Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 90 BRADFORD STREET 4/30/2018
` _ s ''� r� . t— I� � N o� o O1 go �� �� o� o m O m � � r' �_� i � i' w, , .J 4W Paha Lot & Street Map/Parcel / JK CONSTRUCTION APPROVAL Has plan review fee been paid: YES Plan Approval: Date: /q l Designer: 0: C®6 P J r Conditions: NO Permit#_ %/ Approved by: Plan Date: 7 ©� Water Supply: Town Well Well Permit: Driller: Well Tests: Chemical Bacteria I Bacteria II Plumbing Sign -Off: Comments: Form "U" Approval Date Issued Conditions: Final Approval: Dat%Ap oved Datoved Datoved Wi ' 4g Sign-off: Approval to Issue: By:_ YES \NO All Permits Paid? YES NO .-14te4h6enst�cti.on..Ap.p.r-o-vaP --- S NO Septic System Construction Approval? Y NO Certification? ES NO Other? YES NO Any Variance Needed? YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: .0 TIQ FORM U -LOT EASE FORM REL INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANTS �' `� PHONE LOCATION: Assessa's Map Number / e D PARCEL"' SUBDIVISION LOT (S) STREET 2����ST. NUMBER OFFICIAL USE ONL TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD IN ECTOR-H TH DATE APPROVED DATE REJECTED 1/ INSPECTO -HEA H DATE APPROVED % .s k �� DATE REJECTED COMMENTS Lr_ .T, -1,14-, rs�_'�'�.�. rfi > PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT, FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Rwlad N? Im N 0 (411— z -S, 0 R rec--IC� L `V -c Ea— D APR 14 2005 4 & iv -j- 1 -1 P,,\r;OVER 'ALTH DEPARTMENT r�) 0 0 C M W W �Lt IAN 0 0 0 an o 0 r N cca niN N cmN N C 0 RECEIVED APR 14 2005 TOWN OF NOR -1 H ANDOVER HEALTH DEPARTMENT J 0 Town of North Andover Office of the Health Departmen Community Development and Services 400 OSGOOD STREET North Andover, Massachusetts 01845 hgp://www.townofnorthandover.com Susan Y. Sawyer, REHS/RS a-ma>l: healthdepWtownofno.I•thandover.com P (978) 688-9540 Public Health Director F (978) 688-8476 INFORMATION REQUEST Health Department Please use this form if the Health Director. is unavailable to provide immediate assistance. Please fill out this form in its entirety to ensure an accurate and prompt response. All requests for information will be handled as soon as possible. CONTACT INFORMATION Date: V Name: Phone number: �% ✓ , % c2 �& f Fax number: Address: INQUIRY - Property in question: (Please include as much information as possible) Subject: Inquiry: % l - L6/.q e-" ' d 0 Thank you for your interest and inquiry. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 NEW ENGLAND ENGINEERING SERVICES INC August 9, 2004 North Andover Board of Health Town Hall Annex 27 Charles Street North Andover, MA 01845 AUG 10 2004 TO\NIN,-)F NORTHANDOVER HEALTH DEPARTMENT_ RE: TITLE V REPORT: RE: 90 Bradford Street, North Andover, MA Dear Sir or Madam: Enclosed is a copy of the Title V report for the above referenced property. The system PASSED our inspection. If there are any questions please call me at my office, 686-1768. Sincerely Benjamin C. Osgood, r. Certified Title 5 inspector 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: '10 a: A R p ry ,2 D S?. ti02Tiy A -N ov,j2/L /kiA Owner's Name: __ ()OAJ /M i of 0 r t_S Owner's Address: —Cy o f3 /2r+ ) pry a.9 1, Date of Inspection: Name of Inspector: (please print) Beni amin C. Osgood, Jr. Company Name: New England Engineering Services Inc. Mailing Address: 60 Beechwood Drive, Korth Andover, MA 01945 Telephone Number: 978-686-1768 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: �?j_ C Date: g . 3 -A V The system inspector shall submit acopy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use, Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: q Q (39NT>;, :, 9- 1) S %, PaU %Z-rH AN 1) 0ue2 r►n jq Owner: 'C> A /u A4 tC X4,4 0 L!5 Date of Inspection: S e Ll Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D A. System Passes: E 5 I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: /1,/0 One or more system components as described in the "Conditional Pass" section need to be replaced or repaired.1he system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If "not determined" please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: - Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box, System will pass inspection if (with approval of Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A r1CERTIFICATION (continued) Property Address: .-V)VQC&y r 0.• Owner: ban "1 C VhC _ Date of Inspection: P) - -�D - 6q C. Further Evaluation is Required by the Board of Health: /LA_? Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(l)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 few of a bordering vegetated wetland or a salt marsh 2. .System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. —The. system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and, the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 Ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other. Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: V bmaof Owner: G\Y� til �C.Y�C� 1S Date of Inspection: t� - 3 - a y D. System Failure Criteria applicable to all systems: You must indicate "yes" or `Sao" to each of the following for 11 inspections: Yes No -- Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool L- Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/, day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped =' Any portion of the SAS, cesspool or privy is below high ground water elevation. ----Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. -5=-- Any portion of a cesspool or privy is within a Zone 1 of a public well. -,::f Any portion of a cesspool or privy is within 50 feet of a private water supply well. . _,,-Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, Performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] L1L_ (Yes/No) The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either "yes" or `Sno" to each of the following: (The following criteria ply to large systems in addition to the criteria above) yes no — — the system is within feet of a surface drinking water — _ the system is within 200 feet-_ to a surface drinking water supply — the system is 1 a nitrogen ve area (Interim Wellhead Protection Area - IWPA) or a mapped Zone II of ublic water supply well If you have answered "yes" to any question in SectionE ystem. is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: qO -OY6 �aY�rY1 Ain C OU e.Y Ma . Owner: �)(An M t cin c\ e \,> Date of Inspection: _ �A _ S , p►-[ Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health -VWere any of the system components pumped out in the previous two weeks ? Has the system received normal flows in the previous two week period ? _ ✓/`Have large volumes of water been introduced to the system recently or as part of this inspection ? — Were as built plans of the system obtained and examined? (if they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up ? f Was the site inspected for signs of break out ? Were all system components, excluding the SAS, located on site ? _ ✓Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffies or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum ? t-'-= Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes no ✓_ Existing information. For example, a plan at the Board of Health. ermined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of l l . OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: qb 'Fq ff 0yd 3k X10Vk" A"dOVQy Owner: _ �)C1n VI\ k CYC C1 e1 S Date of Inspection: '� - �y►� FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): ?j Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example- 110 gpd x # of bedrooms): Number of current residents: -- I Does residence have a garbage grinder (yes or no): N D Is laundry on a separate sewage system (yes or no): /O [if yes separate inspection required] Laundry system inspected (yes or no): — Seasonal use: (yes or no): PO Water meter readings, if available (last 2 years usage (gpd)): Sump pump (yes or no): A/0 Last date of_occu_w C� c� e ✓�T COMMERCIAL/INDUSTRIAL Type of establishment: Design flow (based on 310 CMR 15.203): - gpd Basis of design flow (seats/pasons/sq%etc.): Grease trap present (yes or no): _ Industrial waste holding tank present (yes or no): Non -sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available Last date of occupancy/use: OTHER (describe): GENERAi. INFORMATION Pumping Records Source of information: Al o f P11174 P (Ale 12 P- F c;/ j Was system pumped as part of the inspection (yes or no): — If yes, volume pumped: gallons - How was quantity pumped determined? Reason for pumping: E OF SYSTEM Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy _ Shared system (yes or no) (if yes, attach previous inspection records, if any) _ InnovativelAltexnative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank _ Attach a copy of the DEP approval — Other (describe): Approximate age of all components, date installed (if known) and source of information: 2000 Were sewage odors detected when arriving at the site (yes or no):/LLD Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: % 6 X 1h Avg A C)\,[ v f Owner: t)o. ISA i C h r► P kS Date of Inspection: Qj - 3 G • \ BUILDING SEWER (locate on site plan) Depth below grade: Materials of construction: ,.st iron 40 PVC other (explain): — Distance from private water supply well or suction line: /✓ r� 'Comments (on condition of joints, venting, evidence of leakage, etc.): -- k4 --,--0 C2: � z o La ( ti 4 '�� E nom; SEPTIC TANK* _ (locate on site plan) Depth below grade: 17-1 Material of construction: _concrete metal fiberglass _polyethylene other(explain) If tank is metal list age: _ Is age confirmed by a Certificate of Compliance (yes or no): _ (attach a copy of certificate) Dimensions: /00,) rti-A- Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffie: How were dimensions determined: Comments (Oft Pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): K u,y1-:>CF- C�� GREASE TRAP: (locate on site plan) Depth below grade: _ Material of construction: concrete metal fiberglass polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffie: Date of last pumping: Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Page 8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ZVQ Q, 5� nNe r Owner: _ ban M i Ch qQ iS Date of Inspection: TIGHT or HOLDING TANK: /(tank must be pumped at time of inspec tion)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass __polyethylene other(explain): Dimensions: Capacit3r gallons Design Flow: _ gallons/day Alarm present (yes or no): Alarm level: Alarm in working order (yes or no): Date of last pumping: Comments (edition of alarm and float switches, etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): -b lx I L) - PUMP CHAMBER: A'A (locate on site plan) Pumps in working order (yes or no): Alarms in working order (yes or no): Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address• q v 13x0, , p S}. Owner: V� a`(1 IA a ek S Date of Inspection; , ol- SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required) If SAS not located explain why: Type leaching pits, number: _ leaching chambers, number: leaching galleries, number: leaching trenches, number, length: leading fields, number, dimensions: / F Ln overflow cesspool, number: innovativetalternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, leve etc.): l of ponding, damp soil, condition of vegetation, CESSPOOLS: %'+(cesspool must be pumped as part of inspectionxlocate on site plan) Number and configuration: Depth — top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction. Indication of groundwater Mow (yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): PRIVYA� (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 00 Bro dfo j c\ 51. ),) o� andoye� tea. Owner: L)o n M� cy, ra i S Date of Inspection: �_ aL� SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 6)�zAD fb i i4� --r 3a. c,' b3 y1.o' Page It of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: qp "V-S�rrad;j6Vd St. Uo�, car�rlo �ie.v MG - Owner: La n Date of Inspection: - 3 _ C5 y SM EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water & feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record - If checked, date of design plan reviewed: Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health -explain: Checked with local excavators, installers- (attach documentation) Accessed USGS database -explain: You must describe how you established the high ground water elevation: f 30, t' COMMONWEALTH OF MASSACHUSETTS Q EXECUTNE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMMAL PROTWnON ONE WRITER STREET, BOSTON MA 02108 (617) 292-5500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM DISPEM011 FORM PART A CEMICATION Property Address: 90 Bradford Street, North Andover Name of Owner: Harry Martinaitis Address of Owner: 90 Bradford Street, North Andover, MA. 01845 Date of Inspection: 3/13/2000 Name of Inspector: Neil J. Bateson I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Bateson Enterprises Inc. Mailing Address: 111 Argilla Road Andover, MA 01810 Telephone Number: ( 978 ) 475-4786 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority X Fit Inspector's Signature: Date: 3/13/2000 The System Inspector s91mit a cop this inspection report to the Approving Authority (Board of Health or DEP)within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page I of 11 Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: One or move system components as described in the'Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or NO). Describe basis of determination in all instances. If "not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed revised 9/2/98 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis 3/13/2000 Date of inspection: C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303 (1)(b) THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water. Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH AND PUBLIC WATER SUPPLIER, IF ANY) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 912198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: X I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. — _X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. _X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. _X Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. _X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. _X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _X Any portion of a cesspool or privy is within a Zone I of a public well. _X Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ Any portion of a cesspool or privy is less -than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS - You must indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area @ IWPA) or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No _X Pumping information was provided by the owner, occupant, or Board of Health. _X None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _N/A_ As built plans have been obtained and examined. Note if they are not available with NIA. X The facility or dwelling was inspected for signs of swage back-up. _X The system does not receive non -sanitary or industrial waste flow. The site was inspected for signs of breakout. _X All system components, excluding the Soil Absorption System, have been located on the site. _X_ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _X Existing information. For example, Plan at B.O.H. _X_ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [I 5.302(3)(b)] X The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 912198 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 FLOW CONDITIONS RESIDENTIAL: Design flow _ N/A g.p.d./bedroom. Number of bedrooms (design):—N/A_ Number of bedrooms (actual - 3 -Total DESIGN flow _WA _ Number of current residents: _1_ Garbage grinder (yes or no): _No _ Laundry (separate system) (yes or no):_ Yes_ Laundry system inspected (yes or no) No Seasonal use (yes or no):_ No_ Water meter readings. 98 ' to i9'= 7300 W x 7.5 = 54,750 Gals. / 730 Days = 75 Gals. / Day Sump Pump (yes or no): –No_ Last date of occupancy: _Current COMM ERCIALIINDUSTRIAL: Type of establishment: Design flow: gpd ( Based on 15.203) Basis of design flow Grease trap present: (yes or no) Industrial Waste Holding Tank present: (yes or no) Non -sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings, if available: Last date of occupancy: OTHER: (Describe) _ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Pumped 2.5 years ago, owner System pumped as part of inspection: (yes or no)_Yes _ If yes, volume pumped: _1000_gallons Reason for pumping: Owner wanted tank pumped. TYPE OF SYSTEM _X Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed (if known) and source of information: House 31 years old, Info @ B.O.H. 8/30/1969 installed Sewage odors detected when arriving at the site: (yes or no)— No- revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 BUILDING SEWER: X (Locate on site plan) Depth below grade: 24" Material of construction: _ X_ cast iron _ 40 PVC _ other (explain) Distance from private water supply well or suction line: Diameter :4" Comments: 4" cast iron to septic tank, 3" cast iron in house. SEPTIC TANK:X (locate on site plan) Depth below grade: 12" Material of construction: _X concrete _metal _Fiberglass _Polyethylene _other (explain) If tank is metal, list age _Is age confirmed by Certificate of Compliance _ (Yes/No) Dimensions: 7'x 5'x 4' x 7.5 =1000 gallons. Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle: N/A Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: N/A N/A = outlet cover under cement landing for deck stairs. Distance from bottom of scum to bottom of outlet tee or baffle: N/A How dimensions were determined: Measure scum & sludge depths. Comments: Inlet baffle ok. Unable to see outlet baffle, outlet cover under cement landing for deck stairs. No evdience of leakage. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: concrete _metal _Fiberglass _Polyethylene_other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C , SYSTEM INFORMATION (continued) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 TIGHT OR HOLDING TANK: _None_ (Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade: Material of construction: concrete _ metal _Fiberglass Polyethylene —other(explain) Dimensions: Capacity:gallons Design flow:_gallons/day Alarm present Alarm level: Alarm in working order. Yes _ No Date of previous pumping: Comments: DISTRIBUTION BOX.:_X_ (locate on site plan) Depth of liquid level above outlet invert: 2" Comments: D -box badly corroded . Water 2" above outlet inverts. D -box cover broken. PUMP CHAMBER: —None, gravity system_ (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No) Comments: Revised 912/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued)) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, if possible; excavation not required, location may be approximated by non -intrusive methods) If not located, explain: Type leaching pits, number leaching chambers, number: leaching galleries, number: leaching trenches, number, length: leaching fields, number, dimensions: 1 Field 20'x 50' As per info @ B.O.H. overflow cesspool, number: Altemative system: Name of Technology: Comments: Soil mushy at end of field. Excavate test hole found water above stone. Signs of hydraulic failure. CESSPOOLS: None (locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 90 Bradford Street, North Andover Owner. Martinaitis Date of inspection: 3/13/2000 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) Test Hole Water Meter House A B Deck 20' D -Box revised 9/2/98 Page 10 of 11 Driveway Ato1=10'6" A to 2 = 13'10" A to 3 = unknown under cement A to D -box = 25'6" A to Test hole = 69' B to I = 46' Bto2=47' B to 3 = unknown under cement B to D -box = 52'9" B to Test hole = 86'5" SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 1' to 3' Feet Deep. Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record _X Observed Site (Abutting property, observation hole, basement sump etc.) —X—Determined from local conditions —X—Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers _X Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Essex county soil map, shhet # 23, Deerfield soil water 1' to 3' deep. revised 9/2/98 Page 11 of 11 Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 90 Bradford Street, North Andover Owner: Martinaitis Date of Inspection: 3/13/2000 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. 4NeJ.!Bat Bateson Enterprises, Inc. n Loc A TION� IMN J VAr F- M -77 j M m I _o Q 0 u 0 O 0 m H O Q. L % 42 EAG 'CT � C N O E C CD 3 O GGQ O 1- O , Q N U O C U y C O U O E L R3 CL a� Cn c m ! C: O U) E E O u c O cv L V) C: O U I t`u O CD C C: ru a t ip Q) O P i ca O n I Q) C 1 O O n Sep -22-00 14:02 North-Andover=-Com--Dev .- 508-688 9542 P-02 JOYCE RADSHAW TOWN CLERK 00.25 NORTH ANDOVER TOWN OF NORTH ANDOVER NOTICE OF VIOLATION TOGO SEP 2S A ca 09 (Date of this Notice) To: J%v DOB (Name of Offend r) (Address of Offender) (City, State, Zip Code) VIOLATION(S): Ch Sec Fine A. r' � i.A L - B. C. D TOTAL FINE at J (A. (P.M.) on �i�,1"6)�z;z me and date of violation) (Signature of Enforcing'Person) (Dept.) I HEREBY ACKNOWLEDGE RECEIPT OF THE FOREGOING CITATION (Signature of Offender) Unable to obtain signature of offender YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER: I. You may elect to pay the above fine, either by appearing in person between 8:30 A.M. and 4:30 P.M., Monday through Friday, legal holidays excepted, before: TOWN CLERK, TOWN HALL, 120 MAIN STREET, NORTH ANDOVER, MA 01845 or by mailing a check or money order to the Town Clerk WITHIN 21 DAYS OF THIS NOTICE. This will operate as a final disposition of the matter, with no resulting criminal record. 2. If you desire to contest this matter in a non -criminal proceeding, you may do so by making a written request WITHIN 21 DAYS OF THIS NOTICE to the Clerk -Magistrate, Lawrence i District Court, 380 Common St., Lawrence, MA 01840, ATTN: 210 non -criminal, for a hearing. A determination by a Judge, Clerk - Magistrate or Assistant Clerk will operate as a final disposition, with no resulting criminal record, provided any fine imposed by that office is paid within the time specified. - 3. If you fail to pay the above fine or to appear as specified, a criminal complaint may be issued against you. I HEREBY ELECT the first option above, confess to the offense charged, and enclo payment467 unt of $ / O O Signature WHITE: ER' S COPYDEP .7PINK:TOWN CLERK A, a� r .. A _ .! V 1T� `�1-RI.► �� ' :'` r'Y, . .. a } � _r... •r c '7 e in ss• t, ,:z p �r1,w���Ly t ],�•�%'1{,,,jj�JG c1. t"" '� r �r % r �11 n+.y fJS�(,�,� k } y it" { r 1 "FW 1i 1 1 P 5 f to 5 � � ... _ ] .'R'.:! XL _"i wn " v C'i .�41 "1 j} 'k r YY'4 2, x�.,y� a w '^5 i �x ��f Y �t� C -t+r ' *Y+r�, - t_� a• %... Fs +;. Pu-0�°hy>':Y" t �'�yM °, n, �f`+S''""" 'h"Xr ��^,'z i' tSaZ a1�F,�ih,,r�a -�+: '^itr'r.' ;i +w µ"u' .� ,:,� ��N4�i.1Ac'y'l"dPo^ ekiiv,'L'aiT i �A �i '�k//�� 11 a Y'S�> �1f V3 !•yA'i 4T 4"v i, F ' l d Y '! f _ "I.1 i7 Z5, 11 �i f T ( St5 f a �'e-C.t"c�]t], }' ?• "i£ I, iWtSxyi, , f° . { � i t �! v _SSSS v� --.1 y✓: (- N� ;1.x �,4 ,'. -,5 0 > a � {(.e _.aII ,,. A av"• U t �m~r y, r, '�'s r '4 ,�+. g: "'a`°.+4i..v_raT i?alxs`�4 0 .coy '� � _ YIx ,is i.+ r,a .r -w rn:•. YJ n...+. i, ° .`.a'v.s "' Y,h�Tr4x4�'a.irrj'."''1��,"�'!''�,".rr - r N i £, 50/.a - a v s CV �S T m. ' 't9�niw- Y S'2,�, F x'o ' S t, , t i Ff w .Y v�"•''2' a '� r f� .r^ c�] O f A` +ZZ, 1 1 Q " c - 7} 5r4 _ _ s . 1 Y. p .:, ` . J - ,..r i 3':� 1 J �... .::f:: ... .. .. M1 1L Y .i C - Y T. ,�1 )Y. t ~ Y C.. - J. �` i F mac- r ! cZ i Z,r �-- I p ] T t,,. -Y S ) er< r r ... z � , r a '� r , °t ' r � �.. �y. 4'' x aid ' ) Fra c r r R° + f F. x- (`'[v� _ _ . , _ I 1 �. 4 w F ' i. L �x� �. ..ii L ] f` : 1 I..s,.. ,f s = z 1 :. -t -st t•' _.S I.= = y !z !z 1' j _ j ru „<w-t y, s t rr- �•�..., a Xt s"r"� v�rfs�'. �' w,�"""' S nr .,:� ^' s : F> ,. �.k i r a r,x, , r, ,.Y! r:..9 ,4uet 1' 1 111 t r Sf*,'VY''Ax '`,s+- --' " E i,� s � rt % v1 r h rT< '..v z{ ['�' rx >:c..'s_ �- z 4 •y�' Tr' s i -(- *r , < ].: 1 ""' ar •5.�0 : ,�;' . _ .. I . rLJ +; s �r _ . .. ,I I . I. M:44,'cd �=. .� . i (-) 1 rm 9. _. £ .., .:; _ F r ... _. '.' .. .. _... _ . P . ']s -�• ..L '-- :,.ee 4. r s 1�._ -17�_.:_,_.._..:�""� _yam. ' U 3 .� ? Lg r} a - 'h• ...1_....�. 1 5• .V L `i. �5='`b�if•, ».�� '. Y .X rES. * %�ei•'t "Y i fi h i. ! 1 I c- a� ' O' - r ]� --- ..-... .'.� __ . f r, 1. ::_ ,.... - _ ... ;..-. :'-.1. A /1� rrr•F^'�k�tb+s.":',x�"Y"'' t7�a.. i,+"�r, `+Ia s �.I. ;CD-Cp _ f _ _ O _s' V .,t F W co J r U) O W >? s.i. � L!7 ? �cr (�Z2Y {, o �'-a. , t -s "L �, - 1-r_ -•t.. - zs..... r�^' Z _"„r r - � -F. CO) J / t ',r1 '� - $ O Y. z-s4 1 p.. -it:_ '- 17" L - _ ^E' -y v' �p �/ Y¢ �� 'I. -� i:. ._ �:.._..........d .:.-. - 1 d / 9 _r :: F z .. - .� -.. .:.:_ ._ _ p . ,�. 1. N 0 y. - t �T SSS 1-e � AO . _.... .-,... ..- J .. ................... Td, .... . - . 4 C { Y R! .. :. n .. _.. - .. ... _. . ...v .. - 11 .. :' : . -. _. :.'j . , _ 4 I ..11 � - ... .f .. ;: W ALL `Si . + }f.� u, Q. r x Yr , Fp p_. ra -t Y , I. 1 s -i a r r v �'�_:. its z :tl' �..a...r1'.*- c.,. ,.,y °1. _ } ) �aRYa q Town Of North Andover Q t�t8° I6 Community Development & Services , William,/. Scott 27 Charles Street Director c°- North Andover, Massachusetts 01845 (978) 688-9531 �4Ssaco+u5etah Fax 978-688-9542 Ben Osgood Jr. New England Engineering 60 Beechwood Drive Board of North Andover, MA 01845 Appeals (978) 688-9541 September 28, 2000 Building Re: 90 Bradford Street Department (978) 688-9545 Dear Mr. Osgood, Conservation This correspondence is in regards to a complaint received at the Health Department Department (978) 688-9530 concerning the recent septic stem repair done at 90 Bradford Street, North Andover. The g P Y P new owner of the property has asked the Health Department to investigate the slope of the Health final grade of the septic system in relation to the approved plan. The follow-up to the Department complaint is as listed below. (978) 688-9540 1) Health Department personnel inspected the property's final grading over the new system Public Health on September 28, 2000 and found that the rear and side slopes are steeper than 3:1 as is Nurse required on the break out slopes. Four areas were measured and were found to be (978) 688-9543 between 1:1 and 2:1 2) In a brief conversation held with you about this issue on September 28, 2000, you Planningthere indicated that although the slope may be greater than planned you were confident that Department Depam was no risk of effluent break out due to its distance from the leach lines. (978) 688-9535 Therefore, since it appears that you agree with the complainant and this office that the area is too steep, the Health Department requests one of the following two options be done. 1) The engineer must submit a new final as — built showing the significant change in the topography. This is required to be sure that there will be no break out of the system onto this new slope. OR 2) If the complainants do not wish to have this slope as it is and further construction over the system is required, please contact this office with plans for this option. The permit for 90 Bradford is still active, and Mr. Soucy may return to the property under your direction without applying for an additional permit. If any other installer is contracted, this office must issue a separate permit. Kindly notify this office as to your chosen course of action. Sincerely, Susan Ford, R. S. Health Inspector Cc: Soucy Sewer Service Home. Owner, 90 Bradford St INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at qO yza relative to the application of '�, �,�� �Z11590 dated - a for plans by A and dated with revisions dated I understand and agree to the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable . 2. 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 my company. a). Bottom of Bed — generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final Inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to BOH, after which installer calls for inspection time. Installer must be present for this inspection. With 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. Does not have to be on site. 1•' 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in the attached application for installation. I further understand that work 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 in the Town of North Andover plus significant fines to all persons involved. 4. 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. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. 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. Undefs4ned License0eptic Installer L TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 11/8/00 This is to certify that the individual subsurface disposal system constructed ( ) or repaired (X ) by John Soucy at 90 Bradford Street has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector t ; TOWN OF NORTH ANDOVER SmVACYr DISPo,SAI. SYgTEm INSTALLA"KION CERTIFICATION The uncerswned here:v certy that the Sewage Disposal Svste:~, (/) recaired.- bv_ Jol-l...!— located at q0 2 t>__- S -T< A) D was installed in cori:fermance with the North Andover Board of Health a. proved plan. Svstem Design Permt = dated _• with an approved des,, -,I] flow or Gallons per day The mate ais used were in coniormar :e '-vit't those specified oft the approver' pian; the system was installed in accordarce th the previsions of 3110 CvfR 0.000, Title 5 and local re�_-slatiors, and the final Qradir.; agrees substantially with the approved plan. .-\.il work is accurateiv reoresented or. the As -built wFkh has been submitted to the Board cf Health. Bed inspection date: 2C>) 00C� Fina! inspectionncate _, LI o lnstal:er: J Cesa-y , E �/�t,41�, R Ensineer Rc gyrase :ailve Encir:etr Representat:-ve Date: Date: 2 z vim! IRs I'�if Ll.��. A Town of North Andover, Massachusetts Form No. 2 f NOR7►BOARD OF HEALTH 7 O � , w A i • • i �• �''' DESIGN APPROVAL FOR ""5`t SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. Site Location q1) A-J� Reference Plans and Specs Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. Fee #% - y � CHAI RMAN, BOARD OF HEALTH Site System Permit No. Z w 0025 TOWN OF NORTH ANDOVER NOTICE OF VIOLATION (Date of this Notice) f �� DOB (Name of Offff end r�) (Address of Offender) (City, State, Zip Code) VIOLATION(S): Ch Sec Fine 0/60 B. C. D. TOTAL FINE at�° °J (A. (P.M.) on F%Z6�Gy me and dateof violation) (Signature of Enforcing Person) (Dept.) I HEREBY ACKNOWLEDGE RECEIPT OF THE FOREGOING CITATION (Signature of Offender) Unable to obtain signature of offender YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER: I. You may elect to pay the above fine, either by appearing in person between 8:30 A.M. and 4:30 P.M., Monday through Friday, legal holidays excepted, before: TOWN CLERK, TOWN HALL, 120 MAIN STREET, NORTH ANDOVER, MA 01845 or by mailing a check or money order to the Town Clerk WITHIN 21 DAYS OF THIS NOTICE. This will operate as a final disposition of the matter, with no resulting criminal record. 2. If you desire to contest this matter in a non -criminal proceeding, you may do so by making a written request WITHIN 21 DAYS OF THIS NOTICE to the Clerk -Magistrate, Lawrence District Court, 380 Common St., Lawrence, MA 01840, ATTN: 21 D non -criminal, for a hearing. A determination by a Judge, Clerk - Magistrate or Assistant Clerk will operate as a final disposition, with no resulting criminal record, provided any fine imposed by that office is paid within the time specified. 3. If you fail to pay the above fine or to appear as specified, a criminal complaint may be issued against you. I HEREBY ELECT the first option above, confess to the offense charged, and enclose payment in the amount of $ .100— Signature_ _ _ _-;� � WHITE: OFF' N W S COPY, YELLOW: DEPT., PINK: TOWN CLERK *04ORTH, Town Of North Andover Community Development & Services * . 27 Charles Street North Andover, Massachusetts 01845 �SSAGHUSk Fax 978-688-9542 August 28, 2000 William J. Scott Director (978) 688-9531 Conservation Department This correspondence is in response to the events, which occurred on. Thursday and Friday, (978) 688-9530 August 24th, and 25th at 90 Bradford Street, North Andover. Please see the following chronology for details: Health Department 1) On Wednesday you applied for a septic installation permit for this property as well as (978) 688-9540 two others. Public Health 2) The application was approved the Thursday morning. A phone call was made to you Nurse indicating that the permit was approved. At that time you wanted to schedule a bottom (978) 688-9543 of bed inspection and I stated that you should not be working on this site until you had the approved plan on site as well as the permit to work. Planning Department 3) I personally told you to call in an inspection when you were ready and I would check (978) 688-9535 my availability. I stated that I might be able to swing by on my way home if you were ready. 4) You did not pick up the permit and approved plans until Thursday afternoon. 5) You then phoned in a request for an inspection late that same day. 6) I went to 90 Bradford at 9:45 AM on Friday. There was no one at the site, but there was already sand covering the bottom of the hole approximately 18" high. 7) As I checked the site, a dump truck from Torremeo Sand and Gravel, backed up to the bed and without looking prepared to dump his load of sand. 8) I instantly jumped out of the hole and chastised the driver for his poor practices. His excuse was that he had been dumping all morning and no one should be in the hole. I don't believe the state licensing board would find this an adequate reason for dumping tons of sand into a hole without checking personally or having a look out., John Soucy Board of Appeals Soucy's Sewer (978) 688-9541 119 West Street Methuen, MA 01844 Building Department (978) 688-9545 Dear John: William J. Scott Director (978) 688-9531 Conservation Department This correspondence is in response to the events, which occurred on. Thursday and Friday, (978) 688-9530 August 24th, and 25th at 90 Bradford Street, North Andover. Please see the following chronology for details: Health Department 1) On Wednesday you applied for a septic installation permit for this property as well as (978) 688-9540 two others. Public Health 2) The application was approved the Thursday morning. A phone call was made to you Nurse indicating that the permit was approved. At that time you wanted to schedule a bottom (978) 688-9543 of bed inspection and I stated that you should not be working on this site until you had the approved plan on site as well as the permit to work. Planning Department 3) I personally told you to call in an inspection when you were ready and I would check (978) 688-9535 my availability. I stated that I might be able to swing by on my way home if you were ready. 4) You did not pick up the permit and approved plans until Thursday afternoon. 5) You then phoned in a request for an inspection late that same day. 6) I went to 90 Bradford at 9:45 AM on Friday. There was no one at the site, but there was already sand covering the bottom of the hole approximately 18" high. 7) As I checked the site, a dump truck from Torremeo Sand and Gravel, backed up to the bed and without looking prepared to dump his load of sand. 8) I instantly jumped out of the hole and chastised the driver for his poor practices. His excuse was that he had been dumping all morning and no one should be in the hole. I don't believe the state licensing board would find this an adequate reason for dumping tons of sand into a hole without checking personally or having a look out., John Soucy August 28, 2000 Page Two 9) In speaking with Kevin, your operator, he stated that earlier that morning you said he should proceed with the installation. He was not aware that I had not done the bottom of bed inspection. 10) I asked him to dig down the corners to show me that all the topsoil had been removed per plan. I told him it was ok to proceed. 11) I also asked him for the stamped plan. He did not have the plan on site with the Health Dept. Approval stamp. He did have a copy of the correct plan, just not the official copy as required by our regulation. At that time I left 90 Bradford. I understand that you consider this incident a mis-communication, however this is not the first time I have had concerns with your work this year. I understand that there are time constraints in your business, however as I stated above this office responded in more than adequate time. It is your tendency to push ahead which is responsible for the action taken by this office. Therefore, please see the attached violation notice. The North Andover Board of Health members have issued a $100.00 fine. Please submit payment to the Town Clerk's Office within the time period allotted. In addition, any further violation to the state or local rules and regulations will result in your appearing before the Board of Health to discuss possible suspension or revocation of your license to operate as a septic installer within the Town of North Andover. Sincerely, Susan Ford, R.S. Health Inspector AS -BUILT CHECKLIST LOT NUMBER, STREET NAME a/ ASSESSORS MAP & PARCEL NUMBER _ LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, / INCL TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM i / LOCATION O WATER, AS, ELECTRIC LINES, CABLE tom' DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D -BOX ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS DRIVEWAYS, ETC. NORTH ARROW v LOCATION & ELEVATIONS OF BENCHMARK USED Jul -17-00 03:46P PORT INGINIERING Civil Engineers & Lend Surveyors One. Harris Slrerl Newburyport, MA 01950 (978)465-8594 Paul D. Turbide, PE/PLS 978-465-0313 P.02 July 17, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE: Title V second review for 90 Bradford Street Dear Sandra, I find that the design plans with revision date of July 12, 2000 adequately addresses the concerns outlined in my report dated June 23, 2000. If you have any questions or comments please feel free to contact me. Sincerely Carlton A. Brown, PE/PLS Bradford9 oc INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initial A. Bottom of Bed % 1. Excavation to proper depth 2. With trenches, sides of excavation are beneath B horizon /G 3. Edge of excavation specified distance from foundation, etc. Comments: :S B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed 3. Wall minimum 10' to leaching dity 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" 2. Schedule 40 pipe 3. Watertight joints (� 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8" per foot minimum 6. Pipe properly set on compact firm base 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90° change 10. 10' minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20" manholes l 7. Inlet tee minimum 12" under invert 8. Outlet tee minimum 14" under invert 9. Outlet line cemented 10. Air space 3" above tees 11. 2" - 3" drop from inlet to outlet 12. Pipe set 13. Compact base with 6" of V crushed stone under tank 14. Tank is watertight Comments: 1r°'���a L✓ Yes NO E. Pump Chambe 1. If separate fr tank, compact base with 6" of V stone underneath 2. Minimum 2" pi to d -box if gravity system 3. 20" access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan spe 'fication 7. Manhole to grade 8. Check valve and bleeder hole presen 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d -box Comments: F. Distribution Box 1. D -box level 2. Minimum 0. IT' (2") drop from inlet to outlet 3. Minimum 6" sump 4. Outlet pipes show equal distribution 5. Compact base with 6" of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double -washed- % 1 - pea stone Bucket test done? 2. Minimum 2". of pea stone above distribution lines 3. Minimum 6" stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9" of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not, then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan - Minimum 2% maximum - 4'. 4. Vent present if <50 feet or specified 5. Distance between trenches minimum 4' and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6" per 100' 8. Depth of trenches below outlet invert minimum of 6". y 9. Pipes set on stable base. Yes NO Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9" soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond 1. Leach Field 1. Maximum length of field 100' 3 ,/ 2. Pipe slope minimum 0.005 or 6" per 100' ,✓ 3. Separation between pipe 6' maximum ✓ 4. Pipes connected at end 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base ✓ 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: I Leaching Pits 1. Minimum et pipe 4" 2. Pits of concret 3. Sidewall between " and 48" wide 4. Access manholes on ch pit 5. Pipes cemented with by lic cement Comments: ' K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9" soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond Town Of North Andover 3rO�`�ee ys'ggO - °A Community Development & Services �* 27 Charles Street *�9� q,reo.��'�y• North Andover, Massachusetts 01845 Fax 978-688-9542 Board of Appeals July 19, 2000 (978) 688-9541 Building Ben Osgood, Jr. Department (978) 688-9545 New England Engineering 60 Beechwood Drive No. Andover, MA 01845 Conservation Department (978) 688-9530 Re: 90 Bradford Street Health Department (978) 688-9540 Dear Ben: Public Health This is to inform you that the revised septic system plans dated 7/12/00 for the Nurse site referenced above has been approved for repair. (978) 688-9543 If you have any questions, please do not hesitate to call the Board of Health Planning Office at 978-688-9540. Department (978) 688-9535 Sincerely, Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: Martinaitis File William J. Scott Director (978) 688-9531 eCD N D .* ro►r fo Gtr, i o►+ ,� .o' 0 D A O A :., O O Al i. A D N %0 S � t'pi'f O� i ash o •, x kAJS N 0 D O r ' O O O o A D N %0 S � O O Z O < m >, C 3 Ula O Z � -o LAc N _3 O 0 3 {+� V Z 0 w APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PER1tiIIT �J Q� DATE: -- 23 — 00 CURRENT r, 'STALLER'S LICENSErr LOCATION: LICENSED INSTALLW: SIGNATURE:4z TELEPHONEr 1"& CHECK ONE: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOti'INDATION AS -BUILT. 575.00 Fee Attached? Foundation As -Built? Administrative Use Only Yes No Yes No Floor Plans? Yes i\io Approval Date: / /P;/7> c.�C_ NEW ENGLAND ENGINEERING INC Sandra Starr, Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 90 Bradford Street, North Andover, Septic system design Dear Sandra: SERVICES July 14, 2000 Enclosed are the following documents relative to the above referenced property. 1. 5 sets of revised septic system design plans. 2. Check to cover the fee. These plans incorporate the water table given in the letter from Port Engineering. A water table local upgrade request and a percolation rate local upgrade have also been included. Plans have been forwarded directly to Port Engineering to expedite the review process. If you have any questions please do not hesitate to contact this office. Sincerely, '5-;) C Benjamin C. Osgood; J ., EIT President CC: Carlton Brown, Port Engineering .1 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 May-27-99 12:45P North Andover Com. Dev. 508 688 9542 SEPTIC PLAN SUBMITTAL FORM LOCATION: q0 NL-W PLANS: YES S125.00/flan REVISED I'LANS: YES S 60.00/Plan_ SITE EVALUATION FORMS INCLUDED: YES NO D ATE:' pp DESIGN ENGINEER: �A, C-(,) C;WtZ(A)C DATE TO CONSLrLTANT: *If you want your plans expedited, please submit three plans and included a stamped envelope with the correct amount of postage to mail plans to fort Engineering. When the submission is all in place, route to the Health Secretary. NoRry 9 �9SSACHUS ��� Fax 978-688-9542 Board of Appeals (978) 688-9541 Building Department (978) 688-9545 Conservation Department (978) 688-9530 Health Department (978) 688-9540 Public Health Nurse (978) 688-9543 Planning Department (978) 688-9535 Town Of NorthAndover Community Developmentl Services 27 Charles Street North Andover, Massachusetts 01845 July 6, 2000 Ben Osgood, Jr. New England Engineering 60 Beechwood Drive North Andover, MA 01845 Re: 90 Bradford Street Dear Mr. Osgood: William J. Scott Director (978) 688-9531 This letter comes in response to your concerns relative to soil tests at the above site and the difference between Mr. Tangard's logs and the Town's. As you should be aware, soil logs of the same deep hole may differ from each other because different areas of the hole are logged. If you will look at the soil logs for 90 Bradford Street, you will see that both of the evaluators placed the seasonal high ground water directly under the B horizon, regardless of where that ended. I suggest the following in, order to proceed with this repair: • In Test Pit #1 use the B horizon depth to 40". • In Test Pit #2 use the B horizon depth to 36". To calculate the groundwater, either use the Town's logs of 34" and 29", respectively, and investigate a variance request. OR: Use Mr. Tangard's logs of 40" and 36" with the understanding that a variance to groundwater may be denied. I trust that you will notify me and Port Engineering when you have decided your course of action. Sincerely, Sandra Starr, R.S., C.H.O. Health Director Cc: C. Brown H. Martinaitis BOH File Jun -23-00 02:26P Paul D. Turbide, PE/PLS POItDi INGINIERING Civil Engineers & Land Surveyors One Harris Slrerl Newburyporl, MA 01950 (978)465-8394 June 23, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE: Title V review for 90 Bradford Street Dear Sandra, 978-465-0313 P.02 Enclosed find the "Checklist for North Andover Septic System Plans" for the above- mentioned site. The following is a list of all the `Problem' areas and deficiencies Port Engineering has found. ❑ The test pit logs shown on the plan (Tangard's logs) are different than the test pit logs performed by Sandy Starr as shown in the Town's field book (the Town's logs). For Test Pit #1, Tangard has 40 inches to mottles, while the Town has 34 inches; and Tangard shows the Bw horizon to be between 19 inches to 40 inches while the Town has the Bw horizon between 19 inches and 33 inches. For Test Pit #2, Tangard has 36 inches to mottles while the Town has 29 inches; and Tangard shows a Bw2 horizon extending from 24 inches to 36 inches while the Town does not have a Bw2 horizon but instead has a C horizon that runs from 24 inches to 90 inches. The net result is that the determination of ESHW is different depending on if you use the Tangard logs or the Town logs. ❑ Assuming that the Town soil logs are correct, to have a four -foot separation between ESHW and the bottom of the field will require that the system be raised by 0.7 feet. As per 310 CMR 220(4xn), the ESHW must be adjusted to the high end of existing grade. The high point of the existing grade under the proposed leaching bed has an elevation of about 99 feet. If we use the depth to mottles of 34 inches for TP #1 (the test pit that is higher on the lot), then the adjusted elevation of ESHW is 96.2 feet. Thus the system must be raised 0.7 feet to maintain the 4 -foot separation. ❑ If the system must be raised, then perhaps the existing septic tank cannot be used, or a pump must be installed. (Perhaps a local waiver request of Moot separation would allow the existing septic tank to be used, which in my opinion is a reasonable request). o In any case, there should bu a note on the plan to check or replace the baffles of the existing septic tank with PVC tees. ❑ The observed perc rate is 40 minutes per inch. This requires a local waiver as per 310 CMR 15.405(c) (which is a reasonable request). 4'b Jun -23-00 02:26P Paul D. Tuvbide, PE/PLS 978-465-0313 P.03 1 (A minor drafting error appears on the left hand edge of the Leach Bed End Section, which shows the end distribution line being 5 feet off the edge of the field, when it should be 3 feet off the edge.) If you have any questions or comments please feel free to contact me. Sincerely , Carlton A. Brown, PE/PLS Bradford94.doc J,4n-23-00 02:25P Paul D. Turbide, PE/PLS 978-465-0313 i Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Carlton A. Brown Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 465-0313 Date June 23, 2000 Pages Including This Cover Page: 3 Comments: Sandy, Enclosed is my report of 90 Bradford Street Thanks, Carlton ... +`.; i: J .... .....Jd JUN 23� =- 5 wet, ,8' 014 Mc.,pprow a.gvL P.01 FORM li - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Got i4o. Iye Ona -site Review. Deep Hole Number .. Date: .••�1>vTime: Weather Location (identify on site plan) ;.v '��':. �....v.: ,.:..h•.:.„ w.vv.....�... �.........,.,,....:........., Land Use'4401�L. Slope S %) Surface Stones--�.•:.,.... Vegetation...... .....:...... LandformZ�...IYla��k . Position on landscape (sketch on the back) •...1�' .=���...:.,,.. Distances from: Open Water Body feet Drainage way .. feet Possible Wet Area feet Property Line feet Drinking Water Well . , . • feet Other., N _w,.....h,.,....v.,..... DEEP OBSERVATION HOLE LOG" Depth from Soil Horizon Soil texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) 9 MINIMUM UF 2 HULF-5 REQUIRED A I EVERY PHUPUSED DISPOSAL AREA r N� f'i>T�vc� Parent Material (geologic) _",�G 7% G Dapthtoeedrock: e h to roundwater: Standing Water in the Hole: �� � .ELS f! Weeping from Pit Face: Es)imated Seasonal High Ground Water: .1� 9 _ DEP APPROVED F'DIUU • 11/07195 MAY 2 4 `. FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 9,P � � /��!?. , ��V.�•��?. T On-site Reuiew Deep Hole Number 77 ... Date:.�1. �% Time: Location (identify on site plan) 7�.:.N1,..T. �.,..... Land Use Slope Surface Stones Vegetation. .. v.,..:...:: :. .....:...... :.M..„,...�.:. Landform .. �ra�, ?... filar e:'�!� ..:.......:..........:........:..M Position on landscape (sketch on the back) ..•7712W. Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line..... feet Drinking Water Well . feet DEEP OBSERVATION HOLE LOG” Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, % Gravel) ©--/O �i�rcT Parent Material (geologic) ` � i7 /_G.. DepthtoSedrock: ---a �� Depsh to�,roundwater: Standing Water in the Hole: Weeping from Pit Face:___ Estimated Seasonal High Ground Water: 3R d DEP APPROVED FORM • 11/07/95 -E �zj-N,�-Pr) I - I I I HI Irli _I I� i I� I I� t�. l_ •.1• �� i FORM 11 - SOIL EVALUATOR FORM Page I of 3 Date: No. oa Commonwealth of Massachusetts Massachusetts ,Soil Suitability Assessment, Sewage�Di�sosal el'00 7 Date: Performed By: .......... ... a., WitnessedBy: .......... . ................. z:: T14.............. ............. . ................. ................ . ............................. ........ ... ... .. Location Address or Owitr's Na= Address, and Telephom I ew construction El Repair Office Review Published Soil Survey Available: No ❑ Yes 0 Soil Map Unit 44,46 ...... .. .. .... Year Published:Publication Scale /.'/........... ...... Drainage Class ... Soil Limitations....... Surficial Geologic Report Available: No � Yes ❑ Year Published . ....... Publication Scale Geologic Material (Map Unit) . ............ . ........... ........................................................ .. ....................................... .. .. . .... . ........ .... Landform.................................................................. .......................................................... q .......................................... ...... .. ....... Flood Insurance Rate Map: Above 500 year flood boundary No []Yes Within 500 year flood boundary No El Yes Within 100 year flood boundary No El Yes ❑ Weiland Area-, National Wetland Inventory Map (map unit) ........................... .... ..................................... . .................... ........ .......... ..... .................. Wetlands Conservancy Program Map (map unit) .................. ............. I ...................... Current Water Resource Conditions (USGS): Month 146,-AzC-11 Range Above Normal ONormal 013elctv Normal ❑ Other References Reviewed: DEP APPROVED FOM - 12107195 r z- -fOV IF] OF NR. PTH ANDOVER/ ti ^'J I { FORM 11 - SOIL EVALUATOR FORM Page 2of3 Location Address or Lot 140. On-site Review Deep Hole Number .. / :.. Date: :.�� Time: � �'� Weathw Location (identify on site plan).,..Y:.::....::...:.:.................::::...........�...............:...:....... ... ...v:..:... Land Use Slope M Surface Stones -- ::.:...:...:..:.... Vegetation.. 5.:.. .. v..., ....:.:...:........... ........... . Landform ...... Position on landscape (sketch on the back) ....1�....: Distances from: Open Water Body<oallc- feet Drainage way ���� feet Possible Wet Aread��O.. feet ,Property Line ,.7a.... feet Drinking Water Well .77. feet Other . DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, 0% Gravel) 9 0Y 40 �w �47 N� i Parent Material (geologic) -- �`�G; 71-1- e— QepthtoBedrock: ti d Depth to Groundwater:' Standing Water in the Hole: 7� Weeping from Pit Face: ,JO q Estimated Seasonal High Ground Water: DEF' APPROVED FORM • 12/07/95 Location Address or Lot No. FORM 11 - SOIL EVALUATOR FORM Page.2 of 3 On-site Review Deep Hole Number Date:.I. Time: ��� Weath ,Q �� .......::....:... Location (identify on site plant..::..,.::...:.::...:::..:.:..:..::..:...::..::.v.:.............:::,...:.:..::.:...::.:...... Land Use Slope i%) Z— Surface Stones777- Vegetation.. .:.Vegetation: Landform e"'iv� Position on landscape (sketch on the back) Distances from: Open Water Body Wim© feet Drainage way. feet Possible Wet Area .ate feet Property Line ..��:....... feet Drinking Water Well ..' feet Other .... DEEP OBSERVATION HOLE LOG* Depth from Surface (Inches) Soil Horizon Soil Texture : (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, % Gravel) �/,� 3 �i1lGT • MINIMUM OF 2 HULt:b hLUU1KLV Ai tVLMY MUVUJty ulJrUJALAKLA Parent Material (geologiclDepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: _ N Weeping from Pit Face: Estimated Seasonal High Ground Water: —._ DEP APPROVED FORM • 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. /i/O, ; Determination for Seasonal Hih Water Table Method Used. ❑ Depth observed standing in observation hole ................ inches ❑ Depth weeping from side of observation hole .......... .... inches ® Depth to soil mottles .......,' inches ❑. Ground water adjustment .................. feet 3� 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 absorption system? .5 If not, what is the depth of naturally occurring pervious material? Certification I certify that on (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 training, expertise and experience described in 310 CMR 15.017. Signatur ;—*WDate 61m0 DEP APPROVED FORM . 12/07/95 Y NEW ENGLAND ENGINEERING SERVICES lk INC May 24, 2000 Sandra Starr, Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 90 Bradford Street, North Andover, Septic system design Dear Sandra: Enclosed are five copies of septic system design plans for the above referenced property. These plans are being submitted for approval. Also enclosed are the following: 1. Draft soil evaluator sheets. 2. Application for approval. 3. Check for review fee. If you have any questions or need additional information please do not hesitate to contact this office. Sincerely, Benjamin C. Osgood, Jr., EI President MAY 24 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 May -27-99 12:45P North Andover Com. Dev. 508 688 9542 SEPTIC PLAN SUBMITTAL FORM LOCATION: D VE�w' PLANS: YES $125.00/111an_ _...._ REVISED PLANS: YES $ 60.00/i'lan SITE EVALUATION FORMS INCLUDED: ES NO DATE: DESIGN ENGINEER: DATE TO CONSLrLTANT: *If you want your plans expedited, please submit three plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in place, route to the Health Secretary. g _ MAY�� a r r P A K -I "T7/ Ikl _LLL-Lj-J. XT Applican Site Locz Engineer Test/I nsr Town of North Andover, Massachusetts BOARD OF HEALTH Form No. 1 APPLICATION FOR SITE TESTING/INSPECTION j� CHAIRMAN, BOARD OF HEALTH Fee 4 Test No. S.S.Permit No. D.W.C. No. C.C. Date Plbg. Permit No. ED , Town of North Andover, Massachusetts BOARD OF HEALTH 01 APPLICATION FOR SITE TESTING/INSPECTION Form No. 1 Applicant NAME r' / ADDRESS TELEPHONE Site Location �'.�� �{/ li: ,i'� iJkL'L� ''/.•� :',t`//�;' i' l tet- �/ Engineer - - NAME / ADDRESS' t TELEPHONE Test/Inspection Date and Timej�/�1'"� UI CHAIRMAN, BOARD OF HEALTH Fee Test No. 61 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. k1 -45q a. -75- BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: 317,400 LOCATION OF SOIL TESTS: q Assessor's map & parcel number: ingp Wgec-l- .mss OWNER: Ay i2y� bzTI NAJ TI s TEL. NO.: 117B .- C -BE -- /7 /8 ADDRESS: q 0 BRADT;=�Z> -`t,. tii f-���o,�=r� l►/� ENGINEER:Akuy Ft464,wo E o&L&t 2t lrrvJEL. NO.:gze- 686--r -76P CERTIFIED SOIL EVALUATOR: 13e,,) Os6--co N 3 212��x&Zp C `T'AruGA12.b Intended use of land: residential subdivision, single family home, commercial Repair testing x Undeveloped lot testing N. A. Conservation Commission Approval: THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. 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). 7. Within 60 days of testing soil evaluation forms shall be submitted. N� W E`TL- /-TtZE7A �12tdr �ic�cJsC. EL --j eI2aDf:�ofz�> si� BOARD OF HEALTH ra TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: LOCATION OF SOIL TESTS: �3 gry�Dr- i Assessor's map & parcel number: MAS OWNER: ttQRY TEL. NO.: 178-ggp--1-718 ADDRESS: 90 f3RAW:� z> ENGINEERX,eg,, NO.: �77c'— 6,F6-1-76& CERTIFIED SOIL EVALUATOR: C TA,uc.AiZD Intended use of land: residential subdivision, single family home, commercial Repair testing x Undeveloped lot testing N. A. Conservation Commission Approval: ,dA THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4.. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. 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). 7. Within 60 days of testing soil evaluation forms shall be submitted. I v NV,`ETL0Aj 1>, Tes\ 71-r } Lot 16 Bradford St. Scott Realty Trust APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make applic tion for a permit for a sewage disposal installation at Lot 10 Bradford St. . I will install this system in ac- cordance with all the laws of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre- ceding the septic tank, where the grade shall not exceed 2%. I will install a con- crete septic tank of 1000 in size. A manhole (s) permitting easy cleaning will be provided with removable 7over (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 200 lineal (square) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree not to cover any portion of this installation until approved by the inspection officer, as provided below, and to incorporate any additional requirements that•may be attached to the permit. Plot Plans must be submitted with application. 1000 Sq foot Bed DATE 5/19/69 , Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE 5/1.9/69 Signature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE' Percolation Test 17 Minutes: Soil Clay Garbage Grinder )JAn Signatur f Inspecting Of cer BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. i o eoeo c ` 4'�° f <v < �---- yr ©t 0 /L) U 1. NAME C D TT _ DATE 2. ADDRESS J OJ f &:ddW LOT NO. TEL. ,, �f Y%%% 3. NO. OF BEDROOMS 3 DEN YES NO 4. GARBAGE GRINDER YES NO .X 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVERI MASSACHUSETTS SEWAGE DISPOSAL DATE NAME OF APPLICANT LOCATION �y Addresso lot no. BUILDING: Dwelling Other SYSTEM: New Repair GENERAL DESCRIPTION OF LAND _ )J-L-Q�L- SUBSOIL: Clay-2Lavel Sand PERCOLATION TEST I7 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 6-B-0 gallon capacity. LEACH FIELDS lineal feet of drain pipe. 4illiam i. Drris)po-iT, Engineer Board of Heal h 1 0 jv—ss' /V lImpmngRecon-d ---------- -N Vii' L v -snOrmation: State C lord I Quar _NT 4 UPI 7� ------------ 'J�6 b 8