICULARLY IN EXHIEff "A" ATTACHED NERETb ANb INCORPORATED BY REFERENCE vft Qurr CU►lM COVENANTS The transfer of the w(thtn real estate does not constitute all or substantially all of the assets of the grantor. BEING the same premises convayed to the grantor by foreclosure deed recorded in the Essex North Registry of Deeds in Book 42454 Page 311 VIItT>,IESS the execution and the corporate sesl of said owWradon this day of October 2011 Deutsche Bank National Trust Company, as Trustee of the lndyMaa INOX Mortgage Loan Trust 2004 A ,M )"Gag 3 Pass -Through Certficates, Series 5 under ftPoolf V snd Servidrrg. &fid,gled AugM 1 its Attorney I k B�Wed m AVPfltEOU sTAM Or TEXAS Covr,ty of TRAVIS on OCT 27 2011 before me, . $11FOINTILVERTON personally appeared personally. known to me {or prove to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed* .to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, ex d the instrument. •'r'�. STEPNENYELVERTON Notary Public, State of Texas WITNESS and and off ial seal. _ : i _ MV Commission Exp+res Auqu3124.2013 OTARY PU ATURE NOTARY PUBLIC SEAL CHAPTER fm SEC. E AS AN NOM SY CrtOPM 407 OF 1M £vwY deed l��+eed for haaar0 a1M1 oprhpin or thaw eedoheed upon tt Mk � namhe. nrmdenq! end paiP oAlOe aadhw at dhe granbe and s mokaf ea the &mom of Lha the oorol0ehadon 1twea kit daAts orthe rah" of tht atlMrowdowabn 1wobr, !fed dairared W a Spsdtk mwmfery Sum. The M oon4de1Vfim Shea mean the Loom P dae for the aomayaoee mON4 dedudbn for any lane a anaurtbrMM *WAY" by the pnn1M or mrdk p ftmon. At such a dor www and ar bW stall be:KWded as part of trhe deed. Faeurs to mrmply wAth Utr eeedah that not .(tact tM hmiidey ar sny deed. Na ngleoer c dSede Sher Sooept a tract hetor�rh¢ urhlees k is in comprichos w71A rhe roWfnruahntS of t►hb Serda► L`' 3 33 , 0o$9 ,. . EXHIBITA Bk 12682 Pg147 #26482 The land In North Andover, Essex County, Massachusetts, Shown as Lot 1 on a.plan of land entitled "Corrective Plan of Land located in North Andover, Massachusetts, -prepared for North Andover Associates, Scale: Y:40', Date: March 23,1977. which said plan is recorded in Essex North District Registry of Deeds as Plan No. 7588 sold lot being more particularly bounded and described on sold plan as follows: WESTERLY by Winter Street;, one hundred fifty and 00/100 (150.00) feet; NORTHERLY by land now or formerly of James H. and Glady B. Chase, three hundred fifty-eight and 62/100 (358.62 feet, EASTERLY by Lot 56 on said pian one hundred forty seven and 45/100 (147.45) feet, SOUTHERLY by Lot 2 on said plan two hundred seventy-five and 53/100 (27553) feet. Containing 43,576 square feet more or less, and being a portion of the land conveyed to Winter Hill Fa rms Inc, by deed of Haymeadow Fars Inc. recorded In said Registry in Book 1346 Page 46. Said premises are conveyed subject to and with the benefit of any and all easements, restrictions, reservations and conditlons of record, if any, Insofa r as the some are now In force. Bk 12682 P9145 #26482 11--02--2011 al 032430 hAS5AMSETTS STATE EXCISE TAX Essex Nwth Resistra ABOVE FOR REGISTY OF DEEDS U NDoc# s 2 6482 COVER SHEET Fee: $1461.16 cons! $298480.06 THIS IS THE FIRST PAGE OF THIS DOCUMENT D5"swf '0/*fv`` f --7W DO NOT Ri, EM_ OVE 6*4MA (, AS'r&W of YWC �,40K ra AAwr rb arl.,W�sr yooy-S .qac' GRANTOR GRANTEE ADDRESS OF PROPERTY MLC 'DEED MORTGAGE DISCHARGE J 4 0 y 1 CITY/TOWN ASSIGNMENT TYPE 6D NOTICE TYPE SUBORDINATION AFFIDAVIT CERT TYPE DEC OF HOMESTEAD. UCC TYPE ,_____DEC OF TRUST f6 -OTHERl A� S s.r TrtE DESCRIBE ESSEX NORTH REGISTRY OF DEEDS Robert F. Kelley, Register 354 Merrimack St. Suite* 304 Lawrence, MA 01843 (978) 683-2745 www.lawrencedeeds.com North Andover Board of Assessors Public Access ; E ,10RTF1 is �.,�, ..... • oc • oma• s {� SACHUSF Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 roperty Record Card Parcel ID :210/104.A-0089-0000.0 FY:2011 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO Location: 730 WINTER STREET Owner Name: COLLUPY, CLAYTON W BARBARA M COLLUPY Owner Address: 730 WINTER STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6 - 6 Land Area: 1.01 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2604 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 458,300 478,400 Building Value: 251,300 271,400 Land Value: 207,000 207,000 Market Land Value: 207,000 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkId=1706831 &town=NandoverPubAcc 9/12/2011 OO N N N N o0XIt U Gj W J (6 d N m ❑ (gyp OCL N0fC6yN C yNC00 C. 2ul0_C O c � IL N c o LL o N J CL=c W C in W 'D 0 n i @ U .., 3 � Cc 0 � H � U) C W H Z_ r M LSA r c0 0 M cc � U � ❑ E a)W O ca a) O U� ma0 U c� Q W U C o M � n . Q o o O�0%-z 0 d ai ai � C LL❑moi = -p OO (Da)a)NO tp O a) (nto U) c) 0 w O J M r I -'N r O :ai v; mQ m O (N6 a C m V U ii _3 E a Ncx006 X G Z) H f- H W 77CL Q O Z oO O H OQ d o � x QLL 3 a 4 Z O J LU r W �O W. LL N Q 022 WZ a >:IL � a J� m ..Z_ W LJW 0 lk c0Q SMC Q 3Um�L•2 CL O Q i • i 00 00 00 N N O O N N U r +; 3°' 22 i00 00 Y' 00 4 N N 3 O , Z� � � 2Z �O mor o0 W O N Q cLL Zoo , M Z Z r r O 0 LO p .. L coo Z LOr 0 .. r ?LU o J c� tT � Q -a r - W ; Q U 0 > mm N p 4)(nQ 0000 # W Z Cl) � m 000 aD aD �v Z w Q r r 3 0 CL M U FdOf O p co H O m 0) a = Z N—N U a co 0 0 w M M N N N a7 O 7 N (a Q a (9 ZT (0 a3 R > 2> > c g �Lt N U) Q a (.)y Ix2c Qiw m 1)0 �MLi IN 00 IN O (coo v m w 40 M N to N 0 Q N a-1 r r N r r LL M r{ N Q ai ai w ca M 0 CQa �Q �= O Ea m LL LL C LLQ C m '= O"Ou O LL ai@0 W U �a-0co �a �❑Q❑.F- WU�� «+ «+ LL LL WGo wvNr W W 0oF-F- ao co V:X W M LL iii U U) L6 U. AiIi m N r1 oia =dp.�_. °O as C�0 2 W C FO-mli2WMYW mmQ O N UN=LL U 20rz o� HoCL _ C o F- F- cum F- O O (6 O C M0OfW'2UmU-U-0 Mailing: 237 Merrimac St., Newburyport, Ma 01950 Phone: 978-360-9358 Fax: 978-372-9970 Email: ciablonski@yahoo.com Operation aub Aaintenance agreement April 9, 2014 To: North Andover Health Department Essex County Registry of Deeds Alternative System Owner for 730 Winter St., North Andover, Ma Address: 730 Winter St. North Andover, Ma 01845 This contract is an agreement between the current property owner of 730 Winter St. in North Andover, Massachusetts and the North Andover Health Department stating that the alternative septic system,to be installed shall be inspected annually. The inspector must be a licensed Massachusetts Title V Inspector and certified by Enviro-Septic (Presby) to perform the inspection. The inspection will require a full Title V inspection including the septic tank distribution box, and inspection port. The inspection is the responsibility of the home owner as written in the deed. This contract expires April 8, 2015 and must be renewed annually. 1-//9/„14 itle V Inspector All 14 $r -'g” v' - ✓'' Current Oroperty Owner (Print) L15' -1 `j SI Number C9Rnt Propejty Owner (S i rt-and--D'df e) Notice of Alternative Sewage Disposal System M.G.L. c. 21A, § 13 and 310 CMR 15.0287(10) This Notice to be recorded and/or filed for registration in the chain of title of the Property served by an Alternative ewage Disposal System ("Alternative System").] NAME(S) OF OWNER OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: ADDRESS OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: TITLE REFERENCE FOR PROPERTY SERVED BY ALTERNATIVE SYSTEM [check and complete each that applies]: Deed recorded with the e7e SS r. Registry of Deeds in Book 1316_9, Page _ Certificate of Title No. issued by the Land Registration Office of the Source of title other than by deed 2� -1 [If Alternative System Owner(s) is other than Property Owner(s), complete the following:] Alternative System Owner Name: Alternative System Owner Address: Registry District WHEREAS, Section 15.280 of Title 5 of the State Environmental Code ("Approval of Alternative Systems"), provides for the Massachusetts Department of Environmental Protection (the "Department") to approve or certify, as appropriate, all proposals to construct, upgrade or replace on-site sewage disposal systems using alternative systems; WHEREAS, owners and/or operators of approved or certified alternative systems are subject to general conditions, as specified in Section 15.287 of Title 5 of the State Environmental Code, 310 CMR 15.287, and maybe subject to specialconditions, as specified in the Department's approvals or certifications; such general and special conditions potentially including, without limitation, requirements relating to the use of trained operators, periodic inspections, maintenance, sampling, reporting and/or recordkecping; WHEREAS, Section 15.287(10) of Title 5 of the State Environmental Code, 310 CMR 15.287(10), requires that "prior to obtaining a Certificate of Compliance for installation of a new or upgraded system, the system owner shall record in the chain of title for the property served by the alternative system in the Registry of Deeds and/or Land Registration Office, as applicable, a Notice disclosing both the existence of the alternative on-site system and the Department's approval of the system. The system owner shall also provide evidence of such recording to the local Approving Authority [;]" and WHEREAS, the Property is served by an alternative sewage disposal system. NOW, THEREFORE, Notice of an alternative sewage disposal system is hereby given for the above -referenced Property, as follows: 1. Existence. An alternative system has been installed as a new or upgraded alternative sewage disposal system, on or adjacent to the Property, and serves the Property. The trade name and model number(s) of the alternative system are as follows: Trade name of technology: CAI V 120 t; 4zlpr C_ Manufacturer Name: 'PCyr:53` j L' -"''V [ 2-© ^^ E'''T Abz'r I Model number(s): Page 1 of 2 IT. 2. Approval/Certification. On 312rj I t Z [date], the Department, pursuant to its authority under the section of Title 5 as spe ified below, approved or certified the technology used in the above - referenced alternative system, under MassDEP Transmittal Number `` -I L- 05 lk [Transmittal Number of approval or certification]. [Check one of the following, as applicable:] Approved for remedial use under 310 CMR 15.284 -Approved for piloting under 310 CMR 15.285 Provisionally approved under 310 CMR 15.286 Certified for general use under 310 CMR 15.288 A copy of the Department's Approval/Certification is available from the Department in person or on- line at the Department's website: http://www.mass. og v/dep . WITNESS the execution hereof under seal this day of , 20 , made by the above-named Alternative System Owner(s). [Alternative S stem O� er(s)] Print Name(s . t3V�� COMMONWEALTH OF MASSACHUSETTS LCbCX , ss On this day of i� ` , 20 4before me, the undersigned notary public, personally appeared c" (name of document signer), proved to me through satisfactory evidence of identification, which were Q Pf , to be the person whose name is r attached document, and acknowledged to me that (he) (she) signed it vOIIHMA [� K stated urpose. Notary Public Commonwealth of Massachusetts (offici 1 signatu#e nd seal otary) L"MKy Commission Expires July 3, 2020 ------------------------------------------------------------------------- -- [Complete the following Property owner(s) Consent if Alternative System Owner(s) is other than the Property Owner(s):] CONSENTED TO: [Property Owner(s)] Print Name(s): _ Date: COMMONWEALTH OF MASSACHUSETTS ss On this day of , 20_, before me, the undersigned notary public, personally appeared (name of document signer), proved to me through satisfactory evidence of identification, which were , to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he) (she) signed it voluntarily for its stated purpose. (official signature and seal of notary) Upon recording, return to: [Name and address of Property Owner(s)] Page 2 of 2 Owner's Certification for 730 Winter St., North Andover, Mass. I, 3t/-1 n V-0 sn , the Owner of record of 730 Winter St., North Andover, Mass., her by certify to the following: have been provided a copy of the Title 5 UA technology Approval, the Owner's Manual, and the Operation and Maintenance Manual for the Presby Enviro-Septic Wastewater Treatment System, and I agree to comply with all terms and conditions; ii. for Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5); iii. the design does not provide for the use of garbage grinders, the restriction is understood and accepted; and iv. whether or not covered by a warranty, I understand the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.383 Signed Date N W Q �L W ti � M ZZZ ° c o _J L CL {{. Lij WZ a1 z -� L 00 ., >CLLU Z C w LL! 4 w V •� n .�. +J tj LV t h � ) gy p, OF NORT/� q�L EF1 (L�E C 0 PY m * t.9 ��SSACH1Js��� PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 7/8/2014 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Repair and Construction of an On -Site Sewage Disposal System By: Chad Jablonski At: 730 Winter Street Map 104.A Lot 0089 North Andover, MA 01845 The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. 4 A VA, 4 W, t. C� Curt Bellavance Director, Community Development 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com x North Andover Health Department (ommunity Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 730 Winter St. MAP: 104A LOT: 89 INSTALLER: Chad Jablonski DESIGNER: Atlantic Engineering & Survey Consultants PLAN DATE: 3/6/12 BOH APPROVAL DATE ON PLAN: 4/2/12 INSPECTIONS s TANK INSPECTION: 4/24/14 DATE OF BED BOTTOM INSPECTION: 4/24/14 DATE OF FINAL CONSTRUCTION INSPECTION: 4/24/14 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Contractor will check with designer about not having inspection port go down to the water table. SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ® Cleanouts per plan ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-20 loading ® Monolithic tank construction ® Water tightness of tank has been achieved by visual testing r Comments: DISTRIBUTION -BOX ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (gas baffle) ® 24" inch cover to within 6" of finish grade installed over one access port ® Neoprene boots ® Installed on stable stone base ® H-20 D -Box N/A Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets N/A Observed even distribution N/A Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: Only one outlet from D -box because Presby system. SOIL ABSORPTION SYSTEM (General) ® Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan N/A 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Presby) ® Presby Enviro-Septic ® 40 Linear Feet/row ® Number of rows (trenches): 5 r FINAL GRADE Loamed Seeded Cover per plan Comments: DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer K2 As -Built Plan BM = 140.97 HR = 2.01 HI = 142.98 SYSTEM ELEVATIONS ROD ELEVATION AS -BLT INVERT ELEV DESIGN INVERT ELEV Benchmark Building Sewer OUT 3.64 138.99 138.77 Septic Tank IN 4.14 138.49 138.39 Septic Tank OUT 4.32 138.31 138.14 Distribution Box IN 4.48 138.15 138.04 Distribution Box OUT 4.69 137.94 137.87 Presby Pipe 1 TOP 4.77 138.21 138.12 Lateral 1 INVERT 137.79 137.70 Presby Pipe 2 TOP 4.77 138.21 Lateral 2 INVERT 137.79 137.70 Presby Pipe 3 TOP 4.77 138.21 Lateral 3 INVERT 137.79 137.70 Presby Pipe 4 TOP 4.77 138.21 Lateral 4 INVERT 137.79 137.70 Presby Pipe 5 TOP 4.77 138.21 Lateral 5 INVERT 137.79 137.70 resb Top of Presby[- 138.21 138.12 Bottom of Bed/Presbyl 137.21 137.12 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback ® Wetlands bordering surface water supply or trib. (in Watershed) Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- ® Waterline 10 10 101 ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 50 56 ® Wetlands bordering surface Suction line 222(2) z 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other) Foundation 10 (5) 20 (10) ® Drywells 20 25 Suction line 222(2) z 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws M Commonwealth of Massachusetts RECEIVED City/Town of ° Certificate of Compliance JUL 08 2014 Form 3 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 the local Board of Health to determine the form they use. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. F -- This is to Certify that the following work on an On -Site Sewage Disposal System El Construction of a new system ® Repair or replacement of an existing system ❑ Repair or replacement of an existing system component Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): DSCP Number AMY BRENNAN - Facility Owner 730 WINTER STREET Street Address or Lot # NORTH ANDOVER City/Town Designer Information: GEORGEZAWBOURAS Name c � Signat e Ins er Informat� Chad Jablonald / Name DSCP Date MA State 01845 Zip Code ATLANTIC ENGINEERING INC. Name of Company 6/10/2014 Date 5. Name of Company 6/10/2014 Signgture Date Use of thisste is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc- 06/03 Certificate of Compliance - Page .1 of 1 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. rah Commonwealth of Massachusetts City/Town of Certificate of Compliance Form 3 RECEIVED JUN 1 '12014 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 the local Board of Health to determine the form they use. This is to Certify that the following work on an On -Site Sewage Disposal System ❑ Construction of a new system ® Repair or replacement of an existing system ❑ Repair or replacement of an existing system component Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): DSCP Number DSCP Date AMY BRENNAN Facility Owner 730 WINTER STREET Street Address or Lot # NORTH ANDOVER MA 01845 City/Town State Zip Code Designer Information: GEORGE Z44BOURAS Name 1/ n // Sigzler /X� Insnformation: ATLANTIC ENGINEERING INC. Name of Company 6/10/2014 Date Name Name of Company Signature Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc• 06/03 Certificate of Compliance • Page 1 of 1 Town of North Andover — Septic Sy tem - AS -BUILT CHECKLIST 1) '-'-All changes to the design plan have been reflected on the as -built 2) J.,-" Is of suitable scale; (one inch = 40 feet or fewer for plot plans and one inch = 20 or fewer for details of system components) 3) number, Street Name, Assessors Map and Parcel Number 4) _L,—I t Lines and Location of Dwellings served by the system 5) _6zLocations, Elevations and Dimensions of system, includin e e (if applicable) 6) Ties to dwelling or Permanent Structure & Wells a. From Septic Tank & Distribution (D) Box b. From Leach Area 7) �/ ies to Lot Lines from leach area 8) ✓ Locations of Deep Holes & Peres 9) _zTop of Foundation Elevation 10)cations of Wells, Drains, Watercourses within 150 feet of system 11) _;Location of water, gas, electric lines, cable 12) Location of Structures within 6 Inches of Finished Grade 13) V Original Stamp & Signature 14) cation and holder of any easements which could impact the system 15) Impervious Areas; Driveways, etc 16) North Arrow I� ILocation & Elevations of Benchmark used 18)TATEMENT PLAN (NA 5.3) a. ' "I certify the locations, elevations, ties, cover material; exposed component covers etc., shown on this as -built substantially agree with the approved plan and have determined that the break out elevations, if applicable, have been met." Si .2 tore of Designer Date b `If a STUCTURAL WALL IS PRESENT (NA 4.9) a Letter or statement on the as -built indicating the wall was, or was not, constructed in accordance with the intended design and anvmanufacturer's specifications." Signature of Designer Date As of: Friday, April 29, 2011 IC Commonwealth of Massachusetts City/Town of a & Certificate of Compliance ^M Form 3 RECEIVED JUN 112014 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc- 06/03 Certificate of Compliance - Page 1 of 1 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. This is to Certify that the following work on an On -Site Sewage Disposal System Important: When filling out ❑ Construction of a new system forms on the ® Repair or replacement of an existing system computer, use ❑ Repair or replacement of an existing system component only the tab key to move your cursor - do not Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): use the return key. DSCP Number DSCP Date AMY BRENNAN Facility Owner 730 WINTER STREET Street Address or Lot # NORTH ANDOVER MA 01845 Cityrrown State Zip Code Designer Information: GEORGE BOURAS ATLANTIC ENGINEERING INC. Name Name of Company 6/10/2014 Sig ture Date In ler Information: Name Name of Company Signature Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc- 06/03 Certificate of Compliance - Page 1 of 1 TO: FROM: NORTH ANDOVER, MASS BOARD OF HEALTH DESIGN ENGINEER 5`Z/ 19 7P Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at 7— 1V'7—.L,e 5 T North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated 19 I�— itarian -Y r TOWN OF NORTH ANDOVER NORTH ANDOVER, MASSACHUSE17S 01845 gytk yyr.C.b toy Ott} o ATIV PermitNuml Date Issued Expiration D Jackie's Law — Permit Application Pursuant to G.L. e. 82A 1 and 520 CMR 7.00 et seq.(as amended) THIS PERMIT MUST BE FULLY COMPLETED PRIOR TO CONSIDERATION NatneofApplicant -T-W. C-)e(.V(-Ajjnj Phone Cell Street Address 1 Ayd'20'co 9 3 q 2 -Cort Ll 2-1 T City/ own M ZIP 0 111 v-1 FN—ome of Excavator (if different front applicant) Phone Cell Street Address Cityrrown MA ZI Name of Owner(s) of Property iPhone Cell W)aIkAi 15tNIVi!Ftl TA( q70 4 5S 713 Street Address -7 e S�-r4e-t t City; i'olvn MA ZIP N-And,oVev o i8Li5 Permit Fee Received No Other Contact Description, location and purpose of proposed trench: Please describe the exact location of the proposed trench and its purpose (include a description of what N (or, is intended) to be laid in proposed trench (eg; pipes/cable lines etc..) Please'use reverse side if additional space is needed. -7 All'-, h' T fV 40 /-0 //C Insurance Certificate LP 39q 77/ CONDITIONS AND REQVIREMENTS PURSUANTTO G,LC82A AND $10 CMR 7,00 el seq. (as amended) By signing the application, the applicant understands and agrees to complywith the following: No trench may be excavated unless the requirement, of sections 40 through 400 of chapter 82, and any accompanying regulations, have been met and this permit is invalid unless and until said requirements have been cornpliedwith by the excavator applying for the permit including, but not limited to, the eslablishruent of a valid excavation number with the underground plant damage prevention system as said system is defined in section 76D of chapter 164 (DIG SAFE); Trenches may pose a significant hc�lth and safety hazard. Pursuant to Section I of Chapter 82 of the General Laws, an excavator shall not leave any open trench unattended without first making every reasonable effort to eliminate any recognized safety ha7ard that may exist as a result of leaving said open trench unattended. Excavators should consult regulations promulgated by the Department of Public Safety in order to familiarize themselves with the recognized safety hazards associated mith excavations and open trenches and the procedures required or recommended by said department in order to make every reasonable effort to eliminate said safety bazards which may include covering, barricading or otherwise protecting open trenches from accidental entry. persons engaging in any in any trenching operation shall familiarize themselves with the federal safety standards promulgated by the Occupational Saf.-ty And Health Administration on excavations: 29 CFR 1920 650 et.seq, entitled Subpart P "Excavations,". iv, M1 Excavators engaging in any trenching operation who utilize hoisting or other mechanical equipment subject to chapter 146 shall only employ individuals licensed to operate said equipment by the DWment of Public Safety pursuant to said chapter and this permit must be presented to said licensed operator before any excavation is commenced; day applying for, accepting and signing this permit. the applicant hereby attests to the, fbllowlslg. (1) that they have read and understands the -regulations promulgated by the Department of Public Safety with regard to construction related excavations and trench safety; (2) that fie ham read and understands the federal safety standards promulgated by the Occupational Safety and Health Adiniiiistration on excavations: 1.9 CMIR 1926,650 et-seq., entitled Subpart P "Excavations" as well as any other excavation requirements established by this municipality; and (3) that he is aware of and has, with regard to the proposed trench excavation on private property or proposed excavation of a city or town public way that forms the basis of the permit application, complied with the requimments of sections 40- 40D of chapter 82A. This permit shall be posted in plain view on the site of the trench. For additional information please visit the Department of Public Safety's website at www.mgs;MYJ140 Name and Contact Information of Inmirer'. PCA kN 0"n C.Q_ 1(0 i—c.. Qjj�_u Policv Fxniration Date: FlTi E Dig Safe 4: Name of Competent Person (as defined by 520 CMR 7.02)- na ky'( Massachusetts Hoisting License # License Grade: Date- '5N) I -� BY SIGNING THIS FORM, THE APPLICANT, OWNER, AND EXCAVATOR ALL ACKNOWLEDGE AND CERTIFY THAT THEY ARE FAMILIAR WITH, OR, BEFORE COMA NIENC_EAMENT OF THE WORK, WILL BECOME FAMILIAR WITH, ALL LAWS AND REGULATIONS APPLICABLE TO WORK PROPOSED, INCLUDING OSHA REGULATIONS, G.L. c. 82A, 520 CMR 7.00 et seq., AND ANY APPLICABLE MUNICIPAL ORDINANCES, BY-LAWS AND REGULATIONS AND THEY COVENANT AND AGREE THAI' ALL WORK DONE UNDER THE PERMIT ISSUED FOR SUCH WORK WILL COIMPLY THEREWITH IN ALL RESPECTS AND WITH THE CONDITIONS SET ]FORTH BELOW. THE UNDERSIGNED OWNER AUTHORIZES THE APPLICANT TO APPLY FOR THE PERMIT AND THE EXCAVATOR TO UNDERTAKE SUCH WORK ON THE PROPERTY OF THE OWNER, AND ALSO, FOR THE DURATION OF CONSTRUCTION, AUTHORIZES PERSON'S DULY APPOINTED BY THE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR AND INSPECT THE WORK FOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND REGULATIONS GOVERING SUCTI WORK. THE UNDERSIGNED APPLICANi F, OWNFR AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO REIMBURSE THE MUNICIPALITY FOR ANY AND ALL COST'S AND EXPENSES INCURRED BY THE IMUNICIPALITY IN CONNECTION WFrHTHIS PERMIT AND THE WORK CONDUCTED THEREUNDER, INCLUDING BUT NOT LIMITED TO ENFORCING THE REQUIREMENTS OF STATE LAW :AND CONDITIONS OF THIS PERMIT, INSPECTIONS MADE TO ASSURE COMPLIANCE THERLWITH, AND MEASURES TAKEN BYTHE MUNICIPALITY TO PROTVCTTIIL'p_UlBLIC WHERE THE APPLICANT OWNER OR EXCAVATOR HAS FAILED TO COMPLY THEREWITH INCLUDING POLICE DETAILS AND OTHER REMEDIAL MEASURES DEEMED NECESSARY BY THE MUNICIPALITY. THE UNDERSIGNED APPLICANT, OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO DEFEND, INDEMNIFY, AND HOLD HARMLESS THE MUNICIPALITY AND ALL OF ITS AGENTS AND EMPLOYEES FROM ANY AND ALL LIABILITY, CAUSES OR ACTION, COSTS, AND EXPENSES RESULTING FROM OR ARISING OUT OF ANY INJURY, DEATH, IA)SS, OR DAMAGE TO ANY PERSON OR PROPERTY DURING THE WORK CONDUCTED UNIDER THIS PC RMIT, APPLICANT SIGNATURE DATE EXCAVATOR SIGNATURE (IF DIFFERENT) DATE OWNER'S SIGNATURE (IF DIFFER E NT) DATE: Nage Bk 13350 Pg297 #4754 02-19-2013 @ 12:15p Quitclaim Deed I, Patrick J. Enright, trustee of Diamond Realty Trust, uldlt November 2, 2011 of Lowell, Middlesex County, Massachusetts in consideration of One Dollar and no/Dollars ($1.00) GRANT TO The Amy E. Brennan Revocable Trust of 2012 u/d/t �2 y - 2(ob of 8 Purington Lane, Hampton, Rockingham County, New Hampshire With QUITCL41M COVENANTS Lot 1 on a plan of land entitled "Corrective Plan of Land located in North Andover, Massachusetts, prepared for North Andover Associates, Scale: 1 "=40', Date: March 23,1977" which said plan is recorded in Essex North Registry of Deeds as Plan No. 7588, said lot being more particularly bounded and described on said plan as follows: Westerly by Winter Street, one hundred fifty and 001100 (150.00) feet; Northerly by land now or formerly of James H. Glady B. Chase, three hundred fifty-eight and 621100 (358.62) feet; Easterly by Lot 56 on said plan one hundred forty seven and 451100 (147.55) feet; Southerly by Lot 2 on said plan two hundred seventy-five and 531100 (275.53) feet Being a portion of the land conveyed to Winter Hill Farms, Inc. by deed of Hayrneadow Farms, Inc. recorded in said Registry in Book 1346, Page 46. For title reference see deed dated October 27, 2011 recorded with Essex North District Registry of Deeds at Book 12682, Page 145. MASSACHUSETTS STATE EXCISE TAX Essex North Registry Date: 02-19-2013 @ 12:15pm Ctl#: 134 Doc#: 4754 Fee: $.00 Cons: $1.00 FA Bk 13350 Pg298 #4754 sealed instrument this day, o1 Y 2013. Trustee STATE OF NEW HAWSHIRE County of N E �/,S &39L, SS. Onday of Febrvar 2013; before me, the undersigned notary public, personally appeared the above-named Patrick J. Enright, Trustee of Diamond Realty Trust, u/d/t November 2, 2011 and proved to me through satisfactory evidence of iden0cation, to be the person whose name is signed on this document, and acknowledged to me that he/she signed it voluntazily for its stated purpose and that the foregoing instrument is his/her free act and deed. , ,- •, Public- 7 ublic: " o0WAS" e SEs 11dytommission Expires: `s MW 24.2015 M. PAUL IANNUCCILLO, REGISTER ESSEX NORTH REGISTRY OF DEEDS E -RECORDED Commonwealth of Massachusetts Map -Block -Lot 104.A0089 BOARD OF HEALTH ---------- ------------ Permit No North Andover - BHP -2014-0492 - --------------------- FEE $250.00 DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Chad Aablonski to (Construct) an Individual Sewage Disposal System. at No 730 WINTER STREET--------------------------------------------- --------------------------------- --- - -- - - ------ --------------------------- - - as shown on the application for Disposal Works Construction Permit No. BHP -2014-049 Dated �- -- - �J----------- ------------ --R.' --__ti= - ------------------- Printed On: Apr -02-2014 Commonwealth of Massachusetts Map -Block -Lot 104.A0089 BOARD OF HEALTH -- -------------------- Permit No North Andover BHP -2014-0492 ----------------------- FEE Nqmw $250.00 DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Chad Aablonski to (Construct) an Individual Sewage Disposal System. at No 730 WINTER STREET -------------------------------------------------------------------------------------- --- - - ---------------------- as shown on the application for Disposal Works Construction Permit No. BHP -2014-049 Dated �'I �• 1 Printed On: Apr-02-2014 ---------------------------------- 4,aRT, Application for Septic Disposal System ^? ,Construction Permit - TOWN OF -�c + ORTH ANDOVER, MA 01845 3�SS+11CM35 S Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. nrm Application is hereby made fora permit to: onstruct a new on-site sewage disposal system* ❑ Repair or replace an existing on-site sewage disposal system* ❑ Repair or replace an existing system component – What? A. Facility Information Address or Lot # I/ /z /Ze ) �T_ TODAY'S DATIt � $ 250.00 – Full Repai 5. - omponent /✓ . 4 w ;�,y City/Town 2.- *TYPE OF SEPTIC SYSTEM*: ❑ Pump ❑ Gravity (choose one) APR J 2 2014 ***If pump system, attach copy of electrical permit to application ❑ Conventional System (pipe and stone system) !I TOWN OF NCRTH ANDOVER ! HEALTH DEPARTMENT ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to instali`thi§ type of system. — ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. Owner Information Name :'Qr"$ Address (if different from above) Iv _ 44•rJ—,. -'*-.0 V City/Town State Telephone Number d)to, Li,!!s Zip Code 3. Installer Information A w3 c_. tn6 S -C' Sy:vL FSC, Name Name of Company ( ?r 7 . -2. tit- L2 ..J tA,tl I - Address �A'c'. i L -L' City/Town . q7�- ek 4. Designer Information Name ,M--1 0 (937:1 - State Zip Code 4 Telephone Number (Cell Phone # if possible Blease) —7e -f-, qac, c_0 r-1 '�oI'J�- C -j ?,a X/ L 4VtiJ A• -r L_ o.. v -r , C- r rV C Address � .� City/Town Name of Company State ot:?,32?, Zip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit - Page 1 of 2 - r ` ({ OE ORthORTN wp Application for Septic Disposal System it •`:°- y "'`;' °c Construction Permit - TOWN OF *°•'•° + ORTH ANDOVER. MA 01845 PAGE 2 OF 2 A. Facility Information continued.... 5. Type of Building: residential Dwelling or ❑Commercial B. Agreement ul'?-j-Z.t TODAY'S DATE $ 250.00 - Full Repair $125.00 - Component The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North dover, not to place the system in operation until a Certificate of Compliance has be iss th" oard of Health. q / Zr'2orill Name Date Applicati¢n Approved By: (Board of Health Representative) Name Date Application Disapproved for the following reasons: For Office Use Only: 1. Fee Attached? Yes No 2. Project Manager Obligation Form Attached? Yes No 3. Pump System? Ifso, Attach copy oiElectrical Permit Yes No 4. Foundation As -Built? (new construction ronly): Yes No (Same scale as approved plan) 5. Floor Plans? (new construction only): Yes No Application for Disposal System Construction Permit • Page 2 of 2 r, SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: ---730 co %N'i �-2 5-T (Address of septic system) Relative to the application of C u A7, �i Sip 13t-4 aS I (Installer's name) Dated Zti �Iroclay's ate For plans by (Engineer) And dated With revisions dated I understand the following obligations for management of this project: 2. 3. 4 6. (Original ate (Last revised date) As the installer, I am obligated to obtain all permits and Board of Health approved plansrp for to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. As the installer, I must call for any and all inspections. If homeowner, contractor, project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against me and/or my company a. Bottom of Bed - Generally, this is the first (1'� inspection unless there is a retaining wall, which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection - Engineer must first do their inspection for elevations, ties, etc. As -built of verbal OK (or e-mail to: healthdept@townofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade - Installer must request inspection when all grading is complete. Installer does not have to be on-site. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. • ;� -»,r, -,- �.,,, As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. �;Ni7' 9 22014 b. Inspection o the sand and stone to be used. p f TOWN or n L;,-< I h AN0QVER i c. Final inspection by Board of Health staff or consultant. HEALTH DEPART,;ZNT d. Installation of tank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other " components. As the installer, I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. -.7 Undersigned Licensed Septic Installer: (Name - Punt 14 t TOW:,V OF NORTH ANDOVER po1+7H Y A Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 ;° ��•,.*'' NORTH ANDOVER, �v1ASSACHUSETTS 01£45 �" $,CKus`�g 978.688.9540 - Phone Susan Y. Sawyer, REIISlRS 978.688.8476- FAX Pubtic Health Director E-MAIL: healtl�trartownofna-thandover.coni WEBSITE: httn:/s www.tox%,nofnortllandover.coni SEPTIC PLAN SUBMITTAL FORM Date of Submission: February 14, 2012 Site Location: 730 Winter Street, Andover Engineer: George Zambouras - Atlantic Engineering New Plans? Yesx review only) RECEIVED 4 2012 TOWN 'OF NORTH ANDOVER $225/Plan Check # (includes V submission and one re- v Revised PIans?Yes $75/Plan Check # Site Evaluation Farms Included? Yes X Local Upgrade Form Included? Yes X Telephone #: 978-352-7870 E-mail: atlantic84@CS.com Homeowner Name: Diamond Realty Trust, William Bonnell OFFICE USE ONLY V1r No Fax #: 978-352-9940 When the submission is complete (including check): > Date stamp plans and letter > (� Complete and attach Receipt > y, Copy File; Forward to Consultant > Enter on Log Sheet and Database l -d 0V66-Z9`✓-9L6-� eaoldaid ue91100 d6Z40 Z6 -VI qac delleC"hiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, February 14, 2012 1:29 PM To: 'ATLANTIC84@cs.com' Cc: Sawyer, Susan Subject: RE: Soil Application 730 Winter St Hello, In addition to the septic plans that William Bonnell dropped off today, I need you to submit forms 11 and 12 for the soil testing information, as well as any lua forms as needed. You may scan and email them to me, or fax them - attention Pamela. Thank you. Best Regards, Pamela DelleChiaie Departmental Assistant I Community Development Division I Health Department Town of North Andover -1600 Osgood Street I Bldg 20 1 Suite 2-36 1 North Andover, MA 01845 T Office - 978-688-9540 11 Fax - 978-688-8476 lWebsite-http://www.townoffiorthandover.com/Pages/index -----Original Message ----- From: ATLANTIC84@cs.com jmailto:ATLANTIC84@cs.coml Sent: Thursday, December 08, 201110:50 AM To: DelleChiaie, Pamela Subject: Soil Application 730 Winter St Pamela Attached is the soils application for the repair at 730 Winter Street. I have attached the application, plot plan and deed. It is my understanding that you already have the required check. Let me know when we can schedule the testing. Thank you John B. Paulson President, P.L.S. Atlantic Engineering &r Survey Cons., Inc. 978-352-7870 office 978-352-9940 fax 978-815-7297 cell Atlantic84@cs.com</HTML> Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. Commonwealth of Massachusetts City(fown of Form 9A - Application for Local Upgrade Approval o 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. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the Diamond Realty Trust, i5illiam Bonnell computer, use only the tab key Name to move your 730 Winter Street cursor - do not Street Address use the return key. Andover NA 01845 Cityrrown state Zip Code €: 2. Owner Name and Address (if different from above): Diamond Realty Trust, William Bonnell 14 Londor_ St., Apt. 2 T Name Street Address Lowell MA City[Town State 01852 978-888-7134 Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: 4 bedroom single family home S. Type of Existing System: 0 Privy ❑ Cesspool(s) Q Conventional ❑ Other (describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): pits (existing), Presby System (proposed) l5form9a.doc • rev. 7106 Application for Local Upgrade Approval, Pagel of 4 Z -d 0V66 -Z99 -9L6-1 eaoidald ueallo0 d6Z40 Z6 -Vl• qad Commonwealth of Massachusetts City/Town of Form 9A - Application for Local Upgrade Approval 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. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: Design flow of proposed upgraded system Design flow of facility: B. Proposed Upgrade of System 440 gpd 440 gpd 440 gpd 1_ Proposed upgrade is (check one): ❑ Voiuntary ❑ Required by order, letter, etc. (attach copy) El Required following inspection pursuant to 310 CMR 15.301: 9'12/2011 date of inspection 2. Describe the proposed upgrade to the system: 462 square foot Presby Environmental septic field (gravity) 3. Local Upgrade Approval is requested for (check all that apply): [ Reduction in setback(s)— describe reductions: ❑ Reduction in SAS area of up to 25%: SAS size. sq. ft. © Reduction in separation between the SAS and high groundwater: 1 foot Separation reduction Percolation rate Depth to groundwater t5form9a.doc • rev. 7/06 ft. 4 mindinch 4 ft. down to 3 ft. ft. % reduction Application for Local Upgrade Approval- Page 2 of 4 £'d 0b66-Z9E-9Z6-6 eaoldald u8e1100 d6Z:1,0 Zl, b6 qac Commonwealth of Massachusetts - - City/Town of Fora 9A - Application for Local Upgrade Approval 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. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 12 -inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met —describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soy evaluatormust be a member or agent of the local approving authority. High groundwater evaluation determined by: John Paulscn (SE 1871) 12/14/2011 Evaluator's Name (type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Witheout tais variance a pump system would need to be designed and additional f_11 and grading in a buffer zone would be required. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: the systen is an alternative system t5formga.doc . rev. 7106 Application for Local Upgrade Approval* Page 3 of 4 t, -d 0V66-Z9E-8L6-6 eaoldald uaalloC d6Z40 Zl, tl Qaj Commonwealth of Massachusetts _t City/Town of Form 9A -Application for Local Upgrade Approval 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. C. Explanation (continued) 3. A shared system is not feasible: n/a 4. Connection to a public sewer is not feasible: not available 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ® Application for Disposal System Construction Permit ® Complete plans and specifications Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other (List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deiiberate violations." Facility Ovme�s Signature William Bonnell, Diamond Realty Trust Print Name George Zambouras PE, Atlantic Engineering Name of Preparer 97 Tenney Street Preparer's address MA 01833 State/ZIP Code t5formga.doc - rev. 7106 9'd 0V66 -7,9`✓ -8L6-1 2/14/2012 Date 2/14/2012 Date Georgetown CitylTovm 978-352-7870 Telephone Application for Local Upgrade Approval* Page 4 of 4 eaoldald u881100 d0C: 60 Z6 til, qac Feb 14 12 12:48p Colleen Piepiora 1-978-352-9940 vo , C01i-f 0NWT_ALTL1 Of MASSACHUSETTS Board of Health, /'i A#rI,, V,,Xk ,1m, FEE P.1 APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION -PERMIT Application for a Permit to Construcc0e) Repair( ) Upgrade( ) Abandon( ) - S Complete System ❑ Individual Components Location 730 W rN7 b ,/ ST Owner's Name Q/A)VAP ?,-AZ7Y TPU / Map/parcel# 11!11/g Address /y Gpf✓QQ�1/ ST LOl✓Gll A, Lot# ' Telephonek q7$ gpg 7/3V Installer's Name Designer's Name A71.Ah?(G Address Address 77 TEppE y S% GAG AGE j� i✓,v Telephone# Telephone# q7 8 .7; Z 7; 7Q Type of Building s, F19, Lot Size y39 i 6 sq, ft. Dwelling -No. of Bedrooms Garbage grinder 1 ) Other -Type of Building No. of persons Showers O, Cafeteria ( ) Other Fixtures Design Flow (min. qued) gpd Calculated design flow Design flow provided Y yd gpdQ Plan: Date f/ L 1/7- 'Number of. sheets Z Revision Date Title 73� WfN7C,t fl Description ofSoil(s) -A -1/0 A M Soil Evaluator Form No. Name of Soil EvaluatorZWN ?,44 `�` d 4/ Date of Evaluation (7 - sr /6 7/ DESCRIPTION OFRERIURS ORALTER'iTIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections No. l,.Ol°Ill"lOWEALT11 OF 1' .ASSt3CI-JUSETTS FEE Board of Health, , Bti4 CERTIFICATE Of COMPLIANCE Description of Work: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed O, Repaired O, Upgraded ( ), Abandoned ( ) by. at has been installed in accordance with the provisions of 310 CMR 15.00 (Tide 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (Gpd) Installer Designer: Inspector: Date: The issuance of this permit shall not be construed as a guarantee that die system will function as designed. No. COMM0WT-ALT11 OF MASSACHUSETTS Board of Heallh, , I'M. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( at Disposal System C011Stl'UctiUjl Pot uit Nu. , dated FEE Abandon( ) anindividual sewage disposal system as described in the application for provided: Construction shall be completed within three -Years of (he date of this permit. All local conditions must be met. FomrE5 aw sreC AN Sulk'n Go. hstoi%W Date Board of Health 0 C4 U) o c Z v 3 G) CD 0 0 (fl n' m CD 'O 0 v v� 6 CD (D n Z �Dy 00 C7 Fn -0 D CD Z a O o O Z = c n m 0 j CD �D y� c fir+ C O CD ❑ O� D m T) NCD 0• a <° � O 00 s 2:a CD (D o, (D m a 0 m 0 0 a CD ? 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Sawyer, RENS, RS l/!� �' e/7/ 97.688.9540 -Phone Public Health Director DEC w 8 ZU11 97 .688.8476—FAX TOWN OF NORTH ANDOVER townofnorthandover.com HEALTH DEPARTMENT APPLICATION FOR SOIL TESTY— DATE: PEC. 512011 MAP & PARCEL: 104.A / 8 LOCATION OF SOIL TESTS: Front Yard OWNER: William Bonnell, tr APPLICANT: William Bonnell ADDRESS: 14 London St, Apt 2, Lowell Contact #: 978-888-7134 Contact #: ENGINEER: Atlantic Engineering Contact#: 978-352-7870 CERTIFIED SOIL EVALUATOR: John Paulson SE1871 Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5" x 11 " Plot plan & Location of Testing (please indicate test nit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval ate: Signature of Conservation Agent: �ON�� Q S (--z) 5J 5J �Q "� (vim `L`' Date back to Health Department: (stamp in): e'i � � '@� ,►1 R) ^ „� ~ A r p • M TOWN OF NORTH ANDOVER f o3ary Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20• SUITE 2-36 * ' NORTH A S 01845a;CN„s Susan Y. Sawyer, RENS, RS l/!� �' e/7/ 97.688.9540 -Phone Public Health Director DEC w 8 ZU11 97 .688.8476—FAX TOWN OF NORTH ANDOVER townofnorthandover.com HEALTH DEPARTMENT APPLICATION FOR SOIL TESTY— DATE: PEC. 512011 MAP & PARCEL: 104.A / 8 LOCATION OF SOIL TESTS: Front Yard OWNER: William Bonnell, tr APPLICANT: William Bonnell ADDRESS: 14 London St, Apt 2, Lowell Contact #: 978-888-7134 Contact #: ENGINEER: Atlantic Engineering Contact#: 978-352-7870 CERTIFIED SOIL EVALUATOR: John Paulson SE1871 Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5" x 11 " Plot plan & Location of Testing (please indicate test nit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval ate: Signature of Conservation Agent: �ON�� Q S (--z) 5J 5J �Q "� (vim `L`' Date back to Health Department: (stamp in): e'i � � '@� ,►1 R) ^ „� i r) � t,�a;,rys.,,.w�'*. t � r .�e.e.��►a i.(' %:vim rma*,r y I«� �..� "...� �:«L+►.i.i..��i.ir+, `�r (+P'tirty4..NMb M�!x/►t �J ; � t I:<o1 .v, Gas � � t �,• -�(�� - %I/ �` 144. oe IN M-7 `Y •�` .. A7- It/ -_ .. .. ...._.r.r_,.c.«.•.nwa.o.w •rxn�wMw+.�.w,�wves.xwWt•••r.. CelleChiaie, Pamela From: Isaac Rowe [irowe@millriverconsulting.com] Sent: Thursday, December 15, 20118:35 AM To: 'Susan Sawyer(ssawyer@townofnorthandover.com)' Cc: DelleChiaie, Pamela; 'Dan Often heimer'; 'Marianne Peters'; rburley@millriverconsulting.com; irowe@millriverconsulting.com Subject: Soil Test Results - 332 Raleigh Tavern Rd & 730 Winter t Attachments: 332 Raleigh Tavern Road - Soil Test Results 12-13-11. df; 730 Winter Street Soil Test Results 12-14-11.pdf Susan, Attached are the soil logs for the above referenced properties. Atlantic Eng was very professional and a pleasure to work with. Please let me know if you have any questions. I also dropped off that soil sample for Cricket Lane. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street mmimmm Aga�l NkAi 1 1 K3 ol Feb 14 12 02:15p Colleen Piepiora 1-978-352-9940 p.1 FORM 11- SOIL EVALUATION FORM Page Iof3 No:A-1111-02 Date: 12/14/2011 Commonwealth of Massachusetts N. Andover, MA Soil Suitability Assessment for On -Site Sewage Disposal Performed By: iobn Paulson VVitnessect by: Isaac ltowe-Mill 1<rver l-onsultm Location Address: 730 Winter Street Owner's Name, or Lot #: MAP 104-A LOT 89 Address, and Telephone # New Construction ❑ Repair Office Review: Published Soil Survey Available: No ❑ Yes E Year Published 1981 Publication Scale 1:15840 Drainage Class B Soil Limitations CbD-CANTON Surficial Geological Report Available: No N Yes ❑ Year Published Publication Scale Geologic Material (Map unit) Land Form Flood Insurance Rabe Map: Above 500 year flood boundary No ❑ Yes ■ Within 500 year flood boundary No Yes 11 Within 100 year flood boundary No Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month: January Range: Above Normal 0 Normal ❑ Below Normal ❑ Other References Reviewed: OER Date 12/14/2011 Diamond Realty Trust C/O William Bonnell 14 London St: apt 2 Lowell, Ma 01852 978-888-7134 Soil Map Unit: 31 Feb 14 12 02:15p Colleen Piepiora 1-978-352-9940 p.2 Location Address or Lot No. 730 Winter St. On-site Review FORM 11- SOIL EVALUATION FORM Page 2 of 3 Deep Hole Number TP -1 Date 12/14/2011 Time am Location (identify on site plan) Land Use Residential Slope (%)-Q-3 Surface Stones VegetationLawn Landform Outwash Plain Position on landscape (sketch on back) Distances from: Open Water Body 60'+ feet Drainage Way na feet Possible iltet Area 60'+ feet Property Line 20 feet Drinking Water Well NA feet Other Weather-p.c. DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (USDA) (Munsell) Mottling (Structure, Stones, Boulder, Consistency, % Gravel) 0-19 FILL 19-23 A SL 10YR-3/2 23-36 B SL 5YR-4/6 36-90 C-1 SL 10YR-6/ 6 REFUSAL 56 MOTTLES WEEPING 70 `MINIMUMUFI"'Ut1ULt3Al tVtLKY V1'U1AVStLU151'VJtiLHl-,Zt% Parent Material(geologic): Glacial Outwash Depth to Groundwater: Standing Water in the Hole: NA Estimated Seasonal High Ground Water: 56 DEP APPROVED FORM -12/07/95 Depth to Bedrock: 90 Weeping from Pit Face: 70 FORM 11- SOIL EVALUATION FORM Feb 14 12 02:15p Colleen Piepiora 1-978-352-9940 p.3 Location Address or Lot No. 730 WINTER ST On—site .Review Deep Hole Number TP -2 Date 12/14/2011 Location (identify on site plan) Land Use Residential Slope (%)-9:3 Vegetation LAWN Landform Outwash Plain Position on landscape (sketch on back) Distances from: Open Water Body 601+ feet Possible Wet Area 604 feet Drinking Water Well NA feet Time am Weather P.C. Surface Stones YES Drainage Way na feet Property Line 60 feet Other Page 2of3 DEEP OBSERVATION HOLE LOG* Depth from Surface Soil Horizon Soil Texture {USDA) Soil Color (munsell) Soil Mottling Other (Structure, Stones, Boulder, Consistency, o Gravel) 0-21 FILL 21-44 B SL 5YR-4/6 44-120 C-1 SL 10YR-6/ 6 66 MOTTLES `MLNIMUMUr LWU BULb5A1 bVh-Ky VKQi'U-=U UIJl VJHL HLCGY Parent Material(geologic): Glacial Outwash Depth to Groundwater: Standing Water in the Hole: NA Estimated Seasonal High Ground Water: 66 DC P APPROVED FORNI- 12/(7/95 Depth to Bedrock: N/A Weeping from Pit Pace: 78 Feb 15 12 04:04p Colleen Piepiora 1-978-352-9940 p.1 FORM 11- SOIL EVALUATION FORM Page 3 of 3 Determination for Seasonal High Water Table 730 Winter Street Method Used: ❑ Depth observed standing in observation hole none inches ❑ Depth weeping from side of observation holes ■ Depth to soil mottles ❑ Ground water adjustment none feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring_ Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil adsorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that on Tuly 1995 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required, expertise and experience described in 310 CMR 15.017. Signatu� Date �� ` l 1871 DEP APPROVED FORM -12/07/95 Feb 14 12 02:16p Colleen Piepiora 1-978-352-9940 p.4 FORM 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS N. ANDOVER, Massachusetts Percolation Test - 730 WINTER ST Date 12/14/2012 Observation Hole # P-1 Depth of Perc 42+17 Start Pre-soak 10:00 End Pre-soak 10:15 Time at 12" 10:15 Time at 9" 10:23 Time at 6" 10:35 Time (9"-6") 12 Rate Min./Inch 4 Site Passed ■ Site Failed ❑ Performed By: John Paulson & Bob Lynch Witnessed By: Isaac Rowe -Mill River Consulting Comments: Amy E. Brennan Blue Water 6e --&,K MORTGAGE CORPORATION 7 Merrill Industrial Drive Hampton, NH 03842 Toll Free: 800.668.9695 Cell: 603.944.2540 eFax: 413.581.3645 @ . Serving all of Massachusetts, New Hampshire and Maine Sawyer, Susan From: ATLANTIC84@cs.com Sent: Monday, December 05, 201111:40 AM To: Sawyer, Susan Subject: Soil Application 730 Winter St Attachments: 730Winter-NAndove-SoilTest-Application.ZIP Susan Attached is the soils application for the repair at 730 Winter Street. I have attached the application, plot plan and deed. It is my understanding that you already have the required check. Let me know when we can schedule the testing. Thank you John B. Paulson President, P.L.S. Atlantic Engineering & Survey Cons., Inc. 978-352-7870 officeX 1 l 978-352-9940 fax 978-815-7297 cell Atla ntic84@cs.com</HTM L> Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please ref http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email.i ✓��(� ' ` (� �T l C Gtr t/ AK- C�-S )�U, v CIA O -n Y) 06 q / n 4 I Blackburn, Lisa From: Dan Ottenheimer <dano@millriverconsulting.com> Sent: Thursday, April 24, 2014 6:24 PM To: Sawyer, Susan; Grant, Michele; Blackburn, Lisa Cc: 'Isaac Rowe'; Pam Lally Subject: 730 Winter Street inspection Attachments: 730 Winter Street Const Inspection.docx Bed bottom inspection completed today. Report is attached. Things that are of note are: • One corner of the overdig was not fully removed due to the tight space they have to work in. We measured it and he reports he will remove it. He seemed genuine and said he will make sure to show where it is dug out in the final inspection. I have no reason to doubt him for such a small amount of digging but did want to call that to your attention in case you wish to, or wish to have us, go check that out to confirm. He made a useful observation that the inspection port is proposed to go all the way down to the water table and could pose a path for sewage to migrate directly from the soil absorption system to the water table. He is going to check with the designer to see if the bottom of it can be brought up higher to prevent this potential problem from occurring. • The tank was backfilled and I could not see if there was stone beneath it. He reports that he did put 6" of stone below, as it is standard practice to do so. When I asked about it further he pulled out the list of inspections that are required per the Health Department and he said it does not indicate the stone at the bottom of the tank needs to be seen. I felt in an awkward position and did not push anything further at this time. Even if I had made him dig it up to show me, he could not have done so at this time as there was basically no room to move any equipment or soil on this tight site until the soil absorption system is built. My gut_ says to let it go but did want to call that to your attention as well. Any questions, let me know. Dan Mill River consulting <1 r:v•II, ,�sem.zrie; g.♦ i't,mm.,s mu" ,(�Pxf ){c,, €Ih cao,4 ,i & Daniel Ottenheimer, President Mill River Consulting, Inc. 6 Sargent Street Gloucester, MA 01930-2719 978-282-0014 x 802 www.millriverconsulting.com Grant, Michele From: Dan Ottenheimer <dano@millriverconsulting.com> Sent: Wednesday, April 09,2014 11:32 AM To: Sawyer, Susan; Grant, Michele Cc: Bellavance, Curt Subject: RE: Jablonski 730 Winter I called, his phone went to voice mail. I'm sure he and I will speak before days end. Will keep you posted. Dan From: Sawyer, Susan Sent: 4/9/2014 10:39 AM To: 'Dan Ottenheimer'; Grant, Michele Cc: Bellavance, Curt Subject: RE: Jablonski 730 Winter I spoke to Curt. He would like you to be the contact with the installer, so when you get a chance please call Chad. Note that we have received the paper application; the fee; and the management obligation form. Michele's email forwarded to you details what else we need before he can pick up the permit and a copy of the approved plan. He has not given us a copy of his Presby certification. We also do not have the owner notice stating that they understand what technology is going in, and what their responsibilities are. We felt that Chad could explain to the owner what is needed from them. For information; below is the contact infor. for the engineer in case you need it. Thanks Susan John B. Paulson President, P.L.S. Atlantic Engineering & Survey Cons., Inc. 978-352-7870 office 978-352-9940 fax 978-815-7297 cell Atlantic84@cs.com</HTML> Thank you Susan From: Sawyer, Susan Sent: Wednesday, April 09, 2014 9:56 AM To: 'Dan Ottenheimer'; Grant, Michele Subject: RE: Jablonski I suppose Isaac would be fine as well for this job is he is available From: Dan Ottenheimer[ma iIto: danoOmilIriverconsulting.com] Sent: Wednesday, April 09, 2014 9:54 AM To: Sawyer, Susan; Grant, Michele Subject: Jablonski heading out to a meeting but please do email over his contact info and whatever you know about outstanding items and I will gladly intervene in between my other appointments 173 Daniel Ottenheimer, President Mill River Consulting, Inc. 6 Sargent Street Gloucester, MA 01930-2719 978-282-0014 x 802 www.millriverconsulting.com dano@millriverconsulting.com Member: Massachusetts Association of Onsite Wastewater Professionals, Massachusetts Environmental Health Association, Cape Ann Chamber of Commerce, Gloucester Rotary Club, New England Water Environment Association Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. [The entire original message is not included.] Grant, Michele From: Grant, Michele Sent: Monday, April 07, 2014 2:03 PM To: Bellavance, Curt Cc: Blackburn, Lisa Subject: FW: 730 Winter Street Attachments: 201404021433.pdf Hi Curt, I called Chad Jablonski today. He was supposed to come in on Friday morning to submit paperwork and pull a Permit for 730 Winter street. Chad has not submitted even the quote for 730 Winter to Amy Brennan as of today at 1:45pm. Chad is out of town tomorrow and probably won't be here until at least Wed. April 9th, 2014. The closing date on this home is April 17th. I communicated, that a conversation should take place with Amy Brennan and the new owner regarding timing. Our Engineer (Mill River) will have several inspections throughout the construction and final paperwork will need to be submit to the Health Department prior the issuance of the COC. Weather also plays a role in completion. Heavy Rain can stop a job. He inquired as to whether or not the Health Department would issue COC early (Prior to the completion of the SAS) and allow the new homeowner to move in. I said "No". Our office has never done that. I'll let you know if there's anything else Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com From: Grant, Michele Sent: Thursday, April 03, 2014 9:15 AM To: 'cjablonskil7@yahoo.com' Subject: FW: 730 Winter Street From: Grant, Michele Sent: Wednesday, April 02, 2014 2:33 PM To: 'cjablonskil7@yaboo.com' Cc: Blackburn, Lisa; Bellavance, Curt Subject: 730 Winter Street Chad, Attached, please find the documents with highlighted items that will need to be submitted to the Health Department. Also, below please find the link to the complete the documents. (Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for Remedial Use : Revised December 17, 2013) Prior to DWC issuance, submit to the Health Department Standard Condition 11 18 (a) see attached for details Standard Condition 11 18 (d) see attached for details Prior to COC submit to the Health Department Standard Condition 11 23 (b) see attached DEP form "Notice of Alternative Sewage Disposal System" During Construction The installer shall maintain on-site, at all times during construction, a copy of the approved plans, the owner's manual, the 0&M manual, and a copy of the Approval. The above is in addition to the North Andover Health Department and other State Code requirements. http://www.mass.gov/eea/searchresuIts.htmI?output=xmI no dtd&client=mg eea&proxvstvlesheet=massgov&getfield s=*&ie=UTF-8&oe=UTF- 8&tlen=215&sitefolder=eea&filter=0&startsite=EOEEAx&g=standard+conditions+for+alternative+soil+absorption+syste ms_+with+general+use+certification+and%2For+approved+for+remedial+use&site=EOEEAx If there are any questions, please call our office Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com Cc: Blackburn, Lisa; Bellavance, Curt Subject: 730 Winter Street Chad, Attached, please find the documents with highlighted items that will need to be submitted to the Health Department. Also, below please find the link to the complete the documents. (Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for Remedial Use : Revised December 17, 2013) Prior to DWC issuance, submit to the Health Department Standard Condition 11 18 (a) see attached for details Standard Condition 11 18 (d) see attached for details Prior to COC submit to the Health Department Standard Condition 11 23 (b) see attached DEP form "Notice of Alternative Sewage Disposal System" During Construction The installer shall maintain on-site, at all times during construction, a copy of the approved plans, the owner's manual, the C&M manual, and a copy of the Approval. The above is in addition to the North Andover Health Department and other State Code requirements. http://www.mass.gov/eea/searchresuIts.htmI?output=xmI no dtd&client=mg eea&proxystylesheet=massgov&getfield s=*&ie=UTF-8&oe=UTF- 8&tlen=215&sitefolder=eea&filter=0&sta rtsite=EOEEAx&q=standard+conditions+for+alternative+soil+absorption+syste ms+with+general+use+certification+and%2For+approved+for+remedial+use&site=EOEEAx If there are any questions, please call our office Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com Grant, Michele From: Grant, Michele Sent: Thursday, April 03, 2014 2:45 PM To: 'cjablonskil7@yahoo.com' Cc: Bellavance, Curt; Blackburn, Lisa Subject: RE: 730 Winter St. Thank you, Please keep in mind that our office closes tomorrow at noon on Fridays'. Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com -----Original Message ----- From: ciablonskil7@yahoo.com [mailto:ciablonskil7@yahoo.com] Sent: Thursday, April 03, 201411:58 AM To: Grant, Michele Subject: 730 Winter St. Michelle, I received your email with the alternative system forms. i'll go over everything tonight. I found my presby cert so I'll get that to you along with the completed forms ASAP Thanks, Chad Jablonski Sent from my iPhone Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 1 Gram, M16hele From: Microsoft Exchange To: 'cjablonskil7@yaboo.com' Sent: Wednesday, April 02, 2014 6:38 PM Subject: Delivery Delayed: 730 Winter Street Delivery is delayed to these recipients or distribution lists: 'dablonskil7@yaboo.com' Subject: 730 Winter Street This message has not yet been delivered. Microsoft Exchange will continue to try delivering the message on your behalf. Delivery of this message will be attempted until 4/4/2014 2:33:29 PM (GMT -05:00) Eastern Time (US & Canada). Microsoft Exchange will notify you if the message can't be delivered by that time. Sent by Microsoft Exchange Server 2007 �J R04 1" mo r n, .,4 Grant Micbele From: Grant, Michele Sent: Thursday, April 03, 2014 9:15 AM To: 'cjablonskil7@yahoo.com' Subject: FW: 730 Winter Street Attachments: 201404021433.pdf From: Grant, Michele Sent: Wednesday, April 02, 2014 2:33 PM To: 'cjablonskil7@yaboo.com' Cc: Blackburn, Lisa; Bellavance, Curt Subject: 730 Winter Street Chad, Attached, please find the documents with highlighted items that will need to be submitted to the Health Department. Also, below please find the link to the complete the documents. (Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for Remedial Use : Revised December 17, 2013) Prior to DWC issuance, submit to the Health Department Standard Condition 11 18 (a) see attached for details Standard Condition 11 18 (d) see attached for details Prior to COC submit to the Health Department Standard Condition 11 23 (b) see attached DEP form "Notice of Alternative Sewage Disposal System" During Construction The installer shall maintain on-site, at all times during construction, a copy of the approved plans, the owner's manual, the 0&M manual, and a copy of the Approval. The above is in addition to the North Andover Health Department and other State Code requirements. http://www.mass.gov/eea/`searchresuIts.htmI?output=xmI no dtd&client=mg eea&proxystylesheet=massgov&getfield s=*&ie=UTF-8&oe=UTF- 8&tlen=215&sitefolder=eea&filter=0&startsite=EOEEAx&g=standard+conditions+for+a Iternative+soil+absorption+syste ms+with+general+use+certification+and%2For+approved+for+remedial+use&site=EOEEAx If there are any questions, please call our office Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com Standard Conditions for Alternative Soil Absorption Systems Page 9 of 16 General Use and Remedial Use Approvals Revision Date: December 17, 2013 18. Upon submission of an application for a Disposal System Construction Permit (DSCP), the Designer shall provide to the Local Approving Authority: a) proof that the Designer has satisfactorily completed any required training by the Company for the design and installation of the Technology; b) certification of the design by the Company for any residential system with a design of 2,000 gpd or more or for any proposed non-residential system or if required by the Special Conditions for an approved Technology; c) certification by the Designer that the design conforms to the Approval, any Company Design Guidance, and 310 CMR 15.000; and d) a certification, signed by the Owner of record for the property to be served by the Technology, stating that the property Owner: i. has been provided a copy of the Title 5 UA technology Approval, the Owner's Manual, and the Operation and Maintenance Manual, and the Owner agrees to comply with all terms and conditions; ii. for Systems installed under a Remedial Use Approval, the owner agrees to fulfill his responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5); iii. if the design does not provide for the use of garbage grinders, the restriction is understood and accepted; and iv. whether or not covered by a warranty, the System Owner understands the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. 19. The System Owner and the Designer shall not submit to the LAA a DSCP application for the use of a Technology under this Approval if the Approval has been revised, reissued, suspended, or revoked by the Department prior to the date of application. The Approval continues in effect until the Department revises, reissues, suspends, or revokes the Approval. 20. The System Owner shall not authorize or allow the installation of the System other than by a locally approved Installer and, if required by the Company, a person certified or trained by the Company to install the System. 21. Prior to the commencement of construction, the System Installer must certify in writing to the Designer, the LAA, and the System Owner that (s)he is a locally approved System Installer and, if required by the Company, is certified by or has received appropriate training by the Company. 22. The Installer shall maintain on-site, at all times during construction, a copy of the approved plans, the Owner's manual, the O&M manual, and a copy of the Approval. 23. Prior to the issuance of a Certificate of Compliance the following shall be provided: Standard Conditions for Alternative Soil Absorption Systems Page 9 of 16 General Use and Remedial Use Approvals Revision Date: December 17, 2013 18. Upon submission of an application for a Disposal System Construction Permit (DSCP), the Designer shall provide to the Local Approving Authority: a) proof that the Designer has satisfactorily completed any required training by the Company for the design and installation of the Technology; b) certification of the design by the Company for any residential system with a design of 2,000 gpd or more or for any proposed non-residential system or if required by the Special Conditions for an approved Technology; c) certification by the Designer that the design conforms to the Approval, any Company Design Guidance, and 310 CMR 15.000; and d) a certification, signed by the Owner of record for the property to be served by the Technology, stating that the property Owner: i. has been provided a copy of the Title 5 UA technology Approval, the Owner's Manual, and the Operation and Maintenance Manual, and the Owner agrees to comply with all terms and conditions; ii. for Systems installed under a Remedial Use Approval, the owner agrees to fulfill his responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5); iii. if the design does not provide for the use of garbage grinders, the restriction is understood and accepted; and iv. whether or not covered by a warranty, the System Owner understands the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. 19. The System Owner and the Designer shall not submit to the LAA a DSCP application for the use of a Technology under this Approval if the Approval has been revised, reissued, suspended, or revoked by the Department prior to the date of application. The Approval continues in effect until the Department revises, reissues, suspends, or revokes the Approval. 20. The System Owner shall not authorize or allow the installation of the System other than by a locally approved Installer and, if required by the Company, a person certified or trained by the Company to install the System. 21. Prior to the commencement of construction, the System Installer must certify in writing to the Designer, the LAA, and the System Owner that (s)he is a locally approved System Installer and, if required by the Company, is certified by or has received appropriate training by the Company. 22. The Installer shall maintain on-site, at all times during construction, a copy of the approved plans, the Owner's manual, the O&M manual, and a copy of the Approval. 23. Prior to the issuance of a Certificate of Compliance the following shall be provided: Standard Conditions for Alternative Soil Absorption Systems Page 10 of 16 General Use and Remedial Use Approvals Revision Date: December 17, 2013 a) the System Installer and Designer must provide certification in writing to --the LAA that the System has been constructed in compliance with the terms of the Approval; and b) For System upgrades installed under a Remedial Use Approval the System Owner shall provide a copy of record and/or register the Deed Notice required by 310 CMR 15.287(10), to the LAA. The Deed Notice shall be completed as follows: i. a certified Registry copy of the Deed Notice bearing the book and page/or document number; and ii. if the property is unregistered land, a copy of the System Owner's deed to the property as recorded at the Registry, bearing a marginal reference on the System Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice provided by the Department. 24. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least equivalent to that of a sanitary sewer system. a) If it is feasible to connect a new or existing facility to the sewer, the Designer shall not propose an Alternative System to serve the facility and the facility Owner shall not install or use an Alternative System; and b) When a sanitary sewer connection becomes feasible after an Alternative System has been installed, the System Owner shall connect the facility served by the System to the sewer within 60 days of such feasibility and the System shall be abandoned in compliance with current Code requirements, unless a later time is allowed in writing by the Department or the LAA. III. Operation and Maintenance 1. For Systems with design flows of 2,000 gpd or greater where the effective leaching area installed is less than 75% of that required by Title 5 (3 10 CMR 15.240(4)), measurement of the depth of ponding within the SAS above the interface with the underlying unsaturated pervious soils shall be performed once per year by means of the inspection port(s) and any other available access to the distribution system. Inspector must be an Approved System Inspector. 2. Whenever an Alt. SAS system's inspection port ponding depth is measured and indicates the ponding level within the SAS is above the invert of the distribution system, an additional measurement shall be made 30 days later. If the subsequent reading indicates the elevation of ponding within the SAS is above the invert of the distribution system, the System Owner shall be responsible for the submittal to the LAA within 60 days of the follow-up inspection, a written evaluation of the System with recommendations for changes in the design, operation, and/or maintenance. The written evaluation with recommendations shall be prepared by a Designer and the Notice of Alternative Sewage Disposal System M.G.L. c. 21A, § 13 and 310 CMR 15.0287(10) VThis Notice to be recorded and/or filed for registration in the chain of title of the Property served by an Alternative age Disposal System ("Alternative System7).] NAME(S) OF OWNER OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: ADDRESS OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: TITLE REFERENCE FOR PROPERTY SERVED BY ALTERNATIVE SYSTEM [check and complete each that applies]: Deed recorded with the Certificate of Title No. Registry of Deeds in Book , Page issued by the Land Registration Office of the _ Source of title other than by deed [If Alternative System Owner(s) is other than Property Owner(s), complete the following:] Alternative System Owner Name: Alternative System Owner Address: Registry District WHEREAS, Section 15.280 of Title 5 of the State Environmental Code ("Approval of Alternative Systems"), provides for the Massachusetts Department of Environmental Protection (the "Department") to approve or certify, as appropriate, all proposals to construct, upgrade or replace on-site sewage disposal systems using alternative systems; WHEREAS, owners and/or operators of approved or certified alternative systems are subject to general conditions, as specified in Section 15.287 of Title 5 of the State Environmental Code, 310 CMR 15.287, and may be subject to special conditions, as specified in the Department's approvals or certifications; such general and special conditions potentially including, without limitation, requirements relating to the use of trained operators, periodic inspections, maintenance, sampling, reporting and/or recordkeeping; WHEREAS, Section 15.287(10) of Title 5 of the State Environmental Code, 310 CMR 15.287(10), requires that "prior to obtaining a Certificate of Compliance for installation of a new or upgraded system, the system owner shall record in the chain of title for the property served by the alternative system in the Registry of Deeds and/or Land Registration Office, as applicable, a Notice disclosing both the existence of the alternative on-site system and the Department's approval of the system. The system owner shall also provide evidence of such recording to the local Approving Authority [J" and WHEREAS, the Property is served by an alternative sewage disposal system. NOW, THEREFORE, Notice of an alternative sewage disposal system is hereby given for the above -referenced Property, as follows: 1. Existence. An alternative system has been installed as a new or upgraded alternative sewage disposal system, on or adjacent to the Property, and serves the Property. The trade name and model number(s) of the alternative system are as follows: Trade name of technology: Manufacturer Name: Model number(s): Page 1 of 2 2. Approval/Certification. On [date], the Department, pursuant to its authority under the section of Title 5 as specified below, approved or certified the technology used in the above - referenced alternative system, under MassDEP Transmittal Number [Transmittal Number of approval or certification]. [Check one of the following, as applicable:] _ Approved for remedial use under 310 CMR 15.284 _ Approved for piloting under 310 CMR 15.285 Provisionally approved under 310 CMR 15.286 Certified for general use under 310 CMR 15.288 A copy of the Department's Approval/Certification is available from the Department in person or on- line at the Department's website: hqp://www.mass. og v/dgp . WITNESS the execution hereof under seal this day of 320 , made by the above-named Alternative System Owner(s). , ss On this appeared [Alternative System Owner(s)] Print Name(s): COMMONWEALTH OF MASSACHUSETTS day of , 20_, before me, the undersigned notary public, personally (name of document signer), proved to me through satisfactory evidence of identification, which were , to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he) (she) signed it voluntarily for its stated purpose. (official signature and seal of notary) ------------------------------------------------------------------------------------------------------------------------------------ [Complete the following Property Owner(s) Consent if Alternative System Owner(s) is other than the Property Owner(s):] CONSENTED TO: [Property Owner(s)] Print Name(s): _ Date: COMMONWEALTH OF MASSACHUSETTS ss On this day of , 20_, before me, the undersigned notary public, personally appeared (name of document signer), proved to me through satisfactory evidence of identification, which were , to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he) (she) signed it voluntarily for its stated purpose. Upon recording, return to: [Name and address of Property Owner(s)] (official signature and seal of notary) Page 2 of 2 DelleChiaie, Pamela From: Sawyer, Susan Sent: Wednesday, March 14, 2012 12:09 PM To: Grant, Michele; Hughes, Jennifer Cc: DelleChiaie, Pamela Subject: RE: 730 Winter Street I called the engineer and left a message before I left Thursday. They have to come to a 130H meeting for the reduction. I can't approve it without that. The revised plans addressed all the other outstanding issues, so if the variance is approved, it is all set with us. Just had to jar my memory. S From: Grant, Michele Sent: Tuesday, March 13, 2012 11:53 AM To: Hughes, Jennifer Cc: Sawyer, Susan Subject: RE: 730 Winter Street No, The revised plan was submitted on March 8th. It has not yet been approved. From: Hughes, Jennifer Sent: Tuesday, March 13, 2012 11:14 AM To: Sawyer, Susan Cc: Grant, Michele Subject: 730 Winter Street Has the replacement system for this address been approved? Jennifer A. Hughes Conservation Administrator Town of North Andover 1600 Osgood Street, Bldg 20, Suite 2-36 North Andover, MA 01845 Phone 978.688.9530 Fax 978.688.9542 "Be a yardstick of quality. Some people aren't used to an environment where excellence is expected. "- Steve lobs Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: htta://www.sec.state.ma.us/ore/preidx.htm. Please consider the environment before printing this email. Mar 19 12 09:07a Colleen Piepiora 1-978-352-9940 p.2 Atlantic Engineering & Survey Consultants, Inc. 97 Tenney Street — Suite 5 Georgetown, MA 01833 978)352-7870 — MAIL - ATLANTC847aCS COMO E To Board of Health March 17, 2012 North Andover, Ma Re William Bonnell 730 Winter Street N. Andover, Ma. The applicant is seeking two waivers from the Town of North Andover Board of Health Bylaw. 1. Reduce the setback of the SAS from the Wetland resource area from 100' to 53'(NA 3.9). 2. Reduce the setback of the septic tank from the Welland resource area from 75' to 50'(NA3.9). Tha % J .tea son, President A. 730 Winter Street — Request from George Zambouras, P.E. of Atlantic Engineering & Survey Consultants, Inc. of Georgetown, MA to: 1. Reduce the setback of the SAS from the Wetland resource area from 100' to 53' (NA 3.9) 2. Reduce the setback of the septic tank from the Wetland resource area from 75' to 50' NA 3.9) Bob Lynch was the representative from Atlantic Engineering. Mr. Lynch stated that 730 Winter Street is an existing 4 -bedroom house. The septic system has failed due to the water level. Soil testing was done, and good soil was found where the existing system is. There was ledge and large glacial rocks that don't allow testing in the other areas. The property is also Parallel to wetlands on the left hand side and they opted not to go there because there are a lot of woods. Mr. Lynch stated that they could go up the hill with a pump system, or put in a gravity system. A typical system is pipes and stone. The effluent runs into the bottom of the system and creates a biomat which breaks down the bacteria in it. The Presby system is a 12 inch pipe, 10 inches on the inside. On the outside, there is a fiber mesh that harbors bacteria on it. There is a "lagoon" in the middle, which receives oxygen and breaks bacteria treated waste which then flows out to the fibrous area on the outside of the filter fabric that also keeps soil and sand from infiltrating back into the system. This system is vented with the candy cane pipe that one frequently sees embedded in the ground for properties who have this type of septic system. This vent allows air in so that the system can receive a lot of oxygen which allows the bacteria to break down the waste. The Presby system has an advantage of 40% less space. This allows a smaller footprint for the septic system and a more efficient bacterialized system. The sand around it is concrete sand which is cracked rock, a very sharp sand. The concrete sand has more surface on it, and locks together differently, and allows more surface area. The type of system installed is primarily the engineer's choice. In New Hampshire, it was noted that most septic systems are the Presby system. The cost is similar to standard system, perhaps slightly more. Motion Dr. MacMillan made a motion to approve the requested waivers as follows: 3. Allow a reduction in septic tank wetlands separation from 75' to 50' (BOH Regulation 3.9- Tablel) as allowed by local upgrade approval; 4. Allow reduction in soi8l absorption area — wetlands separation from 100' to 53' (BOH Regulation 3.9 -Table 1) as allowed by local upgrade approval. The motion was seconded by Mr. Fixler. B. 491 Salem Street — Local Variance Requests from Bill Dufresne of Merrimack Engineering 1. Distance from S.A.S. to wetland from 10' to 60' 2. Distance from septic tank to wetland from 75' to 58' 3. Distance from pump tank to wetland from 75' to 67' Local Upgrade Approval Vertical offset from S.A.S. to E.W.W.T. from 4' to 3' Ms. Sawyer explained that the system, as designed, proposes a setback of 60 ft from the S.A.S. to a wetland where 100 ft. is required and 58 ft. from the septic tank to a wetland where 75 ft. is required. They are not able to put the system in the front, as there is a ditch that holds water in front of the property. This area does not have access to sewer. This has a pump that puts out 40- 60 gallons of water per day to saturate the system. March 29, 2012 North Andover Board of Health Meeting - Meeting Agenda Page 3 of 4 Note: The Board of Health reserves the right to take items out of order and to discuss and/or vote on items that are not listed on the agenda. Board of Health Members: Thomas Trowbridge, DDS, MD, Chairman; Larry Fixler, Member/Clerk; Francis P. MacMillan, Jr., M.D.; Joseph McCarthy, Member; Edwin Pease, Member Health Department Staff: Susan Sawyer, Health Director; Debra Rillahan, Public Health Nurse; Michele Grant, Public Health Inspector; Pamela DelleChiaie, Health Department Assistant Motion: Dr. MacMillan made a motion to Local Variance Requests 1. Allow the Distance from S.A.S. to wetland from 10' to 60' 2. Allow the Distance from septic tank to wetland from 75' to 58' 3. Allow the Distance from pump tank to wetland from 75' to 67' Local Upgrade Approval 1. Allow the Vertical offset from S.A.S. to E.W.W.T. from 4' to 3' The motion was seconded by Mr. McCarthy. VI. COMMUNICATIONS, ANNOUNCEMENTS, AND DISCUSSION Dr. MacMillan made an announcement that March is colon cancer awareness month. Colon cancer is the second leading cause of cancer in the united states, just behind lung cancer. Dr. MacMillan urged the public to get a colonoscopy starting at age 50. Getting the procedure done can reduce cancer rates by over 50 percent. A colonoscopy is a 15 minute procedure. It is painless and the patient is fully sedated and very safe. Dr. Macmillan encouraged everyone to see their primary care physician to arrange an exam. VII. CORRESPONDENCE / NEWSLETTERS VIII. ADJOURNMENT The meeting was adjourned at 8:30 p.m. March 29, 2012 North Andover Board of Health Meeting - Meeting Agenda Page 4 of 4 Note: The Board of Health reserves the right to take items out of order and to discuss and/or vote on items that are not listed on the agenda. Board of Health Members: Thomas Trowbridge, DDS, MD, Chairman; Larry Fixler, Member/Clerk; Francis P. MacMillan, Jr., M.D.; Joseph McCarthy, Member; Edwin Pease, Member Health Department Staff: Susan Sawyer, Health Director; Debra Rillahan, Public Health Nurse; Michele Grant, Public Health Inspector; Pamela DelleChiaie, Health Department Assistant North Andover Health Department Community Development Division Novembe/,2(013 Diamond/Realty Trust 14 Londn St. Apt 2 Lowell, MA 01852 /,'I 31 Lq/i Z RE: Re: Subsurface Sewage Disposal System Plan for 730 Winter Street (Map 104A, Lot 89) Dear Property Owner, The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property, submitted on your behalf by Atlantic Engineering & Survey Consultants Inc., dated January 11, 2012, last revised March 6, 2012. The design has been approved for use in the construction of a replacement, four bedroom (maximum 9 room home), on-site septic system. Generally, this plan is good for 3 -years from the date of approval, however as this is a repair system Title V requires that the system be installed within 2 years. During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid. The following variances to local regulations have been approved. 1. A reduction of the required setback of a septic tank to a wetland from 75 feet to 50 feet 2. A reduction of the required setback of a soil absorption area to a wetland from 100 feet to 53 feet. The following local upgrades have been approved. 1. The vertical offset from SAS to the estimated water table from 4 feet to 3 feet 2. A reduction of the required setback of 10 feet to 8 feet Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 730 Winter Street March 12012 This approval is also subject to the following conditions: 1. Please keep the attached DEP Form 9b for your records 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely, Susan Y. Sawyer, REHS/RS Public Health Director cc: George Zambouras, P.E. file Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 North Andover Health Department Community Development Division April 2, 2012 Diamond Realty Trust 14 London St. Apt 2 Lowell, MA 01852 RE: Re: Subsurface Sewage Disposal System Plan for 730 Winter Street (Map 104A, Lot 89) Dear Property Owner, The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property, submitted on your behalf by Atlantic Engineering & Survey Consultants Inc., dated January 11, 2012, last revised March 6, 2012. The design has been approved for use in the construction of a replacement, four bedroom (maximum 9 room home), on-site septic system. Generally, this plan is good for 3 -years from the date of approval, however as this is a repair system Title V requires that the system be installed within 2 years. During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid. The following variances to local regulations have been approved. BOH meeting March 29, 2012. 1. A reduction of the required setback of a septic tank to a wetland from 75 feet to 50 feet 2. A reduction of the required setback of a soil absorption area to a wetland from 100 feet to 53 feet. The following local upgrades have been approved. 1. The vertical offset from SAS to the estimated water table from 4 feet to 3 feet 2. A reduction of the required setback of 10 feet to 8 feet This approval is also subject to the following conditions: 1. Please keep the attached DEP Form 9b for your records Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 730 Winter Street April 2, 2012 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerel Sus Y. awyer HS/RS Public Health D- ector cc: George Zambouras, P.E. file Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Commonwealth of Massachusetts = v City/Town of Local Upgrade Approval Form 913 GSM V 9 y`0v DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. A. Facility Information Important: When filling out forms 1. Facility Name and Address on the computer, use only the tab Diamond Realty Trust key to move your Name cursor - do not 730 Winter Street use the return Street Address key. N. Andover rQ City/Town 2. Owner Name and Address (if different from above): Name City/Town MA 01845 State Zip Code Street Address State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 gpd 5. System Designer: George Zambouras Name 97 Tenney St, Suite 5 Georgetown 01833 Address City/Town State, ZIP B. Approval 1. Local Upgrade Approval is granted for: ❑ Reduction in setback(s) — specify: ❑ Reduction in SAS area of up to 25%: ® PE ❑ RS SAS size, sq. ft. % reduction 730 Winter St 9b 3.8.12 • rev. 7/06 Local Upgrade Approval* Page 1 of 2 Commonwealth of Massachusetts City/Town of Local Upgrade Approval Form 9B B. Approval (continued) ® Reduction in separation between the SAS and high groundwater: Separation reduction Percolation rate Depth to groundwater ❑ Relocation of water supply well (explain): 1 ft. 4 min./inch 3 ft. ❑ Reduction of 12 -inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: Approving Authority Susan SawyerMarch 6, 2012 Print or Type Name and Title 4gne Date 730 Winter St 9b 3.8.12 • rev. 7/06 Local Upgrade Approval, Page 2 of 2 Commonwealth of Massachusetts City/Town of NORTH ANDOVER o Form 9A - Application for Local Upgrade Approval wM s 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. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance wit#t-eith�en#f9�ti' 310 CMR 15.000. A. Facility Information Important: When filling out forms 1. Facility Name and Address: TOWN OF NORTH ANDOVER on the computer, DIAMOND REALTY TRUST HEALTH DEPARTMENT use only the tab key to move your Name cursor - do not 730 WINTER STREET use the return Street Address key. N. ANDOVER MA 01845 City/Town State Zip Code 2. Owner Name and Address (if different from above): Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: EXISTING 4 BEDROOM SINGLE FAMILY DWELLING 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other (describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): PITS VARIANCEform9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 1 of 4 j Commonwealth of Massachusetts City/Town of NORTH ANDOVER a Form 9A —Application for Local Upgrade Approval ,M 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. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: Design flow of proposed upgraded system Design flow of facility: B. Proposed Upgrade of System 1. Proposed upgrade is (check one): 440 gpd 440 gpd 440 gpd ❑ Voluntary ❑ Required by order, letter, etc. (attach copy) ® Required following inspection pursuant to 310 CMR 15.301: 2. Describe the proposed upgrade to the system: PRESBY ENVIRO-SEPTIC LEACHING SYSTEM 3. Local Upgrade Approval is requested for (check all that apply): 9/12/2011 date of inspection ® Reduction in setback(s) — describe reductions: STATE-(1)SEPTIC TANK 8' from foundation reduced from 10' TOWN -SETBACKS FROM WETLANDS, (2)TANK 50' reduced from 75'& (3)S.A.S 53' reduced from 100' ❑ Reduction in SAS area of up to 25%: SAS size, sq. ft. % reduction ® Reduction in separation between the SAS and high groundwater: Separation reduction Percolation rate 4 min./inch Depth to groundwater 4.7 & 5.5 VARIANCEform9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 2 of 4 Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form 9A - Application for Local Upgrade Approval UI 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. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 12 -inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met —describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Evaluator's Name (type or print) Signature C. Explanation 12/14/2012 Date of evaluation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Alternative system is proposed to minimized the impact on the site. Full compliance would require significant additional cost and result in a greater impact on the vegetation on the property. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: A PRESBY SYSTEM IS PROPOSED VARIANCEform9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 3 of 4 Commonwealth of Massachusetts City/Town of NORTH ANDOVER w o Form 9A —Application for Local Upgrade Approval �,M s 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. C. Explanation (continued) 3. A shared system is not feasible: NOT AVAILABLE 4. Connection to a public sewer is not feasible: NOT AVAILABLE 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ® Application for Disposal System Construction Permit ® Complete plans and specifications ® Site evaluation forms ® A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other (List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." Facility Owners Signature Diamond Realty Tr / William Bonnell Print Name Atlantic Engineering & Syrvey Name of Preparer 97 Tenney St-Suile 5 Preparers address Ma. 01833 State/ZIP Code Date 3/7/2012 Date Georgetown City/Town 978-352-7870 Telephone VARIANCEform9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 4 of 4 •o Abutter to Abutter ( ) Building Dept. ( ) Conservation ( X ) Zoninn ( 1 Town of North Andover Abutters Listing REQUIREMENT: MGL 40A, Section 11 states in Part "Parties in Interest as used in this chapter shall mean the petitioner, abutters, owners of land directly oppositeon any public or private way, and abutters to abutters within three hundred (300) feet of the property line of the petitioner as they appear on the most recent applicable tax list, not withstanding that the land of any such owner is located in another city or town, the planning board of the city or town, and the planning board of every abutting city or town.' Subject Property MAP PARCEL Name Address 104.A 89 Clayton Collupy 730 linter Street, North Andover, MA 01845 Abutters Properties Map Parcel Name Address 104A 21 Commonwealth of Massachusetts 100 Cambridge Street, Boston MA 02202 104A 25 Keith Hery 731 Winter Street, North Andover, AAA 01845 104A 26 James Chase 500 Winter Street, North Andover, MA 01845 104A 86 Katherine Brooks 50 Saw Mill Road, North Andover, MA 01845 104A 87 Boutros Ghassibi 34 Saw Will Road, North Andover, MA 01845 104A 90 Ryan Mcewing 742 Winter Street, North Andover, MA 01845 104.8 100 Dennis Bowersox 15 Saw Mill Road, North Andover, MA 01845 104.6 112 Daniel Taylor 2 Hay Meadow Road, North Andover, MA 01845 104.8 151 James Batson, Jr. 773 Winter Street, North Andover, MA 01845 104.6 152 Stephen Smith 755 Winter Street, North Andover, MA 01845 104.E 153 Stehan Rinaldi 743 Winter Street, North Andover, MA 01845 This certifies that the names appearing on the records of the Assessors Office as of /-1-aU/p ,I I// _ . North Andover Health Department Community Development Division March 2, 2012 NA tt 0 OR George Zambouras, P.E. Atlantic Engineering & Survey Consultants, Inc. 97 Tenney Street, Suite 5. Georgetown, MA 01833 Re:,RS„ubs rface Sewage Disposal System Plan for 730 Winter Street, Map 104A, Lot 89 Dear Mr. Zambouras: The proposed wastewater system design plan for the above site dated January 11, 2012 and received on February 14, 2012 has been reviewed. Unfortunately, the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item. 1. On sheet 1 of 2, please provide the names of abutters from recent tax map (NA 3.2). k�,2. On sheet I of 2, please provide the name of the approving authority representative in the soil test data on the plan (3 10 CMR 15.220(4)(h). Isaac Rowe was the Board of Health representative. �. On sheet 1 of 2, the scaled profile does not have a 1"=2' vertical scale (NA 3.2). V4. Please provide the most recent DEP Remedial Use approval letter for the alternative technology that is proposed (NA 3.3). �5. Please indicate whether or not the property is within a nitrogen sensitive area (3 10 CMR 15.214). 6. Please provide a statement identifying whether the property is within or not within the Lake Cochichwick watershed (NA 3.2). 7. Please provide the elevation/location statement as described in section 3.2 of the North Andover Board of Health regulations. �8. Board of Health variance requests are needed for the setback distance for septic tank and leaching facility to the wetland resource area (NA 3.§). Page 1 of 3 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 — J9. On sheet 1 of 2, please indicate the material of the existing driveway (310 CMR 15.220(4)(4). 10. Please provide notes that the building sewer line. shall have watertight joints, pipe laid on a compact firm base and pipe laid on continuous grade in a straight line (3 10 CMR 15.222(5-8)). �s- 11. On sheet 1 of 2, please indicate a cleanout at the proposed bend in the building sewer pipe (3 10 CMR 15.222(8)). 12. On sheet i of 2, please provide a distance between the proposed septic tank and dwelling (NA 3.2). The tank appears to be 10' from the dwelling. 43. Please indicate all modelsibrands of the system components. Specifically the proposed septic tank and distribution box (NA 3.2). 14. Please indicate the size and material of at least one access cover above the septic tank to within 6" of finish grade (310 CMR 15.228(2)). — - 15.On sheet 1 of 2, please indicate if the proposed septic tank is H-10 or H-20 loading (3 10 CMR 15.226(3). —16. Please indicate the size of the crushed stone proposed beneath the septic tank and distribution box. X17. On sheet 2 of 2, please indicate if the proposed distribution box is H-20 loading (NA 3.2). ' 18. On sheet 2 of 2, please provide a note that all the outlets of the d -box shall, be set level for { the first two feet (310 CMR 15.232(3)(c)). 1,9'. On sheet 2 of 2, a riser to within 6 inches of finish grade is required above the distribution box if greater than 9 inches below grade (3 10 CMR 15.221(13)&15.232(3)(0). 20. On sheet 2 of 2, please indicate that the distribution box shall be watertight (3 10 CMR JA5.221(1). , 21�� n sheet 2 of 2, the detail of the Presby system indicates 6" of topsoil above the system sand. The profile indicates 1'min. — 3' max.cover. Please clarify this discrepancy. - - 2- On sheet 2 of 2, Operation and Maintenance note #4 indicates maintenance of a pump. Please modify or remove this note accordingly. T 3. Please submit the soil evaluation results on current DEP forms 11 and 12 (NA 3.2). —7,�—'A/24. Please indicate who determined the edge of the wetland resource area. Although not a reason for disapproval you may wish to consider the following comments: r 1. Provide a vent detail for the installer. ,,/2. Indicate on the plan the requirement of a deed notice to be recorded with the title of the property for the Presby Enviro-Septic system. Please feel free to contact the office with any questions you may have. We Iook forward to working with you to obtain a wastewater treatment and dispersal system which will be in Page 2 of 3 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476