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HomeMy WebLinkAboutMiscellaneous - 922 DALE STREET 4/30/2018N O ir e SEPTIC SYSTEM INSTALLATION IS THE INSTALLER LICENSED? YE j) TYPE OF CONSTRUCTION: NEW NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES CONDITIONS OF APPROVAL YES (FROM FORM U) NO NO ISSUANCE OF DWC PERMIT NO DWC PERMIT PAID? YE NO DWC PERMIT NO . U�TT INSTALLER : - ��S Ga C v p BEGIN INSPECTION 4YES NO: EXCAVATION INSPECTION: NEEDED: PASSED �16 BY CONSTRUCTION INSPECTION: NEEDED: AS . Bg1J.,T .PLAN SATISFACTORY : YES: s APPROVAL TO BACKFILL: DATE: FINAL GRADING APPROVAL: DATE BY FINAL CONSTRUCTION APPROVAL: DATE: Sawyer, Susan From: Sawyer, Susan Sent: Thursday, May 10, 2012 3:31 PM To: 'joemccvam@comcast. net' Cc: DelleChiaie, Pamela Subject: RE: question I fixed the typos and mistake in number 3. Save this one. Susan From: Sawyer, Susan Sent: Thursday, May 10, 2012 2:58 PM To: 'joemccvam@comcast.net' Subject: question Hi Joe, I decided to write, rather than call you, so we have this for your property file. This is regarding an inquiry into possibly adding a bathroom in the barn (which without info. I would call 1 room) The septic system designed for 922 Dale Street in 1996 was for a 4 bedroom (or maximum 9 room) home. This was designed at 110 gallons per day, hence it was for 440 gpd. However, in this case the local Board of Health Regulation at that time had a minimum leach bed requirement of 900 square feet. Because of this, your field was designed for 540 gpd. In Title V today, a 5 bedroom home (or maximum 11 room) is sized at 550 gpd. It is the opinion of this Health Director that if requested, 922 Dale would be allowed to add rooms to a maximum total of 11. That includes all rooms except the bathrooms, mud rooms etc. Kitchen, living room, den, study ... all count. Note 1) in North Andover we would require that a Title V inspection be done prior to approval of the building permit to ensure the 16 year old system is working. 2) A floor plan of all rooms would be submitted 3) An engineer would need to draw up the plan and submit it to the Health Department for approval. Probably an ejector pump to the line prior to entering the septic tank would be a good alternative if gravity cannot be achieved because pumping right into the tank itself in not allowed. 4) A licensed septic installer would be required to install the system Hope this answers your questions. Call me for any clarification needed. Thank you, Susan Susan Sawyer Public Health Director Town of North Andover Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 SEP Z 3 2013 DEP has provided this form for use=by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/ Right front of house, Left/ Right rear of house, e / rig side of Left/ Right side of building, Left / Right front of building, Left / Right rear of building, Under deck Address Citylrown `1 \ 2. System Owner. � G Name. Address (d different from location) Cityfrown B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): State Zip Code 1 State �Code�� Y'6 Telephone Number q,)b -(3 Date 2. Qua" 'ty Pumped Cesspool(s) Septic Tank 4. Effluent Tee Filter present? ❑ Yes [ 1 No 5. Conditio f ys m: 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc- Company na Company 7. Location where contents were disposed: I nwpll Wactp Wnhur Gallons ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No. F5821 Vehicle License Number � 8� — k --:$ 41, t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 DelleChiaie, Pamela From: Sawyer, Susan Sent: Thursday, May 10, 2012 3:31 PM To: 'joemccvam@comcast. net' Cc: DelleChiaie, Pamela Subject: RE: question I fixed the typos and mistake in number 3. Save this one. Susan From: Sawyer, Susan Sent: Thursday, May 10, 2012 2:58 PM To: 'joemccvam@comcast.net' Subject: question Hi Joe, I decided to write, rather than call you, so we have this for your property file. This is regarding an inquiry into possibly adding a bathroom in the barn (which without info. I would call 1 room) The septic system designed for 922 Dale Street in 1996 was for a 4 bedroom (or maximum 9 room) home. This was designed at 110 gallons per day, hence it was for 440 gpd. However, in this case the local Board of Health Regulation at that time had a minimum leach bed requirement of 900 square feet. Because of this, your field was designed for 540 gpd. In Title V today, a 5 bedroom home (or maximum 11 room) is sized at 550 gpd. It is the opinion of this Health Director that if requested, 922 Dale would be allowed to add rooms to a maximum total of 11. That includes all rooms except the bathrooms, mud rooms etc. Kitchen, living room, den, study ... all count. Note 1) in North Andover we would require that a Title V inspection be done prior to approval of the building permit to ensure the 16 year old system is working. 2) A floor plan of all rooms would be submitted 3) An engineer would need to draw up the plan and submit it to the Health Department for approval. Probably an ejector pump to the line prior to entering the septic tank would be a good alternative if gravity cannot be achieved because pumping right into the tank itself in not allowed. 4) A licensed septic installer would be required to install the system Hope this answers your questions. Call me for any clarification needed. Thank you, Susan Susan Sawyer Public Health Director Town of North Andover 0 D) CD 0 D O �o O'mmm o gX xww C40afn3� N, D oNy Dnm c O O 0—,:-5 > 0 ivy fin' D m �� °= ' �° Z m ' i 3 N O' -i S vv�-I a�w = D r _ D��� off= m O iA0C- n o C7 r o A -c x CD s D co 0 oW CCD PIm I D� A m ZvO� 0 c 00 3 Z W�wr cn I o R?T mm mx,mmmc moo o cn W � N oo N 030 0 v NI r pG� (Jpw °'!ID —0 O 000 �� v l 3 iii 0) 3 :r 3 3 m 'ncnn-:.Xy.'yN m 5 cn tN N c 3 CD w_ w CL O N O C i -i -10 NACO m j,m d .Q iv CD o -00Om CDC3 -� 7 rf rf ON v r? ? �. O n O.' O.. -, m m o0 oW 3• �3,i Z OD CL �.v ? 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STEWART of 922 Dale Street, North Andover, Essex BK 4760 PG 21Z County, Massachusetts in consideration of TWO HUNDRED EIGHTY FIVE THOUSAND AND NO/100---------------------- (#285,000.00) grant to JOSEPH W. MCCARTHY and SHARON MCCARTHY, Husband and Wife as Tenants by the Entirety of North Andover, Massachusetts with q1tTtClattl[ talTptt3rit8 t&D%WW MAY 23'97 A certain parcel of land, with all the buildings thereon, being shown as parcel containing 4,762 acres, more or less, on plan of land entitled "Plan of Land in North Andover, Mass., Scale: V .. SQ' dated Dec. 17, 1963," George C. Hayes, Civil Engineer, recorded with North Essex Deeds as Plan No. 6208, said parcel being bounded: SOUTHEASTERLY by Dale Street in three courses, 64.00 feet, 193.99 feet and 114.00 feet; SOUTHEASTERLY again 51.79 feet by Winter Street West, as shown on said Plan; SOUTHWESTERLY 154.98 feet, more or less, by Winter Street West, as shown on said Plan; NORTHWESTERLY 226.1 feet, more or less, by lot marked "S.C. 6LAL Rea" as shown on said WESTERLY Plan; 165.00 feet, more or less, by said lot marked "S.C. &AL. Rea",- ea";SOUTHEASTERLY "S.C. SOUTHEASTERLY again 91.6 feet, more or less, by said lot marked &A.L Rea'; SOUTHWESTERLY again 172.1 feet, more or less, by lot marked "H. Gemmel" as shown on said Plan; NORTHWESTERLY again in four courses, 30.00 feet, more or less, 220.97 feet, 84.80 feet and $ 83.32 feet by land conveyed by Sidney C. Rea and Adah L Rea to McKay Construction Co., Inc. by deed recorded with North Essex Deeds, Book 1022, Page 167; as shown on said plan; NORTHEASTERLY 308.38 feet by said land, now or formerly, of McKay Construction Co., NORTHEASTERLY Inc.; again 44.09 feet by said land of McKay Construction Co., Inc.; NORTHEASTERLY again 228.27 feet by said land of McKay Construction Co., Inc.; and SOUTHEASTERLY again 42.81 feet by a curved line as shown on said Plan. Being part of the premises conveyed to us by Deed of Sidney C. Rea et ux dated June 1, 1970 and recorded in the North East Registry of Deeds in Book 1153, Page 501. Executed as a sealed instrument this 23rd day of _ Ma_Y_ _9.97 i Halold S Stewart Dorothy Z. Stewart - — r r• 942 d4mintat&CM191 of �&Gw 4usetts Essex ss• May 23 l9 97 Then personally appeared the above named Harold S. Stewart and Dorothy L. Stewart .and ackno�e fomping instrument to be theiras and 41 L Before me,'�a"� Minasian Notary 11101 Pubfic My commission expires 12/8/00 Xffi VCs�Y owK- North Andover Board of Assessors Public Access pORTF� � O.�t�•o �•� �O ��SSwcMuget� Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 roperty Record Card Parcel ID :210/104.A-0061-0000.0 FY:2010 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge 971 DALE STREET Location: 922 DALE STREET Owner Name: MC CARTHY, JOSEPH W SHARON MC CARTHY Owner Address: 922 DALE STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 6 - 6 Land Area: 5.20 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2993 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 519,800 545,100 Building Value: 281,000 292,400 Land Value: 238,800 252,700 Market Land Value: 238,800 Chapter Land Value: 1. http://csc-ma.us/PROPAPP/display.do?linkId=1517753 &town=NandoverPubAcc 1/21/2010 Phone: 978-632-2660 JAMES A. TRUDEAU Adjustment Service Inc. P. O. Box 7 Gardner, MA 01440 Fax: 9 0�k 1 V4U5~Kin HEp,�TH pEPPR(M�N� W N ur Notice of Casualty Loss of Buildinp- Under Massachusetts General Laws, Chapter 139, Section 3B September 10, 2014 Building Inspector 120 Main Street North Andover, MA 01845 oard of Health 120 Main Street North Andover, MA 01845 Fire Department Dept. of Records 124 Main Street North Andover, MA 01845 Insured: Joseph McCarthy Loss Location: 922 Dale Street, North Andover, MA 01845 Insurance Company: Preferred Mutual Insurance Co. Policy No.: PHOO100597993 Date of Loss: September 8, 2014 File Number: 14-12291 Claim Number: 14119650 Type of Loss: Property Damage 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, Chapter 1.39, Section 3B" is appropriate, please direct it to the writer and include a reference to the captioned insured, location, policy number, date of loss, and file or claim number. On this date, I cause copies of this notice to be sent to the person(s) named above at the address indicated by first class mail. Sincerely, Joshua M. Trudeau Claims Adjuster i� O Wrnrn V, ^M n LL O Q� 4-J I= 9 ^0 W O U N t O r n. a + � o 42 U C o € C 4) U ' R O `}+ ; OCQ 4 1 l f t C � l f C O L � Q C 4 t rt E C !z O U O O C 1 L L i, Form No. 4 Town of North Andover, Massachusetts BOARD OF HEALTH jai4uar— —3,^ 19 9:7 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired (X ) by Ben Osgood Jr. I at 922 Dale Street, North Andover,MA 01845 SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. A71 dated ^? 0/7 19 9-6 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD OF HEALTH Form No. 4 Town of North Andover, Massachusetts BOARD OF HEALTH May 21, 19 —97 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired (X) by Ben Osgood, Jr. INSTALLER at 922 Dale Street, North Andover, MA 01845 SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 873 dated Oct. 7, 19 96 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD OF DATE TI. AM P . Pin H FRO AREA CODE /^ NO. O � et .i i O 00 E M M E s E s 0 15 M c 9r E s PHONED[:] CALL ❑ RETURNED ❑ WANT TO ❑ WILL ALL ❑ WAS IN [IURGENT ❑ North Andover Health Department • 146 Main Street North Andover, MA 01843 To: &,�Fax: ,/ V R From: Date: V Re: Pages: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle y e » / \ 7 _ / \ ° / \ { (D ƒ / � § \ . no / e / , % 2 \ $ / / [ % / / / c /. %i U / k 0 / / 2 O c = q 0 \ crq / > / / 2 u e S 0 M 7� g\ @ c> 2 & m = m J n r=+Q / / >R @ c % c Cl. �< r \ ƒ/i:$ / / m e ƒ§ 2 =zo f e 70 \ \ s� \ _ \ / Oct c ul rri \ \ \ - \ = Q / / \ \ / 2 ƒ } r 7 & \ / g \ \ \ / ƒ } CD z -• \ \ 9 � APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: 26 CURRENT INSTALLER'S LICENSE# LOCATION: !�ZZ 2 Doli S7�. e,7` LICENSED INSTALLER: P( e.-) SIGNATURE: _TELEPHONE# b96-176 CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only `, $75.00 Fee Attached? . Yes No Foundation_ As -Built? Yes No Approval Date: � � •+ Town of North Andover, Massachusetts Form No. 3 NORTN BOARD OF HEALTH �'y/�' O Z 19 1�� 9 "°�•..o��''`� DISPOSAL WORKS CONSTRUCTION PERMIT ,SSIemusst n \ h Applicant_ NAME DDRESS TELEPHONE Site Location _ q Permission is hereby granted to Construct ( ) or Repair (-)/an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. 0, Fee CHAIRMAN, BOARDOFHEALTH D.W.C. No. epe POMP C bac. wt,�el- p�i(os� Co vvt t C�LTl a n S WSJ ✓v1 C ll�30. C�/y I S Cf.t 1 l U�t C kc, . W, vz_ 1,11 I . 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Y w e%& i -t T off- T4 10 i z, aRmy 7r9NA L E-iv6-77-/ - 1;�! �J�s-�Y� -_ lz v.9Cr1✓lT ol=oTT�O�vi f wc�GK� c � js Vi e, G m r o -F Ta w e, G h RS,s ►�, c l 2 0 ,= L -r �qN M� i.� x T t p TTH x o Vjc bhf' 4-- b k 5 .f(6,�e tc, ^ L 2 o, ? 43 (11 7 I o/ C/ `7 Ne b 5� O ,) 1 .G o ���1. o�v T N1� tN�� �O or -7A-A.) A w1LL A-/u7l )-`Lc-))OT 4w TOWN OF No SYSTEM PU;WF L)A t -SYSTEM OWNER & ADDRESS 9:27a Z)a-4?0- cs*� I ANDOVER Q RECORI-) , INYS'FFM LOCATION RECEIVED OCT 0 5 2004 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 0 LJA I t Ull VUMFINU: . . ..... ---......-Qt,JANTITY PUMPED: - CLSSPOOL: Nol-l-.....-.. YES- NO- YES' NA rUKb OF SERVICE: KOUTINE... e----bMl--RGEN('Y L)13SERVATIUNS: GOOD CONDjT-10N I/FULLTO covER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHMELD RUNBACK --- fiXCESSIVE SOLIDSFLOODED SOLID CARRYOVER '-----,_ OTHER EXPLAIN Syatom pumpcd by �: U M M h N 1-h. CON I LN FS FKANSktKRED I f �10RTly o 4L ;1 b''no SS�ICHUSEt Town of North Andover, Massachusetts BOARD OF HEALTH Form No. 2 DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant�S�6— . Test No. Site Location ����0. Reference Plans and Specs. ! EN 01x:101.1 Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. Fee CHAIRMAN, BOARD OF HEALTH Site System Permit No. 2?3 "Vo MEMORANDUM TO; Sandra Starr, Health Administrator North Andover Board of Health FROM; Francis P. MacMillan, MID, Board Member DATE; October 31, 1996 RE: Variances for Ben Osgood, Jr. 1. Variance to North Andover Regulation X le --Distance to Wetlands --100 foot setback. Distance being requested Is 86 Meet. As this Is a repair, I will give my approval. 2. Variance to North Andover Regulation 2.14 --Minimal requirement for leaching bed Is 900 square feet. Plan submitted is for 733 square feet. I would deny this variance and request that the developer Increase the leeohing bed to 900 square feet. Respectf submi d Francis P. MaoMlllan, MD Board ember NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: Imo PERMIT # DATE RECEIVED OCT. 7, APPLICANT -Z). :57-�Ae-7 MAP p PARCEL ADDRESS �## 7 4;7;1O ENG. G STREET ADDRESS / PLAN DATE �Ol��/ REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED REASONS FOR DISAPPROVAL: All T CA) Tia A -).G 1A-) i�cco��r�Nc �v� coo Y�',Ucy C'E7--;5fe 7-D �R147'lp A 771-1r 1-6 Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 (508) 688-9533 October 21, 1996 Mr. Ben Osgood, Jr. New England Engineering 33 Walker Road North Andover, MA 01845 Re: 922 Dale Street Dear Ben: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. Tank not 10 feet from foundation. 2. Water line not shown. 3. Perc test depth missing. 4. Gas baffle/deflector missing on septic tank. 5. Field less than 900 sq. ft. 6. Less than 100 feet to wetlands. 7. Manhole to grade on tank and pump chamber not shown, 8. Tank and pump chamber should both be weighted in accordance with buoyancy calculations. To be submitted with plans. (3 10 CMR 15.221 (8)) 9, Please indicate TD14, taking into consideration the lowest elevation of forcemain. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S., Health Administrator BOARD OF APPEAIS 688-9541 BUJLIIiNQ 688-9545 CONSERVATION 6M9530 HEALTH 688-9540 PLANNING 688-9535 Julie Perrino D. Robert Nicetta Michael Howard sands Starr Kathleen E3radley Colwell l' PLAN REVIEW CHECKLIST ADDRESS 7,� �191./-1! 5 ENGINEER 05 GOAD GENERAL 3 COPIES 41-1, STAMP(/ LOCUS ,'�` NORTH ARROW L--"- SCALE CONTOURS v PROFILE L--' SECTIONS-� BENCHMARK — SOIL & PERCS Iff ELEVATIONSX WETS, DISCLAIMER WELLS & WETS WATERSHED?A10 DRIVEWAY 6-�--(Elev) WATER LINE FDN DRAIN SCH40t-- TESTS CURRENT?SOIL EVAL SEPTIC TANK MIN 150OG �/ .17 INVERT DROP_je:L� GARB. GRINDER_,6(2 comps +200) 10' TO FDN-z. MANHOLE ELEV GW_, # COMPS. GBZ D -BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET p 6— - OUTLET90-54 _ A1 ( 2" OR .17 FT) REQ' D?�R6 LEACHING r MIN 440 GPD?y / RESERVE AREA 100' TO WETLANDS/ 100' TO WELLS 20' TO FND & INTRCPTR DRAINS 4' PERM. SOIL BELOW FACILITY/ BREAKOUT MET? TRENCHES 4' FROM PRIMARY? 2% SLOPE Z ---- 4- r 4' TO S.H.GW G/ (5'>2M/IN) 400' TO SURFACE H2O SUPP L----- MIN ✓ MIN 12" COVER -ci� FILL?G�(15') MIN 440 gpd SLOPE (min .005 or 6"/1001) W OR D (MIN 6') RESERVE BETWEEN TRENCHES? SIDEWALL DIST. 3X EFF. IN FILL? MUST BE 10' MIN. 4" PEA STONE? VENT? (>3' COVER; LINES >50') BOT + SIDE X LDNG = TOT (L x W x #) (DxLx2x#) (G/ft2) Copyright © 1995 by S.L. Starr PITS MIN 660 LEACHING MIN 1 (13'x16') PIT MANHOLE/PIT GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x ##) (2x(L+W)xD x #) (G/ft2) CHAMBERS MIN 660 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60' X 60') MIN 13' X 16' PIT BOT (L x W x #) + SIDE X LOAD = TOTAL (2 x (L+W)xD x #) (G/ft2) FIELDS MIN #GPD ✓ 900 ft2 BED_ GW MIN 4' BELOW BOTTOM OF FIELD Cf PIPE ENDS JOINED?' 4" PEA STONE? t/— DIST LINE SLOPE .005?<--- >3'COVER-VENT SCH 40 __----MIN 12" COVER RATE '� LDG X 660 = X = TOTAL G/ft2 REQ'D (ft2) LXW DOSING TANKS AND PUMPS Se 73 5 _ (� Z i -f 3 DIMENSIONS 7U X �X /cY- " PUMP CAPACITY gpm L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME gp/m MANHOLES TO GRADE ALARM SEP. CIRC./ GW (Min. 1' below inlet) HWL9/•7.5 LWL RV CHECK VALVE ✓BLEEDER HOLE C-' MANUAL OP. SWITCH t ----- Copyright (3 1995 by S.L. Starr No. DUAHD 01: - -ff—A - I OCT - 7 199., I I - SOIL EVALUATOR FORM Page I of 3 Commonwealth of Massachusetts Date: q – 4�L- -- I —A I , Massachusetts Soil Suitability Assessment for On-site Sewage DiWosal Performed By: —;�:2'11111'2-?�Date: -7/ Witnessed By: q�Og4 ...... zL..........W--k ............... . ............................................. Location Address or La I Addren. and —77 -::7 Telephone I Jew Construction El Repair .Whee Review Published Soil Survey Available: No El Yes FX1 Year Published......... Publication Scale . ..... .. ......Soil Map Unit Drainage Class ......... Soil Limitations Surficial Geologic Report Available: No El Yes D Year Published Publication Scale GeologicMaterial (Map Unit) ............................................................................................................... . ................ Landform Flood Insurance Rate Map: Above 500 year flood boundary No E]Yes 0 Within 500 year flood boundary No E]Yes El Within 100 year flood boundary No OYes El Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal DNormal ElBelcw Normal E-1 Other References Reviewed: WDEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR NORA1 Page 2 of 3 Location Address or Lot No. %2Z 7 %, fid: 4, On-site Review Deep Hole Number Z. .::: Dater/q/gk Time:. ��'Fo Weather�Z�/�� Location (identify on site plan) Land Use ...:.�—.'=c`171G Slope (%)`. Surface Stones .....:'..:.:..... Vegetation .%F�p ......::. Landform Position on landscape (sketch on the back) 6!oce Distances from: Open Water Body . — feet Drainage way ��.5. feet Possible Wet Area � feet Property Line ...:c'.. feet Drinking Water Well ::-.:: 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, % Gravel) ;;;Z—/ L Z- ----- /41 - 2syr 7e2--- 7 Sy2 ��8/NcT e 34 — �o- /�¢ C2 Z-- / - -- -- ----- /> Qa�5F 75�� ,�> ox� 1+1 75>/ 1�111�11VIv10, v. G CVLFII rllVrVJCV UIJr VJHL MntK Parent Material (geologic) 6�u'�l/�S�i Depthtoliedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: 3 / DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR F(}RNI Page 2 of 3 Location Address or Lot No. On-site Review Deep Hole Number Date:.:..:./: �C<<i��— pU �.. .:: % / Time:. �.�.,... .. Weather , .. . Location (identify on site plan) Land Use Slope {%) Z�� .. Surface Stones .... :..:r.... ... Vegetation ./.:`GD.....::. Landform ..:i(/�q�f / Position on landscape (sketch on the back) S��(?...7Tf - Distances from: Open Water Body . feet Drainage way S feet Possible Wet Area ` . feet Property Line ...:.. �.... feet Drinking Water Well :: 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, % Gravel) 4 — -sL /� �w /s/� /���/ F•t/ q � d� L S 41 75 /� Z-5 G vFG nm�nrwryr G lIVLCJ ncuv�ncv ncvcm rf�VrV JCU VWf"V.' Hf1CN Parent Material (geologic) A� �= :?4C'T Gc/T�!/ �/� DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: _ Weeping from Pit Face: Eslimated Seasonal High Ground Water: DEP APPROVED FORM . 12107195 FORM 11- SOIL EVALUATOR FORM Page 3 of 3 n/�zf ? Location Address or Lot No. ZZ 741 �i A/©, Method Used: ❑ Depth observed standing in observation hole ................... inches ❑ Depth weeping from. side of observation hole ................... inches ❑ Depth to soil mottles -E-4— inches ❑ Ground water adjustment ......... ........ feet Index Well Number .................. Reading .Date .............:..... Index well level Adjustment factor ................... Adjusted ground water level ........................ Qegth of Natyfally Occurring Pervious --Material Does at least four feet of naturally occurring pervious material exist in ail areas observed throughout the area proposed for the soil absorption system? y� s If not, what is the depth of naturally occurring pervious material? – Ce tificetion 1 certify that on=%�9(date) I have passed the soil evaluator examination approved by the apartment 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. ;X Signature /�Date AEP APPROVED FORM -1WOMS a FORM 11 • SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot -No.�,4�� T Method Used: ❑ Depth observed standing in observation hole ................... inches ❑ Depth weeping from. side of observation hole ................... inches © Depth to soil mottles z8 inches ❑ Ground water adjustment ........ ......... feet Index Well Number .................. Reading.Date ................... Index well level ..... __.......... Adjustment factor ....._....._.... Adjusted ground water level ........................................................ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in dll areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? I certify that onAepartment ' (date) 1 have passed the soil evaluator examination approved by the o 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 Date / W. AEP AMOVM FORM -1210719S SEPTIC PLAN SUBMITTALS LOCATION: q )-- -. ,(. J NEW PLANS: (YDESJ� REVISED PLANS: YES DATE: k 0 b lc,� DESIGN ENGINEER: w $60.00/Plan $25.00/Plan When the submission is all in place, route to the Health Secretary Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH APPLICATION FOR SITE TESTING/INSPECTION Applicant NAME ADDRESS TELEPHONE Site Location Engineer_ NAM - A SS TELEPHONE Test/Inspection Date and Timep7. 9 l,�C50 �j CHAIRMAN, BOARD OF HEALTH Fee— 1,-, Test No.��� S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts BOARD OF HEALTH QED 6 N � R6 � APPLICATION FOR SITE TESTING/INSPECTION Form No. 1 19 Applicant NAME ADDRESS TELEPHONE Site Location Engineer N NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN, BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. PS TOSD TIME�.6 kM u 4 FROI��) _ AREA bDE EXNO. (o^ T. i I � (p OF E M m E s E s M G E SIGNED PHONED [I BALL E] RNE CALL SEE YOTO 0 AGAIN ALL EJ WAS IN URGENT I,& E �I �c.� 7;Ll,e 3 i./ <:!5:7- 75- �� 17-2- APPLICATION 7z APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby m e application for a permit for a sewage disposal installation at F:- -?, . 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 in size. A manhole (s) permitting easy cleaning will be provided with removable cover (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 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. DATE Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE 3 7 e, Signature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE 6 g '0 t tJ; Signature of T pecting Off ic Percolation Test L Garbage Grinder lid BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. 36q 0 15, 9 ---? 1 x•71 � 1. NAME-_ �� _p, C•- DATE �r�,.�o , . �) %p 2. ADDRESS 4 Z Z //9 G, LOT NO. TEL. 3. NO. OF BEDROOMS DEN YES NO__�, 4. GARBAGE GRINDER YES NO 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 ell - 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 TOWN OF NORTH ANDOVER, MASS. 1. NAME �' %K11 DATE7�, l� 2. ADDRESST v U LOT NO. TEL . ?/ AV,U 3. NO. OF BEDROOMS /�0-4,,t, DEN YES No -y-- 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 ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL c� DATE r /3 p F NAME OF APPLICANT LOCATION 7 Z-2— Address of lot no, BUILDING: Dwelling JC Other SYSTEM: New X Repair E GENERAL DESCRIPTION OF LAND SUBSOIL: Clay__ G vel Sand PERCOLATION TEST 4:1 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK -0 gallon capacity. LEACH FIELD `Z lineal feet of drain pipe, 4 William J. Dr'scoll, EngineZr Board of Hea h BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 June 5, 1986 Mr.Harold Stewart 922 Dale St. No.Andover, Mass. Dear Mr. Steward: This Board had received a complaint about flies supposedly caused by cows and horses on your property. Our records indicate that you do not have a permit from this Board to keep animals or birds. Kindly get in touch with us on this matter. Very truly yours, John S. Rizza, DMD Chairman TEL. 682-6400 �L\ Commonwealth of Massachusetts City/Town of P v System Pumping Record Zg10 Form 4 AN wM DEP has provided this form for use by local Boards of Health. Other forms m DAVER information must be, substantially the same as that provided here. Before usENT i r local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health or ottxer. approving authority. A. Facility Information 1. System Loca eft side of�house fight side of house, Left front of house, Right front of house, Left rear of hou ar se. Left rear of building. Right rear of building. Address City/Town 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): q—a0-cam Date Stag —?/a• t f q Z� Code Telephone Number 1 l C 2. Quantity Pumped: Gallons s)eptic T nk ElTight Tank o `�; 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Cond 6. System Pumped By: If yes, was it cleaned? ❑ Yes ❑ No Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locati here contents were disposed: G. L. W WwAWaste.Water /C) Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1