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Miscellaneous - 75 FOREST STREET 4/30/2018 (2)
�� N_ O D 0 Q �a North Andover Board of Assessors Public Access I ,1 T °f ,yOR7 anti �O 3= • - _ °c �9SSgCNUSEt Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page I of 1 Morth Andover Board of ,assessors ��Property Record Card Parcel ID :210/106.A-0170-0000.0 FY:2008 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO Click on Photo to 71 17- ,'.; 75 FOREST STREET Location: 75 FOREST STREET Owner Name: MELSON, JENNIFER A Owner Address: 75 FOREST STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6 - 6 Land Area: 1.02 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2794 sgft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 561,500 596,800 Building Value: 352,700 365,800 Land Value: 208,800 231,000 Market Land Value: 208,800 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=1181184&town=NandoverPubAcc 8/26/2008 DelleChiaie, Pamela From: Andrew Devore [devoreandrew@gmail.com] Sent: Tuesday, June 29, 2010 5:34 PM To: DelleChiaie, Pamela Subject: Re: I.R. - 75 Forest Street - Scanned Copy of File Thank you. We were hoping to be able to ascertain the location of the septic tank by using the as -built diagram (page 2 of the attachment), but the scan of the diagram (particularly the measurements) is not readable. Is the copy that you have readable? If so, could you enlarge the diagram in a new scan. Alternatively, is it available for viewing at your office? Thank you again, Andrew Devore On Tue, Jun 29, 2010 at 4:49 PM, DelleChiaie, Pamela <pdellech e,townofnorthandover.com> wrote: Commonwealth of Massachusetts Z.11d, City/Town of System Pumping Record JUN,0' Form 4 DEP has provided this form for use by local Boards of Hea but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information System Location: Left / Right front of hous , Le / rFic r or^ "nos Left / right side of house, Left / Right side of building, Left / Right front of bul Ing, Left / Right rear of building, Under deck Address L� s �, — City/rown State Zip Code 2. System Owner. Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): Date Cesspool(s) State`.� _6� Zip Code Telephone Number — 2. Quan . Pumped: Septic Tank Gallons ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condi ion of System: 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Location where contents were disposed: Waste Water F5821 Vehicle License Number Date 5 cA--�3 t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 scope 2��vi�z���n�r (-rso) �.4T/QN ,4T:. (TOP OF 5TONE� _ ........ :.:..:.. E,'/5T/.Ne E'LEMT/ON 4T= 2EQU .............. n . ops/w �s r /NI/. P/Pe OvT. OF 1104115E / 5 `� . � C - /Nf/ P/f-'" /NTO THINK INi/ PIPE' 04/7 OF . THINK �-/NI/. P/PL" 04T Or D f30X ,6-26/ � � ? � ,�, �? IN A.4TC C1 ,rll,4rraN DE-PT11 . 7 lPeOBE Q 71.1/5 PLAN /� ADT .4. .4 .4tV/"Y % � E ,SYSTEM IlSeWl .471 T 'E L'TU E6. t, _�. _�. _. _ _ ..,. .�. , _ . � �T. -+��� i .t �� ,� / _�. 4/r �.� � ���.t _ � �,.. � i GG•C� rte_ t� "tt ,,,,� 4 � Q .:.. . i y �.��. �� '`� � Of NORTH 1y � l 1 , ' 1 Town of North Andover HEALTH DEPARTMENT CHU CHECK #:/�� D--A--TE:�`0� LOCATION: H/O NAME: NAME: Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ 0- Title 5 Report $ J ❑ Other: (Indicate) $ Com, Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer Claim # 033165931 Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road #B North Andover, MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings Town Hall North Andover, MA 01845 Re: Insured: Andrew Devore Property address: 75 Forest St. Board of Health ov-*� Board of Selectmen Town Hall North Andover, MA 01845 North Andover, MA 01845 Policy #: 78868400003 Loss of: 2011/10/30 File or Claim No. AD 9625 Claim has been made involving loss, damage or'destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. _Gen._Laws,_Chapter_143,Section_6 to be applicable. If any notice under Mass_ Gen_ Laws,_ Ch._139_Sec. _3B is appropriate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. L Glenn Guarente Title: Adjuster On this date, I caused copies of this notice to be sent to the persons i named at the addresses indicated above by first class mail. Signature and.date NORrM q � tt6lD �6 11 • 0 � y •p_ cocw�cgwrtw PUBLIC HEALTH DEPARTMENT Community Development Division RTI(FICA7E OAF C0�1�1'LIA9VCrE As of: September 10, 2008 This is to cert that the ind viduaCsu6surface disposaCsystem received a SMI'SFAC ORTINS(PEMONof the: Replacement of Septic Dlstridution fox By: John Soucy At: TS Forest Street Map 106..,x; Q'arrell70 NorthAndover, W,4 01845 The Issuance of this certificate shaCC not 6e construed as a guarantee that the system wiCC function satisfactorify. f;. J` SAL 7 Savvy M& iTeaCth (Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 11 k h SLOPE l'fQU/R'E�t.1NT ; (150) X e /50 — _ .... _. DES/ON Ec EVdT/ON AT....... (rOP Of STONE) _ ......... . . . . . . . . . EX/5T/NCS ELEt�4T/ON AT ........ C'E4a/ . f/LL DES/GN 45, iW&r JA�� .... M1 P/P�- OVT OF I/0415E '1V1P1Pc INTO 74Nff 4! /N/. PIPE 0417 OF. ,T4NK t .. ::a t :E i :17 /NY. P/Ac IWO L5 my ¢' / r CNK 7/P77 bUT OF � 13O.1' IN41 ENV OF P/PE �TS"k TrOiv 4VEeA6E S•WNE DEPT"/,/ , 4T ,Reo a:7wiI,I -, /h/ AOR ,n ©,4TH; 12 °ti ym � /ST1,4NSEN EN�fNA.,s� M fNr 7k5' Pr4iYt fS IVOT A W4,� '4Ni'!' I/4 .X8W,74 .4Y,6,, AWVe,eWI44,,ik1.4 41C TfI_E Any appeal shall be filed within (1-0) ,ays after the date of filing of this Notice in the Office of. the Town Clerk. ' SSMC NUSt TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE OF DECISION Property: 75 Forest St. ��IVft; 10YCI!R�IiA06liAW TOWN AL€R . NORTH ANDOVER SEP 18 1 59 PYI.-191 NAME: Donald & Jennifer Melson Date: 9117/97 ADDRESS: 75 Forest St.. Petition: 016-97 North Andover, MA 01845 Hearing: 919197 The Board,ot Appeals held a regular meeting on Tuesday evening, September 9, 1997 upon the application of Donald & Jennifer Melson, requesting a Variance from requirements of Section 7, paragraph 7.3 of a side setback for the construction of an addition, of the Zoning Bylaws. Said premises is land and building located at 75 Forest St., which is in the R-1 Zoning District. The following members were present: William Sullivan, Walter Soule, Raymond Vivenzio, Robert Ford, John Pallone, Scott Karpinski, Ellen McIntyre. The hearing was advertised in the Lawrence Tribune on 8/26/97 and 912197, and all abutters were notified by regular mail. Upon a motion made by Raymond Vivenzio and seconded by Ellen McIntyre, the Board of Appeals unanimously voted to GRANT the Variance requested of 6 112 feet on the Southerly side as shown on the plan revised 8/21197. Voting in favor: William Sullivan, Walter Soule, Raymond Vivenzio, Robert Ford, Ellen McIntyre. The petitioner has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning bylaw. Note: The granting of the Variances and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a Building Permit as the applicant must abide by all applicable local, state and federal building codes and regulations, prior to the issuance of a building permit as requested by the Building Commission. /testd"eel3 BOARD OF APPEALS, —�� cG�GYry William J. Sullivan, Chairman M FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify approvals/permits from Beards and De a that all necessary have been obtained, This does not relieve is having landowner from compliance withapplicable i ]urisdiction . regulations or Le �Y applicabeelocal�o ant an Z w requirements. ****************Applicant fills out this segtion***************** APPLICANT: �i� ���• ��z�/^ Phone " LOCATION: Assessor's Map Number �� b Parcel Subdivision Street --/L i� U �' n 9 Lot (s) ---L= St. Number 17,5 Official Use only************************ RECOiNDATION$ OF TOWN AGENTS: Conservation Adm' 1 Administrator Comments Town Planner Comments Food In pector-Health `SeP is Inspector -Health Comments Date Approved Date Rejected t,L'/ 1,•, 1AI) Date Approved Date Rejected Date Approved Date Rejected Date Approved le2 ° Date Rejected -Public Works - sewer/water connections driveway permit Fire Department �l �'�`- �D •2 �% Received by Building inspector Date __� 0 �/ Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. VQ Commonwealth of Massachusetts City/Town of NORTH ANDOVER System Pumping Record Form 4 0 DEP has provided this form for use by local Boards of Health. TheSYitfZr-F(M'V§R' be be submitted to the local Board of Health or other approving autho ity. A. Facility Information 1. System Location: Address JUL_ I tj LUUU TOVVN OF NORT H ANDD`: T HEALTH DEFIARTIVIEN 0, . . ...... .. City/Town State Zip Code 2. System Owner: Name Address {if different from location)....... .. . ........ State ip d Telephone Number 6.-Pumpinq Record 1. Date of Pumping Date 7 2. Quantity Pumped: Gallons Type of system: ❑ CessP001(s) Tight Tank 11 Other (describe): 4. Effluent Tee Filter present? ❑ Ye S If yes, was it cleaned? 5. Condition of System: 6. Sy em Pumped By: n Name.. ............. ..... - ----- Vehicle License Number I- � _" (5t ... - t�fitt'_� ---l— Company 7. Location where contents were disposed- , � /W'u� reo' 2. Date hftp://www.mass.gov/dep/water/;r-p/rovalsit5forms.htm#jnspect (5f0rM4.doC, 06/03 System Pumping Record , Page 1 of 1 S YSTEM OWAtlt ADDRESS w.��� DATE OF PUWNO -QUANTITY PUMPED: 0 ;:"SPOOL: NO ...........YES SnPdc TA0. NU. 1'E NA, ttlkis ON 9ERVlCE: ROUTiNs U MBRUHNC'Y, V��ERVA'CiON3: DOOR CONi?!TION FULI. 'TU CQVi3R HEAVY GR +158 � BAFFLES IN PLACL It00'1"S ' LBACfii+iELD RUNBACK •w. 5XC3$ WE soum FLOODED -SOLMCARRYOVER _.OTKER EXPLAIN ..... �7•t+rm Pwtpcdbr _w ...._ T./.fa„,.� •.. 6 e_.�. NMS. .. ww.Mw.w....`...n wN... «..ww... ... ... .. ..r •......- .•« .. ... .. N rLN•t'� rKAN�r'lrRRBt) 't1 `" ��r�z,c;,� �. � . r woof TOWN OF NORTH ANDC?V1;r!% UA R SYSTEMPU MP1Np RECOKL� S YSTEM OWAtlt ADDRESS w.��� DATE OF PUWNO -QUANTITY PUMPED: 0 ;:"SPOOL: NO ...........YES SnPdc TA0. NU. 1'E NA, ttlkis ON 9ERVlCE: ROUTiNs U MBRUHNC'Y, V��ERVA'CiON3: DOOR CONi?!TION FULI. 'TU CQVi3R HEAVY GR +158 � BAFFLES IN PLACL It00'1"S ' LBACfii+iELD RUNBACK •w. 5XC3$ WE soum FLOODED -SOLMCARRYOVER _.OTKER EXPLAIN ..... �7•t+rm Pwtpcdbr _w ...._ T./.fa„,.� •.. 6 e_.�. NMS. .. ww.Mw.w....`...n wN... «..ww... ... ... .. ..r •......- .•« .. ... .. N rLN•t'� rKAN�r'lrRRBt) 't1 `" ��r�z,c;,� �. � . v Tb" OF NORTH ANDOVER': SYSTEM PUMPINC RECORD 2 2003 1 tM VWNl✓R & ADDRESS.. )0C0V—&,S/- 6/7 S Y S T E M L 6--CTA—T—ra---- — — :� I,. I . (e"mPltlcf( from of hour) I--,- /-. Rt, n I- U %TC 0 . F PUM?fNC:l QUANTITY . .PUMPED_�V(;,i NO YES SEPTIC TANK: NO Yes '-�TUREOI: SERYICE: ROUTINE EMERGENCY COOD CONDITION. b'U L L TO COYER HEAVY CREASE BAFFLES IN PLACE ROOTS LEACHFICILD RUNBACK... CXCESSIVE SOLIDS FLOODED SOLIDS CARRYOYER �HFR (EXPLAJN) a'I'L•'M P U M P C, D 8Y. U VIM p N T S: ON, !'I A N S F C, I Z I Z ED TO: AI,6(4,1 .6.4. Avr,6ver 0.6.4.- J-36 1Jb Moon Sf Jt/a fl A dd Wi t65Q OSG,00� ,nC4� 1 I /74 O/y.»ri c /Qhr F STWMIS sWMc scE 47 RAixA= gfp= MAMM, MR 41835 976-372-7471 t ADDRESS ✓ G— ��75 .Sy /en .�� ✓� " t65Q OSG,00� /74 O/y.»ri c /Qhr ✓ /9477 `f3 JxlxLl f 6 - 103 �v 155-0 00075 rrq r� 1� 1660 /Oto MR Wo Ma PAGE II STEWART'S SEPTIC TANK SERVICE (CONT'D) 04-22-96 A 31 S`T'ONE CLEAVE ROAD 11800 201 BRADFORD STREET 11000 04-23-96 585 BOXFORD STREET 11500 HEAVY A 175 GREAT POND ROAD 2,000 04-24-96 1615 OSGOOD STREET 500 FLOCOED .A 122 OLYMPIC LAME 11500 A 1.116 SALEM STREET 750 04-25-96 A 75 FORREST STREET 11000 04-26-96 550 BOSTON STREET 2,000 2-1,000 TANKS 04-27-96 A 1015 JOHNSON STREET 11000 175 FOREST STREET 11000 350 SHARPNER'S POND. ROAD. 1,500 04-29-96 A 18 STEVENS STREET 1,250 A 100 FOREST STREET 1,500 A 82 PADDOCK LANE 1,500 04-30-96 A 133 SUMMER STREET 11000 A 347 HILLSIDE ROAD 11000 l� i' BOARD OF HEALTH r No.Andover, Mass. " i• SUBSURFACE DISPOSAL DWIGN CHECK `SST f LOTr�1�s APPROVED. DATE Provided: DISAPPROVED DISAPPROVED DATE— .. Reasons: Title V FAIL 011 - — -- - Reg._2.. The submitted plan must show as a minimum: a) the lot to be served -area, dimensions lot #j'abutters b location and log deep observation hoes -distance to ties c location and results percolation tests -distance to ties d design calculations & calculations showing required leaching area (e) location and dimensions of system -including reserve area f) existing and proposed contours (g) location any wet areas within 1001 of sewage disposal system or disclaimer -check wetlands mapping (h) surface and subsurface drains within 1004, of sewage disposal system or disclaimer {i) location any drainage easements withii 1001 of sewage disposal system or disclaimer -Planning Board P les (j) known sources of water supply within :'001 of sewage disposal d . system or disclaimer (k) location of any. proposed well to serve. lot -1001 from leaching facilk (1) location of water lines on property -L°;' from leaching facility (m) location of benchmark (n) driveways (o garbage disposals {p no PVC to be used in construction (q) profile of system -elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and other elevations (r) maxim= ground water elevation in area sewage disposal system s) plan mast be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks (a) capacities -150;6 of flow, water table, tees, depth of tees, access, pumping (b) cleanout (c) 101 from cellar wall or inground swimming pool (d) 25+ from subsurface drains . Reg 10.2 Distribution Boxes 1(a) slope greater 0.08 Reg 10.4 (b)..IM'W K Board of Health North AnP.yer,Mass. SEPTIC SZSTEi INSTALLATICK CHECK LIST APPR-OM DATE DI SAPPrtQ�k9 DAT �easonst { OK y qf rem LOT' 'Fy j XG�AVATICN OX FAIL 1. Distance Tot a. Wetlands be Drains c.. Well , 2. Water Line Location 36- No PVC Pipe he Septic Tank - a. Tees -._Length & To Clean Out Covers b. Cement Pipe to Tank - On Both Sides of Tank 5• Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flox 6. Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Fids d. Clean Double Washed Stone 7. Leach Pits a. Dimensions b. Stone Depth c. Splash Pads d. Tees e. Cement Pipe to Pit - Both Sides £. Clean Double Washed Stone 8. No Garbage Disposal 9. Anal Grading Inspection 10. Barricading Covered System 11. As Built Submitted a. Lot Location be Dixaensions of System c. Location with Regard -to Pere Test d. Elevations ae Water Table v MWA Commonwealth of Massachusetts a _ City/Town of NORTH ANDOVER, M System Pumping Record �j Form 4 Important: When filling out forms on the computer, use only the tab key' to move your cursor - do not use the return key. VQ AGHUUTTS DEP has provided this form for use by local Boards of Health. The be submitted to the local Board of Health or other approving autho A. Facility Information 1. System Location: To.,� ,I UF NORTH ANDD HEALTH DF_PARTMEN-1 2 7--i rZV�-72t �, Address City/Town -- --_ State System Owner: Name----.-----_-- ------ --- -- Address (if different from location) City/Town Zip Code ---------------- - State ip d 9 - Telephone Number mu! B` -Pumping Record - 1. Date of Pumping ---.- p g Date 7 2. Quantity Pumped: --�'� --- ---- - Gallons Type of system: ❑ Cesspool(s)c Tank ❑ Tight Tank ❑ Other (describe): -_ ---.-. _-------- ----- - ---- - --- — - - 4. Effluent Tee Filter present? ❑ Yes If yes, was it cleaned? ❑ Ye 5. Condition of System: 6. Sy em Pumped By: Name- -- - - �. Vehicle License Number Company - 7. Location where contents were disposed: §7ic ature of Haul Date http://www. mass.gov/dep/water/ Haul r t5form4.doc• 06/03 System Pumping Record • Page t of ? TOWN OF NORTH AIYDOVEP, UA 11�_� /-- SYSTEM PUMPING RECORD SYSTEM OWNERS ADDRESSI SYSTEM LOCATTAN H 2 DATE OF PUWNQ: ._QUANTITY PUMPED; /S �-'tSSPOOL: NO Ygg -.....•. S.00c Tahk: NO. YES N^ rUKE ON SERVICE: ROU'rwla.>w`t-.•.. MAY 0 6 2005.. UbSURV A'rl0N9; ANoovER 000D CONDITION PULL'T'U C`OVBR HRAVY ORH,^S$ �_+ BAPFI.$S IN PLACE TON EA�TVAUEV, ROOTS .._. LBACHFIELD RUNBACK 5XCISMYS SOLIDS.— FLOODED SOLID CARRYOVER, OTKER EXPLAIN 016, .,..r.}'1<.. �... • Com;:.. ,l3ra��4�z�; irra. UUMMENTS• L:vN mm's rKANBF'ERRBD 11) TOWN OF NORTHANDOVER SYSTEM PUMPING RECORD 2 2003 �l STEM OWNER & ADDRESSSYSTEM LOCATION (example; left front of house) U:\TC OF PUMPINC, QUANTITY 'PUMPC- DLLc», C. .-SP00L: NO — YES SEPTIC TANK: NO YES , ATURE OF SERVICE: ROUTINE EMERCENCY GOOD CONDITION. FULL TO COVCIZ HRAYY CREASE BAFFLES IN 1'LACI: ROOTS LEACHFIELD RUNBACK., CXCESSI•YE SOLIDS FLOODED SOLIDS CARRYOVER p HF,R (EXPLA.IN) PUMf'Cp By., � u )11.'Yl P. NTS: TRANSFI CI RRED TO. PAGE II STEWART'S SEPTIC TANK SERVICE (CONT'D) 04-22-96 A 31 STONE CLEAVE ROAD 1,800 201 BRADFORD STREET 11000 04-23-96 585 BOXFORD STREET 1,500 HEAVY A 175 GREAT POND ROAD 2,000 04-24-96 1615 OSGOOD STREET 500 FLOODED A 122 OLYMPIC LANE 1,500 A 1116 SALEM STREET 750 04-25-96 A 75 FORREST STREET 11000 04-26-96 550 BOSTON STREET 2,000 2-1,000 TANKS 04-27-96 A 1015 JOHNSON STREET 11000 175 FOREST STREET 11000 350 SHARPNER'S POND ROAD 1,500 04-29-96 A 18 STEVENS STREET 11250 A 100 FOREST STREET 1,500 A - 82 PADDOCK LANE 1,500 04-30-96 A 133 SUMMER STREET 11000 A 347 HILLSIDE ROAD 11000 BOARD OF HEALTH No.Andover, Mdss. e e SUBSURFACE DISPOSAL DESIGN CHECK .IST '" J T LOT # APPROVED DATE DISAPPROVED DATE_ _ � � v Provided: Reasons: y Title V FM Ob -Reg -2.5 The submitted plan must show as a minims t. a) the lot to be served -area, dimensions lot #,abutters blocation and log deep observation hoes -distance to ties c location and results percolation tests -distance to ties d design calculations k calculations showing required leaching area (e) location and dimensions of system -including reserve area -- f) existing and proposed contours (g) location any wet areas Athin 100' of sewage disposal system or disclaimer -check wetlands mapping (b) surface and subsurface drains within 10041, of sewage disposal system or disclaimer (i) location any drainage easements withii 100' of sewage disposal system or disclaimer -Planning Board P les (j) known sources of water supply within `00I of sewage disposal d system or disclaimer (k) location of any proposed well to serv►. lot -1001 from leaching facility (1) location of water lines on property -la from leaching facility (m) location of benchmark (n) driveways (o) garbage disposals (p) no PVC to be used in construction (q) profile of system -elevations of basement,, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Other elevations (r) maximum ground water elevation in area sewage disposal system (s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks (a) capac t es- 50;6 of flow, water table, tees, depth of tees, access, pumping (b) cleanout (c) 101 from cellar wall or inground swimming pool (d) 251 from subsurface drains Reg 10.2 Reg 10.11 7 Distribution Boxes (a) Rope greater than 0.08 (b) sump Board of Health - North Anc verxylass. _IP Rf OVED DATE 1. easDnst SEPTIC STSTEH INSTAI.LATICK CHECK LIST 5s LOT ` J F r-o�s - —r ---CN 0& FAIL 1. Distance To: a. Wetlands b. Drains c .. Well 2. Water Line Location 3.' No PVC Pipe %. Septic Tank a. Tees -_Length & To Clean Out Covers b. Cement Pipe to Tank - On Both Sides of Tank 5. Distribution Box a. Covers 4 Box - No Cracks b. All Lines FloAmg Equal Amounts C. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Inds d. Clean Double Washed Stone 7. Leach Pits a. Dimensions b. Stone Depth c. splash Pads d. Tees e. Cement Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No Garbage Disposal 9. Final Grading Inspection 10. Barricading Covered System 1J.' As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard -to Pere Test d. 'Elevations e: Water Table At tw -IoAananS kP,1t,"zH zaau-1 lug i' 3Q UI T -P011 jo p.zL-TL / nz»oF `�uzuu7T,7 :0- 75T-5 `IAF'n� ,�� uo aungL.AL a1 rP j a.i�i;:iih;;�, . . 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PLUOOP-I l puPL J@ILP. of 177011lipl Illy?I I I LM I i,r Ir1;i lj.,i 'I• 'i :SAau 10 lLpazl S0jPLJOSSt/,.anT I.. i,r !I • I , aoLIoN a I uo VW `.AanopUti III.AoN `laa,AlS IJLPt� O,:I `IIJc rrZl I,IIL I. `IULPLpq uMol aul lP 'hJ'd oo:q "Ir' �jq(,l 6uL AeaH OL qnd P PLou LI_LM UOLSSIuJUI0- unt ten.A,),ur .; .l.,nr,(,ut/ Ial.,�rp,1 aqq `Me -I Xq uoLjoaloAd P1AP110t1 S�J;)AOPut/ IIIJOtJ It, IrMrrl ' lWj I,,fr= Ipapuawt) SP `Ob U()L4oaS `L FI AaadPIIO ;MPI L�>.,��u,��, >a:nla,r� ,st,Ul 'jDV UOt1-o;)1OJd SPuPLIOM -III Lr, i(jj .Aoijjnr• :,,1i r?1 aunn, ,jry NOISSIWWOO NOIJ_VOIT�NW) 30 3) 1.71-10 S IA3S(IHOVSSVW `� IAOONV III PH If) NMO I 13 U[:./ UJ/ 1 77 / UU. 3U JU63/ JOOl l 11 I 1 WHM I / HIYVUVCr "3"T'S S SEPTIC TANK SMMCE 47 RMT tW glygMT MADPM,, HW 01835 978.372-7471 mogm OF afxylQ ADMtWS 66 -- ✓6 : 165q' DSG�odr> ✓ � � '7o/ >o ros l- X51, IJb ojr% Sf Ne raj A "v ! 161-L1p Le- I 1 WHM I / HIYVUVCr "3"T'S S SEPTIC TANK SMMCE 47 RMT tW glygMT MADPM,, HW 01835 978.372-7471 mogm OF afxylQ ADMtWS 66 -- ✓6 : 165q' DSG�odr> ✓ � � loan /0010 a� rHVG UJ '7o/ >o ros l- X51, r tv Ida ��- /03 Dd6zr9vm ✓ ( 155'0 W OQJ by e A/ �✓ 6 --ro Oyu �bts�n �j. loan /0010 a� rHVG UJ Any appeal shall be filed within ('0) days after the date of firing of this Notice in the Office of. the Town Clerk. ,SS�CNu5t�1 h TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE OF DECISION Property: 75 Forest St. R€n'zIVIt; JOYCE @liAO! THAW NORTH OEt vK a ANOO.ER SEP 16 1 59 NAME: Donald & Jennifer Melson Date: 9/17/97 ADDRESS: 75 Forest St.. Petition: 016-97 North Andover, MA 01845 Hearing: 9/9/97 The Board•of Appeals held a regular meeting on Tuesday evening, September 9, 1997 upon the application of Donald & Jennifer Melson, requesting a Variance from requirements of Section 7, paragraph 7.3 of a side setback for the construction of an addition, of the Zoning Bylaws. Said premises is land and building located at 75 Forest St., which is in the R-1 Zoning District. The following members were present: William Sullivan, Walter Soule, Raymond Vivenzio, Robert Ford, John Pallone, Scott Karpinski, Ellen McIntyre. The hearing was advertised in the Lawrence Tribune on 8/26/97 and 9/2/97, and all abutters were notified by regular mail. Upon a motion made by Raymond Vivenzio and seconded by Ellen McIntyre, the Board of Appeals unanimously voted to GRANT the Variance requested of 6 1/2 feet on the Southerly side as shown on the plan revised 8/21/97. Voting in favor: William Sullivan, Walter Soule, Raymond Vivenzio, Robert Ford, Ellen McIntyre. The petitioner has satisfied the provisions of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of these variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Note: The granting of the Variances and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a Building Permit as the applicant must abide by all applicable local, state and federal building codes and regulations, prior to the issuance of a building permit as requested by the Building Commission. /testdec/3 BOARD OF APPEALS, William J. Sullivan, Chairman LM FORM U - LAT RELEASE FORD INSTRUCTIONS: This form is used to verify approvals/permits from Boards and pea that all necessary have been obtained. This does not relieve is having jurisdiction landowner from compliance with an th y applice applicant and/or regulations or requirements. able local or state law, ****************Applicant fills out this se9tion*************** APP Phone�'(�'7�j LOCATION: Assessor's Map Number Parcel Subdivision Street Lot (s) St. Number '7 15 Official Use Only************************ RECOMMENDATION$ OF TOWN AGENTS: Conservation n Administrator�� IL Date A Approved Date Rejected Comments /lit �•�; �-('�lL,�,�S Town Planner Comments Food In pector-Health '`Sep is Inspector -Health Comments l�x Date Approved Date Rejected L _ 7TT Date Approved Date Rejected Date Approved Date Rejected IJ'I� Public Works - sewer/water connections - driveway permit Fire Department Q- �'�- , �� •Z� Received by Building Inspector Date TOWN OF NOCTti ;4NDOVER N°RT1 Office of COMMUNITY DEVELOPMENT AND SERVICES 3r •``_ �''• °� HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS Public Health Director Comments:/ cv�l! GL'6EJ SOIL ABSORPTION SYSTEM El Comments: Installed on stable stone base s�CHus < 978.688.9540 — Phone 978.688.8476 — FAX Inlet tee (if pumped or >0.08'/foot) Hydraulic cement around inlet & outlets Observed even distribution Speed levelers provided (not required) Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel -less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Wastewater System Documentation — Feb 2006 Page 3 of 6 f MORT4 , Commonwealth of Massachusetts Map -Block -Lot o ,, ti8 106.A- 0170 - ti' o� ----------------------- ,. Board of Health Permit No •= " North Andover BHP -2008-0176 P.I. FEE r3ac►+u4ti�h F.I. $125.00 Disposal Works Construction Permit Permission is hereby granted John_ Soucy_ -------- to (REPLACE D -BOX) an Individual Sewage Disposal System. at No 75 FOREST STREET as shown on the application for Disposal Works Construction Permit No. BHP -2008-017 Dated August -26,2008 Issued On: Aug -26-2008 Board'o ' g f Hee alth --------------------------------------------------------------------------------- f yORtH , Commonwealth of Massachusetts Map-Block-Lot °���`° •,00L 106.A -0170 - Board of Health ----------------------- North Andover Certificate of Compliance isSAcwus£i THIS IS TO CERTIFY, That the Individual Sewage Disposal System (REPLACE D -BOX) by ___John Sou__c__y__---- Installer at No 75 FOREST STREET has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. -BHP-2008-017-- - - -- - Dated --ugust 26, 2008 ---------------- - ----- g Board of Health Printed On: Aug -26-2008 w 3j oc + Town of North Andover HEALTH DEPARTMENT '�SSACNU CHECK #: l/ S� O DATE.- LOCATION: ATE:LOCATION: H/O NAME: CONTRACTOR NAME: Type of Permit or License:( ❑ Animal ❑ Body Art Establishment ❑ Body Art Practitioner ❑ Dumpster ❑ Food Service - Type:_ ❑ Funeral Directors ❑ Massage Establishment ❑ Massage Practice ❑ Offal (Septic) Hauler ❑ Recreational Camp ❑ Sun tanning ❑ Swimming Pool ❑ Tobacco ❑ Trash/Solid Waste Hauler ❑ Well Construction SEPTIC Systems: ❑ Septic - Soil Testing box) ❑ Septic - Design Approval eptic Disposal Works Con#ruyion (DWC) ❑ Septic Disposal Works Installers (DV ❑ Title 5 Inspector ❑ Title 5 Report ❑ Other: (Indicate) Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer P\ 6 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. ISI Application for Septic Disposal System (Construction Permit - TOWN OF TOD IS DAT Full..R'pair 125.00 - LC o!�nt Application is hereby made fora oermit to: Construct a new on-site sewage disposal system* CA&4-) ❑ epair or replace an existing on-site sewage disposal system* �1/ Repair or replace an existing system component - What? A. Facility Information Address or Lot # City/Town 2.- *TYPE OF SEPTIC SYSTEM*: ❑ Pump ❑ Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. 3. /-t? - -'3;r , 5T_ Address ' different from ove) t E414 . Ci y own '— StateZip Code :9 ?C Telephork Number Name A n /')L Name of q City/Town State Zip Code Telephone Number (Cell Phone # If possible please) 4. Desi ner Information / / 7 Name Address City/Town Name of Company State Zip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 ' SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: —�!S— 6reS (.Address of septic system) . Relative to the application of SO (,tC nstaller's name) Dated 16�1 rl'oddy's ate For plans by ��/ (Engineer) And dated A/ ,(i n3 genal date) With revisions dated y'41_ (Last revis d date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer, I must call for any and all inspections. If homeowner, contractor, project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection. without comnletion 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: healthdel2t&toxvnofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade — Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board of Health staff or consultant. d. Installation of tank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer, I understand that I am solely responsible for the installation of the system as per the approved glans. No instructions by the homeowner, general contractor, or anv other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer: C 6 am —Print) (Todav's Date) Page 1 of 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Monday, July 28, 2008 4:28 PM To: 'ja_melson@yahoo.com' Subject: 75 Forest Street - Health Department Files - North Andover Hello, Here are copies from your file as you requested. Please call if any questions. 541 Ragwidk, PaIWaBq A9000.0040,9 1410 Health Department Assistant Town of North Andover 1600 Osgood Street Building 20, Suite 2-36 North Andover, MA o1845 8978.688.9540 - Phone r 978.688.8476 - Fax http:J/,Atiaw.townofnorthandover.com healthdept@townofnorthandover.com 7/28/2008 E I EMIL J. INCOLLI NGO, INC. 239 TYLER STREET METHUEN, MASSACHUSETTS 01844 Telephone 617 / 685-0253 w OR6 7 i n �6111 l' 4L (�So) Y s NT x /50 — _ DES/�N CEk 4T/O�/ ......................... . N� &Q-0471—ON ,4T ......... (TOP Ooo- oclu STONE) — _ ............................ /N!i OUT OF,UOUSE //Vl!/NTO TgNK /N1! P/PE 0/17OF 74—Mot' , /N//, P/PE' /NTp r t BOX /NI! P/PE 01-17-0, p BOX /N!! END OF P/PE i 6vGTE2 EL E1147 -10N .4t/E2,46C STONE ONOT 4� l .4 ,e AI / i,T A7 ,,,Cl U4 ST,eUlt/ STi..iiY� T /plll y' N. SYSq/- 5—Re IN oa SC.41- E.- / - - C11jf �4��,4N,56W //fit AlENOZ�N�/%����//�% .4v�, r1'4P67el7o(lL4 AW -4.. 1 OR6 7 i n �6111 l' 4L (�So) Y s NT x /50 — _ DES/�N CEk 4T/O�/ ......................... . N� &Q-0471—ON ,4T ......... (TOP Ooo- oclu STONE) — _ ............................ /N!i OUT OF,UOUSE //Vl!/NTO TgNK /N1! P/PE 0/17OF 74—Mot' , /N//, P/PE' /NTp r t BOX /NI! P/PE 01-17-0, p BOX /N!! END OF P/PE i 6vGTE2 EL E1147 -10N .4t/E2,46C STONE ONOT 4� l .4 ,e AI / i,T A7 ,,,Cl U4 ST,eUlt/ STi..iiY� T /plll y' N. SYSq/- 5—Re IN oa SC.41- E.- / - - C11jf �4��,4N,56W //fit AlENOZ�N�/%����//�% .4v�, r1'4P67el7o(lL4 AW -4..