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HomeMy WebLinkAboutMiscellaneous - 980 WINTER STREET 4/30/2018J
Lot & Street Map/Parcel g- 6 A.
CONSTRUCTION APPROVAL
Has plan review fee been paid: ES NO Permit#
Plan Approval: Date: pproved by:
Designer: ge `1>��� 1 ✓J� Plan Date:
Conditions:
Water Supply: Town Well
Well Permit: Driller:
Well Tests: Chemical ~!Date
Bacteria I Dafe
Bacteria II Date
Plumbing Sign -Off:
Comments:
Form "U" Approval:
Date Issued
Conditions:
Final Approval:
Approved
Wiring Sig
Approval to Issue:
By:_
YES NO
All Permits Paid? YES NO
Well Construction Approval? YES NO
Septic System Construction Approval? YES NO
Certification? YES NO
Other? YES NO
Any Variance Needed? YES NO
FINAL BOARD OF HEALTH APPROVAL:
DATE:
APPROVED BY:
SEPTIC SYSTEM INSTALLATION
CONDITIONS:
Is the installer licensed? ,__YES
Type of Construction: NEW A"_1
New Construction: Certified Plot Plan Review YES NO
Floor Plan Review YES NO
Conditions of Approval from Form U YES NO
Issuance of DWC permit:
DWC Permit Paid?
DWC Permit # _ /'�? �ID
Begin Inspection:
Excavation Inspection:
Needed:
Passed: /�'�i /Q By:
Construction Inspection:
Needed:
d NO
YES NO
Installer: G1) . 7175A4 SOCA
NO
As Built Plan Satisfactory:
YES: b( ,
Approval of Backfill: Date:
Final Grading Approval: Date: �� 3 aZ By:
Final Construction Approval: Date: By: M M
Certificate of Compliance: Approval: Date: 0-7—
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10/12/2016 Town of North Andover Mail - Re: 980 W Inter Street
NORT.1 )" l -OVER
Massachus�s.a-. Brian LaGrasse <blagrasse@northandoverma.gov>
Re: 980 Winter Street
1 message
Tim Willett <twillett@northandoverma.gov>
To: Brian LaGrasse <blagrasse@northandoverma.gov>
Wed, Oct 12, 2016 at 11:53 AM
Oddly enough we have a record of a water line going into the house but no water billing account. I will instruct my crew
to shut water off at the curb stop but we do not enter homes without permission.
Sent from my iPhone
On Oct 12, 2016, at 8:45 AM, Brian LaGrasse <blagrasse@northandoverma.gov> wrote:
Is 980 Winter Street on water or private well? Got a complaint that it was abandoned and going through
the foreclosure process and the neighbors are worried about frozen pipes etc. Also, does the DPW have a
crew that would secure properties like this?
Brian J. LaGrasse, CEHT
Director of Public Health
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone
978.688.9540
Fax
978.688.8476
Email
blagrasse@northandoverma.gov
Web
www.northandoverma.gov
https://mail.google.com/mail/u/0/?ui=2&ik=2c94973612&view=pt&search=inbox&type=157b992707ba25f8&th=157b999Oc259e83c&siml=157b999Oc259e83c 1/1
Essex North Registry of Deeds
RG300R 10/12/16 8:53:24
Selected by Public Inquiry
M. Paul Iannuccillo
Page 1
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
Book: 8931-117 Recorded: 07-16-2004 @ 10:36:OOa Inst #: 31240 Chg:Y Vfy:Y
Grp: 1 Type: MORTGAGE Doc$: 221,600.00
Town: NORTH ANDOVER Addr: 980 WINTER ST
Gtor: SULLIVAN BARBARA E
Gtee: MORTGAGE ELECTRONIC REGISTRATION SYSTEMS INC
Ref
By:06-19-2009
ASGT
ASSIGNMENT
In
book:11650-223
Ref
By:10-12-2010
ONOT
ORDER OF NOTICE
In
book:12229-41
Ref
By:02-27-2013
MODFNMODIFICATION
In
book:13361-320
Ref
By:03-08-2013
ASGT
ASSIGNMENT
In
book:13378-119
Ref
By:03-20-2014
ASGT
ASSIGNMENT
In
book:13800-298
Ref
By:01-26-2015
ASGT
ASSIGNMENT
In
book:14112-16
Ref
By:09-28-2015
ONOT
ORDER OF NOTICE
In
book:14393-4
Ref
By:11-12-2015
AFFT
AFFIDAVIT
In
book:14443-71
Return addr: GUARANTY RESIDENTIAL LENDING
P 0 BOX 2198
AUSTIN, TX 78768
Recording Fee: 175.00 State excise: .00 Surcharge: .00
--------------------------------------------------------------------------------
�J ar-a'Va rraVuflar 1Jgaa.�
Property Address: 980 Winter Street, North Andover, Massachusetts 01845
Mortgage: Barbara E. Sullivan to Mortgage Electronic Registration Systems, Inc. as nominee for Guaranty
Residential Lending, Inc., dated July 12, 2004 recorded with the Essex County (Northern District) Registry of
Deeds at Book 8931, Page 117 as affected by a modification agreement recorded with said records at Book
13361, Page 320
Mortgagee: Nationstar Mortgage LLC
1. I am employed as a .Document Execution Socialist by Nationstar Mortgage LLC
("Nationstar"), the servicer for the mortgage loan that is the subject of this action. I have
personal knowledge of the facts contained in this affidavit as follows: I am familiar with the
systems of record that Nationstar uses to record and create information related to the residential
mortgage loans that it services, including the processes by which Nationstar obtains the loan
information in those systems. While many of those processes are automated, the information
manually entered by Nationstar employees relating to loans on those systems is based upon
personal knowledge of the information and is entered into the system at or near the time the
knowledge was acquired. These computerized records are created and maintained in the regular
course of its business as a loan servicer and Nationstar relies on the records in the ordinary
course to conduct its business as a loan servicer.
2. Based upon my review of the business records of Nationstar Mortgage LLC, together with
copies of the subject note and the applicable Notice(s) of Right to Cure Default, I certify that
with respect to the Mortgage:
a) [Check One]
Nationstar Mortgage LLC has complied with G.L. c. 244, 35B, by taking
X reasonable steps and making a good faith effort to avoid foreclosure.
GL. c. 244, s. 35B, does not apply to the promissory note secured by the
above -referenced mortgage
b) In accordance with the requirements of GL. c. 244,35C, the Mortgagee is:
[Check One]
the holder of the promissory note secured by the Mortgage
the authorized agent of the holder of the promissory note secured by the
X Mortgage
Signed under the pains and penalties of perjury this 6th day of H,ovember , 2015
Allison Fries
Title: Document Execution Specialist
State of Texas
County of Denton
Before me, a notary public, on this _filhL_ day of November , 20_a_ personally appeared
Allison Fries , known to me to be the person whose name is subscribed to the foregoing
document and, being by me first duly sworn, declared that the statements therein contained are true and
correct.
Notary ublic's Signature
(Personalized Seal)
.. i�,p+, tATOSHA OAVIS !"
tdotory Public. stare of iexus
;O^.� • My CommWlon EIQ*es iy
yMHenniw� Oclobet 27, 2019 I
a
ABO.YE FOR' REGISTR I' O
Bk 12229 P941 0,26981
117-12---2010 & 01"
290
OAEY
Co.R SHEET
TTS Is -THE FIRST PAGE Off' THIS D
PCO NO�`RE1V�0 OCUM�NT
rt G•RANTOR
r
RESS OF PROPERTY
—DEED
_:,. MORTGAGE
--DISC$ARGE. `
--..._..AFFIDAVIT
-_DEC OF .HOMESTEAD
--`-DEC OF TRUST
GRAIV'�'EE
TYPE
CITY/TOWN
OF DO CUM ENT
ASSIGNMENT
• 6D TYPE
..*.1GN0TICS d �/
:
—SUBORDINATION
-�2ERT
TYPE
UCC
TYPE
O'T.HER
DESCRIBE
Essex Forth Registry of Deeds
Robept F. -Kelley.,, .Register '
354 Merrimack St. Suite 304
Lawrence, NIA. 018.43
(978) 681-2743
vvw"w.Iawren cedeeds. co m
r- (SEAL,)
To:
Barbara E. Sullivan
Bk 12229 Pg42 #26981
THE COMMONWEALTH OF MASSACHUSETTS
LAND COURT
DEPARTMENT OF THE TRIAL COURT
10 MiSC 435721
�ililigillillill
BAC Home Loans Servicing, L_P.
d
a
c�
L�
f
fv
and to all persons entitled to the benefit of the Servicemembers Civil Relief Act.
BAC Home Loans Servicing, L.P.
claiming to be the holder of
covering real
a Mortgage
property in North Andover,
numbered 980 Winter Street
Qc
C:
given by Barbara E. Sullivan to Mortgage Electronic Registration Systems, Inc., dated July 12, 2004, and
recorded with the Essex County (Northern District) Registry of Deeds at Book 8931, Page 117 and now
held by the plaintiff by assignment
has filed with said court a complaint for authority to foreclose said mortgage
in the manner following: by entry and possession and exercise of power of sale.
If you are entitled to the benefits of the Servicemembers Civil Relief Act as amended and you object to such
foreclosure you or your attorney should file a written appearance and answer in said court at Boston on
or before NOV 0 8 2011
or you may be forever barred from claiming that such foreclosure is invalid under said act.
Witness, KARYN F. SCHEIER, Chief Justice of said Court on SEP 2 7 2010
ATRUE COPY
Attest: ATTEST
MG ,rr�� DEBORAH L PATTERSON
4RECORDER
200911-1628-BLU-%Ap
W 8931 PG 133
MIN 100012900017633152 1763315
ADJUSTABLE RATE RIDER
(LIBOR One -Year Index (As Published In The Wall Street Journal) - Rate Caps)
THIS ADJUSTABLE RATE RIDER is made this 12th day of July, 2004 ,
and is incorporated into and shall be deemed to amend and supplement the Mortgage, Deed of Trust,
or Security Deed (the "Security Instrument") of the same date given by the undersigned (the "Borrower") to
secure Borrower's Adjustable Rate Note (the "Note") to
Guaranty Residential Lending, Inc.
(the "Lender") of the same date and covering the property described in the Security Instrument and located at:
980 WINTER STREET, NORTH ANDOVER, MASSACHUSETTS 01845
[Property Address]
THE NOTE CONTAINS PROVISIONS ALLOWING FOR CHANGES IN THE
INTEREST RATE AND THE MONTHLY PAYMENT. THE NOTE LIMITS THE
AMOUNT THE BORROWER'S INTEREST RATE CAN CHANGE AT ANY
ONE TIME AND THE MAXIMUM RATE THE BORROWER MUST PAY.
ADDITIONAL COVENANTS. In addition to the covenants and agreements made in the Security
Instrument, Borrower and Lender further covenant and agree as follows:
A. INTEREST RATE AND MONTHLY PAYMENT CHANGES
The Note provides for an initial interest rate of 5.375 °!o. The Note provides for
changes in the interest rate and the monthly payments as follows:
4. INTEREST RATE AND MONTHLY PAYMENT CHANGES
(A) Change Dates
The interest rate I will pay may change on the first day of August, 2007
,
and on that day every 12th month thereafter. Each date on which my interest rate could change is called a
"Change Date."
MULTISTATE ADJUSTABLE RATE RIDER - WSJ One -Year LIBOR -Single Family- Fannie Mae
UNIFORM INSTRUMENT
V06DB37
�188R (0109).01 Form 318 / I MIN
III IIIIII IIIII! III! 1111
IIIA
Page 1 of 4 Initials;
VMP MORTGAGE FORMS - (800)521-7291
BK 89131 PG 134
1763315
(B) The Index
Beginning with the fust Change Date, my interest rate will be based on an Index. The "Index" is the
average of interbank offered rates for one-year U.S. dollar-denominated deposits in the London market
("LIBOR"), as published in The Wall Street Journal. The most recent Index figure available as of the date 45
days before each Change Date is called the "Current Index."
If the Index is no longer available, the Note Holder will choose a new index which is based upon
comparable information. The Note Holder will give me notice of this choice.
(C) Calculation of Changes
Before each Change Date, the Note Holder will calculate my new interest rate by adding
TWO AND ONS -QUARTER percentage points
( 2.250 %) to the Current Index. The Note Holder will then round the result of this
addition to the nearest one-eighth of one percentage point (0.125%). Subject to the limits stated in Section
4(D) below, this rounded amount will be my new interest rate until the next Change Date.
The Note Holder will then determine the amount of the monthly payment that would be sufficient to
repay the unpaid principal that I am expected to owe at the Change Date in full on the maturity date at my
new interest rate in substantially equal payments. The result of this calculation will be the new amount of my
monthly payment.
(D) Limits on Interest Elate Changes
The interest rate I am required to pay at the first Change Date will not be greater than
7.375 % or less than 3.375 %. Thereafter, my interest rate will
never be increased or decreased on any single Change Date by more than two percentage points from the rate
of interest I have been paying for the preceding 12 months. My interest rate will never be greater than
11.375 %.
(E) Effective Date of Changes
My new interest rate will become effective on each Change Date. I will pay the amount of my new
monthly payment beginning on the first monthly payment date after the Change Date until the amount of my
monthly payment changes again.
V06DB38 Initials:
�®166R (0109).01 Page 2 of 4 Form 3189 6101
BK a2`1011 PG 135
1763315
(F) Notice of Changes
The Note Holder will deliver or mail to me a notice of any changes in my interest rate and the amount of
my monthly payment before the effective date of any change. The notice will include information required by
law to be given to me and also the title and telephone number of a person who will answer any question I
may have regarding the notice.
B. TRANSFER OF THE PROPERTY OR A BENEFICIAL INTEREST IN BORROWER
Section 18 of the Security Instrument is amended to read as follows:
Transfer of the Property or a Beneficial Interest in Borrower. As used in this Section 18,
"Interest in the Property" means any legal or beneficial interest in the Property, including, but not
limited to, those beneficial interests transferred in a bond for deed, contract for deed, installment
sales contract or escrow agreement, the intent of which is the transfer of title by Borrower at a
future date to a purchaser.
If all or any part of the Property or any Interest in the Property is sold or transferred (or if
Borrower is not a natural person and a beneficial interest in Borrower is sold or transferred)
without Lender's prior written consent, Lender may require immediate payment in full of all sums
secured by this Security Instrument. However, this option shall not be exercised by Lender if such
exercise is prohibited by Applicable Law. Lender also shall not exercise this option if: (a)
Borrower causes to be submitted to Lender information required by Lender to evaluate the
intended transferee as if a new loan were being made to the transferee; and (b) Lender reasonably
determines that Lender's security will not be impaired by the loan assumption and that the risk of a
breach of any covenant or agreement in this Security Instrument is acceptable to Lender.
To the extent permitted by Applicable Law, Lender may charge a reasonable fee as a
condition to Lender's consent to the loan assumption. Lender may also require the transferee to
sign an assumption agreement that is acceptable to Lender and that obligates the transferee to keep
all tate promises and agreements made in the Note and in this Security Instrument. Borrower will
continue to be obligated under the Note and this Security Instrument unless Lender releases
Borrower in writing.
If Lender exercises the option to require immediate payment in full, Lender shall give
Borrower notice of acceleration. The notice shall provide a period of not less than 30 days from
the date the notice is given in accordance with Section 15 within which Borrower must pay all
sums secured by this Security Instrument. If Borrower fails to pay these sums prior to the
expiration of this period, Lender may invoke any remedies permitted by this Security Instrument
without further notice or demand on Borrower.
V06DB39 Initials:99
®166R (0109).01 Page 3 of 4 Form 3169 6101
LIRK 8 tK .,e l PG 136
1763315
BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this
Adjustable Rate Rider.
,
� 'p iIdeal>
BARBARA E SULLIVAN -Borrower
—(Seal)
-Borrower
—(Seal)
-Borrower
_(Seal)
-Borrower
(Seal)
-Borrower
(Seal)
-Borrower
(Seal)
-Borrower
(Seat)
-Borrower
V06DB40
Q; 166R (0109).01 Page 4 of 4 Form 3189 6/01
BK 89-71 PG 117
Retum To: GUARANTY RESIDENTIAL LENDING, INC.
Banking & Shipping Dept.
P.O. Box 2198
Austin, TX 78768-2198
Prepared By: Stella Fedorayn
[Space Above This Line For Recording Data]
MORTGAGE 1763315
MIN 100012900017633152
DEFINITIONS -
Words used in multiple sections of this document are defined below and other words are defined in Sections .
3, 11, 13, 18, 20 and 21. Certain rules regarding the usage of words used in this document are also provided
in Section 16.E
(A) "Security Instrument" means this document, which is dated July 12, 2004
together with all Riders to this document.
(B) "Borrower" is
BARBARA E SULLIVAN
0
w
NO
4
Borrower is the mortgagor under this Security Instrument.
(C) "MERS" is Mortgage Electronic Registration Systems, Inc. MFRS is a separate corporation that is acting
solely as a nominee for Lender and Lender's successors and assigns. MERS is the mortgagee under this
Security Instrument. MERS is organized and existing under the laws of Delaware, and has an address and
telephone number of P.O. Box 2026, Flint, MI 48501-2026, tel. (888) 679-MERS.
MASSACHUSETTS -Single Family -Fannie Mae/Freddie Mac UNIFORM INSTRUMENT WITH MERS
Form 3022 1/01
U 6MA01
(-6A(MA) (0401)
Page , of 15 initials: ! 1111111 !11111 III Illlll Illi ILII illi
VMP Mortgage Solutions (800)521•7291
BK 8 9 3)1 PG 118
1763315
(D) "Lender" is Guaranty Residential Lending, Inc.
Lender is a corporation
organized and existing under the laws of NEVADA
Lender's address is 1300 South Mopac Expressway
Austin, TX 78746
(E) "Note" means the promissory note signed by Borrower and dated July 12, 2004
The Note states that Borrower owes Lender TWO HUNDRED TWENTY ONE THOUSAND SIX
HUNDRED & 00/100 Dollars
(U.S. $ 221, 6 00.00 ) plus interest. Borrower has promised to pay this debt in regular Periodic
Payments and to pay the debt in full not later than August 1, 2034
(F) "Property" means the property that is described below under the heading "Transfer of Rights in the
Property."
(G) "Loan" means the debt evidenced by the Note, plus interest, any prepayment charges and late charges
due under the Note, and all sums due under this Security Instrument, plus interest.
(ii) "Riders" means all Riders to this Security Instrument that are executed by Borrower. The following
Riders are to be executed by Borrower (check box as applicable]:
® Adjustable Rate Rider E Condominium Rider 0 Second Home Rider
❑ Balloon Rider F-1 Planned Unit Development Rider 711-4 Family Rider
❑ VA Rider ❑ Biweekly Payment Rider FI Other(s) (specify]
(1) "Applicable Law" means all controlling applicable federal, state and local statutes, regulations,
ordinances and administrative rules and orders (that have the effect of law) as well as all applicable final,
non -appealable judicial opinions.
(J) "Community Association Dues, Fees, and Assessments" means all dues, fees, assessments and other
charges that are imposed on Borrower or the Property by a condominium association, homeowners
association or similar organization.
(K) "Electronic Funds Transfer" means any transfer of funds, other than a transaction originated by check,
draft, or similar paper instrument, which is initiated through an electronic terminal, telephonic instrument,
computer, or magnetic tape so as to order, instruct, or authorize a financial institution to debit or credit an
account. Such term includes, but is not limited to, point-of-sale transfers, automated teller machine
transactions, transfers initiated by telephone, wire transfers, and automated clearinghouse transfers.
(L) "Escrow Items" means those items that are described in Section 3.
(M) "Miscellaneous Proceeds" means any compensation, settlement, award of damages, or proceeds paid by
any third party (other than insurance proceeds paid under the coverages described in Section 5) for: (i)
damage to, or destruction of, the Property; (ii) condemnation or other taking of all or any part of the Properly;
(iii) conveyance in lieu of condemnation; or (iv) misrepresentations of, or omissions as to, the value and/or
condition of the Property.
(N) "Mortgage Insurance" means insurance protecting Lender against the nonpayment of, or default on, the
Loan.
(0) "Periodic Payment" means the regularly scheduled amount due for (i) principal and interest under the
Note, plus (ii) any amounts under Section 3 of this Security Instrument.
(P) "RESPA" means the Real Estate Settlement Procedures Act (12 U.S.C. Section 2601 et seq.) and its
implementing regulation, Regulation X (24 C.F.R. Part 3500), as they might be amended from time to time,
or any additional or successor legislation or regulation that governs the same subject matter. As used
U06MA02 Initials: V9�
40.6A(MA) (0401) Page 2 of is Form 3022 1/01
0
1763315
in this Security Instrument, "RESPA" refers to all requirements and restrictions that are imposed in regard to a
"federally related mortgage loan" even if the Loan does not qualify as a "federally related mortgage loan"
under RESPA.
(Q) "Successor in Interest of Borrower" means any party that has taken title to the Property, whether or not
that party has assumed Borrower's obligations under the Note and/or this Security Instrument.
TRANSFER OF RIGHTS IN THE PROPERTY
This Security Instrument secures to Lender. (i) the repayment of the Loan, and all renewals, extensions and
modifications of the Note; and (ii) the performance of Borrower's covenants and agreements under this
Security Instrument and the Note. For this purpose, Borrower does hereby mortgage, grant and convey to
MERS (solely as nominee for Lender and Lender's successors and assigns) and to the successors
and assigns of NIERS, with power of sale, the following described property located in the
County of Essex
[Type of Recording Jurisdiction]
[Name of Recording Jurisdiction]:
All that tract or parcel of land as shown on Schedule uAn attached
hereto which is incorporated herein and made a part hereof.
Parcel ID Number:
980 WINTER STREET
NORTH ANDOVER
which currently has the address of
[Street)
[City] , Massachusetts 01845 [Zip Code]
("Property Address"):
TOGETHER WITH all the improvements now or hereafter erected on the property, and all easements,
appurtenances, and fixtures now or hereafter a part of the property. All replacements and additions shall also
be covered by this Security Instrument. All of the foregoing is referred to in this Security Instrument as the
"Property." Borrower understands and agrees that MERS holds only legal title to the interests granted by
Borrower in this Security Instrument, but, if necessary to comply with law or custom, NIERS (as nominee for
Lender and Lender's successors and assigns) has the right: to exercise any or all of those interests, including,
but not limited to, the right to foreclose and sell the Property; and to take any action required of Lender
including, but not limited to, releasing and canceling this Security Instrument.
BORROWER COVENANTS that Borrower is lawfully seised of the estate hereby conveyed and has
the right to, mortgage, grant and convey the Property and that the Property is unencumbered, except for
encumbrances of record. Borrower warrants and will defend generally the title to the Property against all
claims and demands, subject to any encumbrances of record.
THIS SECURITY INSTRUMENT combines uniform covenants for national use and non-uniform
covenants with limited variations by jurisdiction to constitute a uniform security instrument covering real
Property
U06MA03 initials:
40.6A(MA) (0401) Page 3 of 15 Form 3022 1/01
DK07t r �� t L
1763315
UNIFORM COVENANTS. Borrower and Lender covenant and agree as follows:
1. Payment of Principal, Interest, Escrow Items, Prepayment Charges, and Gate Charges.
Borrower shall pay when due the principal of, and interest on, the debt evidenced by the Note and any
prepayment charges and late charges due under the Note. Borrower shall also pay funds for Escrow Items
pursuant to Section 3. Payments due under the Note and this Security Instrument shall be made in U.S.
currency. However, if any check or other instrument received by Lender as payment under the Note or this
Security Instrument is returned to Lender unpaid, Lender may require that any or all subsequent payments
due under the Note and this Security Instrument be made in one or more of the following forms, as selected
by Lender: (a) cash; (b) money order, (c) certified check, bank check, treasurer's check or cashier's check,
provided any such check is drawn upon an institution whose deposits are insured by a federal agency,
instrumentality, or entity; or (d) Electronic Funds Transfer.
Payments are deemed received by Lender when received at the location designated in the Note or at
such other location as may be designated by Lender in accordance with the notice provisions in Section 15.
Lender may return any payment or partial payment if the payment or partial payments are insufficient to bring
the Loan current. Lender may accept any payment or partial payment insufficient to bring the Loan current,
without waiver of any rights hereunder or prejudice to its rights to refuse such payment or partial payments in
the future, but Lender is not obligated to apply such payments at the time such payments are accepted. If each
Periodic Payment is applied as of its scheduled due date, then Lender need not pay interest on unapplied
funds. Lender may hold such unapplied funds until Borrower makes payment to bring the Loan current. If
Borrower does not do so within a reasonable period of time, Lender shall either apply such funds or return
them to Borrower. If not applied earlier, such funds will be applied to the outstanding principal balance under
the Note immediately prior to foreclosure. No offset or claim which Borrower might have now or in the
future against Lender shall relieve Borrower from making payments due under the Note and this Security
Instrument or performing the covenants and agreements secured by this Security Instrument.
2. Application of Payments or Proceeds. Except as otherwise described in this Section 2, all payments
accepted and applied by Lender shall be applied in the following order of priority: (a) interest due under the
Note; (b) principal due under the Note; (c) amounts due under Section 3. Such payments shall be applied to
each Periodic Payment in the order in which it became due. Any remaining amounts shall be applied first to
late charges, second to any other amounts due under this Security Instrument, and then to reduce the principal
balance of the Note.
If Lender receives a payment from Borrower for a delinquent Periodic Payment which includes a
sufficient amount to pay any late charge due, the payment may be applied to the delinquent payment and the
late charge. If more than one Periodic Payment is outstanding, Lender may apply any payment received from
Borrower to the repayment of the Periodic Payments if, and to the extent that, each payment can be paid in
full. To the extent that any excess exists after the payment is applied to the full payment of one or more
Periodic Payments, such excess may be applied to any late charges due. Voluntary prepayments shall be
applied first to any prepayment charges and then as described in the Note.
Any application of payments, insurance proceeds, or Miscellaneous Proceeds to principal due under the
Note shall not extend or postpone the due date, or change the amount, of the Periodic Payments.
3. Fends for Escrow Items. Borrower shall pay to Lender on the day Periodic Payments are due under
the Note, until the Note is paid in full, a sum (the "Funds") to provide for payment of amounts due for: (a)
taxes and assessments and other items which can attain priority over this Security Instrument as a lien or
encumbrance on the Property; (b) leasehold payments or ground rents on the Property, if any; (c) premiums
for any and all insurance required by Lender under Section 5; and (d) Mortgage Insurance premiums, if any,
or any sums payable by Borrower to Lender in lieu of the payment of Mortgage Insurance premiums in
accordance with the provisions of Section 10. These items are called "Escrow Items." At origination or at any
time during the term of the Loan, Lender may require that Community Association Dues, Fees, and
Assessments, if any, be escrowed by Borrower, and such dues, fees and assessments shall be an Escrow Item.
Borrower shall promptly furnish to Lender all notices of amounts to be paid under this Section. Borrower
shall pay bender the Funds for Escrow Items unless Lender waives Borrower's obligation to pay the Funds
for any or all Escrow Items. Lender may waive Borrower's obligation to pay to Lender Funds for any or all
Escrow Items at any time. Any such waiver may only be in writing. In the event of such waiver, Borrower
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shall pay directly, when and where payable, the amounts due for any Escrow Items for which payment of
Funds has been waived by Lender and, if Lender requires, shall furnish to Lender receipts evidencing such
payment within such time period as Lender may require. Borrower's obligation to make such payments and
to provide receipts shall for all purposes be deemed to be a covenant and agreement contained in this Security
Instrument, as the phrase "covenant and agreement" is used in Section 9. If Borrower is obligated to pay
Escrow Items directly, pursuant to a waiver, and Borrower fails to pay the amount due for an Escrow Item,
Lender may exercise its rights under Section 9 and pay such amount and Borrower shall then be obligated
under Section 9 to repay to Lender any such amount. Lender may revoke the waiver as to any or all Escrow
Items at any time by a notice given in accordance with Section 15 and, upon such revocation, Borrower shall
pay to Lender all Funds, and in such amounts, that are then required under this Section 3.
Lender may, at any time, collect and hold Funds in an amount (a) sufficient to permit Lender to apply
the Funds at the time specified under RESPA, and (b) not to exceed the maximum amount a lender can
require under RESPA. Lender shall estimate the amount of Funds due on the basis of current data and
reasonable estimates of expenditures of future Escrow Items or otherwise in accordance with Applicable Law.
The Funds shall be held in an institution whose deposits are insured by a federal agency, instrumentality,
or entity (including Lender, if Lender is an institution whose deposits are so insured) or in any Federal Home
Loan Bank. Lender shall apply the Funds to pay the Escrow Items no later than the time specified under
RESPA. Lender shall not charge Borrower for holding and applying the Funds, annually analyzing the
escrow account, or verifying the Escrow Items, unless Lender pays Borrower interest on the Funds and
Applicable Law permits Lender to make such a charge. Unless an agreement is made in writing or Applicable
Law requires interest to be paid on the Funds, Lender shall not be required to pay Borrower any interest or
earnings on the Funds. Borrower and Lender can agree in writing, however, that interest shall be paid on the
Funds. Lender shall give to Borrower, without charge, an annual accounting of the Funds as required by
RESPA.
If there is a surplus of Funds held in escrow, as defined under RESPA, Lender shall account to
Borrower for the excess funds in accordance with RESPA. If there is a shortage of Funds held in escrow, as
defined under RESPA, Lender shall notify Borrower as required by RESPA, and Borrower shall pay to
Lender the amount necessary to make up the shortage in accordance with RESPA, but in no more than 12
monthly payments. If there is a deficiency of Funds held in escrow, as defined under RESPA, Lender shall
notify Borrower as required by RESPA, and Borrower shall pay to Lender the amount necessary to make up
the deficiency in accordance with RESPA, but in no more than 12 monthly payments.
Upon payment in full of all sums secured by this Security Instrument, Lender shall promptly refund to
Borrower any Funds held by Lender.
4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines, and impositions
attributable to the Property which can attain priority over this Security Instrument, leasehold payments or
ground rents on the Property, if any, and Community Association Dues, Fees, and Assessments, if any. To the
extent that these items are Escrow Items, Borrower shall pay them in the manner provided in Section 3.
Borrower shall promptly discharge any lien which has priority over this Security Instrument unless
Borrower: (a) agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to
Lender, but only so long as Borrower is performing such agreement; (b) contests the lien in good faith by, or
defends against enforcement of the lien in, legal proceedings which in Lender's opinion operate to prevent the
enforcement of the lien while those proceedings are pending, but only until such proceedings are concluded;
or (c) secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this
Security Instrument. If Lender determines that any part of the Property is subject to a lien which can attain
priority over this Security Instrument, Lender may give Borrower a notice identifying the lien. Within 10
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days of the date on which that notice is given, Borrower shall satisfy the lien or take one or more of the
actions set forth above in this Section 4.
Lender may require Borrower to pay a one-time charge for a real estate tax verification and/or reporting
service used by Lender in connection with this Loan.
S. Property Insurance. Borrower shall keep the improvements now existing or hereafter erected on the
Property insured against loss by fire, hazards included within the term "extended coverage," and any other
hazards including, but not limited to, earthquakes and floods, for which Lender requires insurance. This
insurance shall be maintained in the amounts (including deductible levels) and for the periods that Lender
requires. What Lender requires pursuant to the preceding sentences can change during the term of the Loan.
The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's right to
disapprove Borrower's choice, which right shall not be exercised unreasonably. Lender may require
Borrower to pay, in connection with this Loan, either: (a) a one-time charge for flood zone determination,
certification and tracking services; or (b) a one-time charge for flood zone determination and certification
services and subsequent charges each time remappings or similar changes occur which reasonably might
affect such determination or certification. Borrower shall also be responsible for the payment of any fees
imposed by the Federal Emergency Management Agency in connection with the review of any flood zone
determination resulting from an objection by Borrower.
If Borrower fails to maintain any of the coverages described above, Lender may obtain insurance
coverage, at Lender's option and Borrower's expense. Lender is under no obligation to purchase any
particular type or amount of coverage. Therefore, such coverage shall cover Lender, but might or might not
protect Borrower. Borrower's equity in the Property, or the contents of the Property, against any risk, hazard
or liability and might provide greater or lesser coverage than was previously in effect. Borrower
acknowledges that the cost of the insurance coverage so obtained might significantly exceed the cost of
insurance that Borrower could have obtained. Any amounts disbursed by Lender under this Section 5 shall
become additional debt of Borrower secured by this Security Instrument. These amounts shall bear interest at
the Note rate from the date of disbursement and shall be payable, with such interest, upon notice from Lender
to Borrower requesting payment.
All insurance policies required by Lender and renewals of such policies shall be subject to Lender's
right to disapprove such policies, shall include a standard mortgage clause, and shall name Lender as
mortgagee and/or as an additional loss payee. Lender shall have the right to hold the policies and renewal
certificates. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and
renewal notices. If Borrower obtains any form of insurance coverage, not otherwise required by Lender, for
damage to, or destruction of, the Property, such policy shall include a standard mortgage clause and shall
name Lender as mortgagee and/or as an additional loss payee.
In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender. Lender may
make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in
writing, any insurance proceeds, whether or not the underlying insurance was required by Lender, shall be
applied to restoration or repair of the Property, if the restoration or repair is economically feasible and
Lender's security is not lessened. During such repair and restoration period, Lender shall have the right to
hold such insurance proceeds until Lender has had an opportunity to inspect such Property to ensure the work
has been completed to Lender's satisfaction, provided that such inspection shall be undertaken promptly.
Lender may disburse proceeds for the repairs and restoration in a single payment or in a series of progress
payments as the work is completed. Unless an agreement is made in writing or Applicable Law requires
interest to be paid on such insurance proceeds, Lender shall not be required to pay Borrower any interest or
earnings on such proceeds. Fees for public adjusters, or other third parties, retained by Borrower shall not be
paid out of the insurance proceeds and shall be the sole obligation of Borrower. If the restoration or repair is
not economically feasible or Lender's security would be lessened, the insurance proceeds shall be applied to
the sums secured by this Security Instrument, whether or not then due, with the excess, if any, paid to
Borrower. Such insurance proceeds shall be applied in the order provided for in Section 2.
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If Borrower abandons the Property, Lender may file, negotiate and settle any available insurance claim
and related matters. If Borrower does not respond within 30 days to a notice from Lender that the insurance
carrier has offered to settle a claim, then Lender may negotiate and settle the claim. The 30 -day period will
begin when the notice is given. In either event, or if Lender acquires the Property under Section 22 or
otherwise, Borrower hereby assigns to Lender (a) Borrower's rights to any insurance proceeds in an amount
not to exceed the amounts unpaid under the Note or this Security Instrument, and (b) any other of Borrower's
rights (other than the right to any refund of unearned premiums paid by Borrower) under all insurance
policies covering the Property, insofar as such rights are applicable to the coverage of the Property. Lender
may use the insurance proceeds either to repair or restore the Property or to pay amounts unpaid under the
Note or this Security Instrument, whether or not then due.
6. Occupancy. Borrower shall occupy, establish, and use the Property as Borrower's principal residence
within 60 days after the execution of this Security Instrument and shall continue to occupy the Property as
Borrower's principal residence for at least one year after the date of occupancy, unless Lender otherwise
agrees in writing, which consent shall not be unreasonably withheld, or unless extenuating circumstances
exist which are beyond Borrower's control.
7. Preservation, Maintenance and Protection of the Property; Inspections. Borrower shall not
destroy, damage or impair the Property, allow the Property to deteriorate or commit waste on the Property.
Whether or not Borrower is residing in the Property, Borrower shall maintain the Property in order to prevent
the Property from deteriorating or decreasing in value due to its condition. Unless it is determined pursuant to
Section 5 that repair or restoration is not economically feasible, Borrower shall promptly repair the Property if
damaged to avoid further deterioration or damage. If insurance or condemnation proceeds are paid in
connection with damage to, or the taking of, the Property, Borrower shall be responsible for repairing or
restoring the Property only if Lender has released proceeds for such purposes. Lender may disburse proceeds
for the repairs and restoration in a single payment or in a series of progress payments as the work is
completed. If the insurance or condemnation proceeds are not sufficient to repair or restore the Property,
Borrower is not relieved of Borrower's obligation for the completion of such repair or restoration.
Lender or its agent may make reasonable entries upon and inspections of the Property. If it has
reasonable cause, Lender may inspect the interior of the improvements on the Property. Lender shall give
Borrower notice at the time of or prior to such an interior inspection specifying such reasonable cause.
S. Borrower's Loan Application. Borrower shall be in default if, during the Loan application process,
Borrower or any persons or entities acting at the direction of Borrower or with Borrower's knowledge or
consent gave materially false, misleading, or inaccurate information or statements to Lender (or failed to
provide Lender with material information) in connection with the Loan. Material representations include, but
are not limited to, representations concerning Borrower's occupancy of the Property as Borrower's principal
residence.
9. Protection of Lender's Interest in the Property and Rights Under this Security Instrument. If
(a) Borrower fails to perform the covenants and agreements contained in this Security Instrument, (b) there is
a legal proceeding that might significantly affect Lender's interest in the Property and/or rights under this
Security Instrument (such as a proceeding in bankruptcy, probate, for condemnation or forfeiture, for
enforcement of a lien which may attain priority over this Security Instrument or to enforce laws or
regulations), or (c) Borrower has abandoned the Property, then Lender may do and pay for whatever is
reasonable or appropriate to protect Lender's interest in the Property and rights under this Security
Instrument, including protecting and/or assessing the value of the Property, and securing and/or repairing
the Property. Lender's actions can include, but are not limited to: (a) paying any sutras secured by a lien which
has priority over this Security Instrument; (b) appearing in court; and (c) paying reasonable
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attorneys' fees to protect its interest in the Property and/or rights under this Security Instrument, including its
secured position in a bankruptcy proceeding. Securing the Property includes, but is not limited to, entering the
Property to make repairs, change locks, replace or board up doors and windows, drain water from pipes,
eliminate building or other code violations or dangerous conditions, and have utilities turned on or off.
Although Lender may take action under this Section 9, Lender does not have to do so and is not under any
duty or obligation to do so. It is agreed that Lender incurs no liability for not taking any or all actions
authorized under this Section 9.
Any amounts disbursed by Lender under this Section 9 shall become additional debt of Borrower
secured by this Security Instrument. These amounts shall bear interest at the Note rate from the date of
disbursement and shall be payable, with such interest, upon notice from Lender to Borrower requesting
payment.
If this Security Instrument is on a leasehold, Borrower shall comply with all the provisions of the lease.
If Borrower acquires fee title to the Property, the leasehold and the fee tide shall not merge unless Lender
agrees to the merger in writing.
10. Mortgage Insurance. If Lender required Mortgage Insurance as a condition of making the Loan,
Borrower shall pay the premiums required to maintain the Mortgage Insurance in effect. If, for any reason,
the Mortgage Insurance coverage required by Lender ceases to be available from the mortgage insurer that
previously provided such insurance and Borrower was required to make separately designated payments
toward the premiums for Mortgage Insurance, Borrower shall pay the premiums required to obtain coverage
substantially equivalent to the Mortgage Insurance previously in effect, at a cost substantially equivalent to
the cost to Borrower of the Mortgage Insurance previously in effect, from an alternate mortgage insurer
selected by Lender. If substantially equivalent Mortgage Insurance coverage is not available, Borrower shall
continue to pay to Lender the amount of the separately designated payments that were due when the insurance
coverage ceased to be in effect. Lender will accept, use and retain these payments as a non-refundable loss
reserve in lieu of Mortgage Insurance. Such loss reserve shall be non-refundable, notwithstanding the fact that
the Loan is ultimately paid in full, and Lender shall not be required to pay Borrower any interest or earnings
on such loss reserve. Lender can no longer require loss reserve payments if Mortgage Insurance coverage (in
the amount and for the period that Lender requires) provided by an insurer selected by Lender again becomes
available, is obtained, and Lender requires separately designated payments toward the premiums for Mortgage
Insurance. If Lender required Mortgage Insurance as a condition of making the Loan and Borrower was
required to make separately designated payments toward the premiums for Mortgage Insurance, Borrower
shall pay the premiums required to maintain Mortgage Insurance in effect, or to provide a non-refundable loss
reserve, until Lender's requirement for Mortgage Insurance ends in accordance with any written agreement
between Borrower and Lender providing for such termination or until termination is required by Applicable
Law. Nothing in this Section 10 affects Borrower's obligation to pay interest at the rate provided in the Note.
Mortgage Insurance reimburses Lender (or any entity that purchases the Note) for certain losses it may
incur if Borrower does not repay the Loan as agreed. Borrower is not a party to the Mortgage Insurance.
Mortgage insurers evaluate their total risk on all such insurance in force from time to time, and may
enter into agreements with other parties that share or modify their risk, or reduce losses. These agreements are
on terms and conditions that are satisfactory to the mortgage insurer and the other party (or parties) to these
agreements. These agreements may require the mortgage insurer to make payments using any source of funds
that the mortgage insurer may have available (which may include funds obtained from Mortgage Insurance
premiums).
As a result of these agreements, Lender, any purchaser of the Note, another insurer, any reinsurer, any
other entity, or any affiliate of any of the foregoing, may receive (directly or indirectly) amounts that derive
from (or might be characterized as) a portion of Borrower's payments for Mortgage Insurance, in exchange
for sharing or modifying the mortgage insurer's risk, or reducing losses. If such agreement provides that an
affiliate of Lender takes a share of the insurer's risk in exchange for a share of the premiums paid to the
insurer, the arrangement is often termed "captive reinsurance." Further.
(a) Any such agreements will not affect the amounts that Borrower has agreed to pay for
Mortgage Insurance, or any other terms of the Loan. Such agreements will not increase the amount
Borrower will owe for Mortgage Insurance, and they will not entitle Borrower to any refund.
(b) Any such agreements will not affect the rights Borrower has - if any - with respect to the
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Mortgage Insurance under the Homeowners Protection Act of 1998 or any other law. These rights may
include the right to receive certain disclosures, to request and obtain cancellation of the Mortgage
Insurance, to have the Mortgage Insurance terminated automatically, and/or to receive a refund of any
Mortgage Insurance premiums that were unearned at the time of such cancellation or termination.
11. Assignment of Miscellaneous Proceeds; Forfeiture. All Miscellaneous Proceeds are hereby
assigned to and shall be paid to Lender.
If the Property is damaged, such Miscellaneous Proceeds shall be applied to restoration or repair of the
Property, if the restoration or repair is economically feasible and Lender's security is not lessened. During
such repair and restoration period, Lender shall have the right to hold such Miscellaneous Proceeds until
Lender has had an opportunity to inspect such Property to ensure the work has been completed to Lender's
satisfaction, provided that such inspection shall be undertaken promptly. Lender may pay for the repairs and
restoration in a single disbursement or in a series of progress payments as the work is completed. Unless an
agreement is made in writing or Applicable Law requires interest to be paid on such Miscellaneous Proceeds,
Lender shall not be required to pay Borrower any interest or earnings on such Miscellaneous Proceeds. If the
restoration or repair is not economically feasible or Lender's security would be lessened, the Miscellaneous
Proceeds shall be applied to the sums secured by this Security Instrument, whether or not then due, with the
excess, if any, paid to Borrower. Such Miscellaneous Proceeds shall be applied in the order provided for in
Section 2.
In the event of a total taking, destruction, or loss in value of the Property, the Miscellaneous Proceeds
shall be applied to the sums secured by this Security Instrument, whether or not then due, with the excess, if
any, paid to Borrower.
In the event of a partial taking, destruction, or loss in value of the Property in which the fair market
value of the Property immediately before the partial taking, destruction, or loss in value is equal to or greater
than the amount of the sums secured by this Security Instrument immediately before the partial taking,
destruction, or loss in value, unless Borrower and Lender otherwise agree in writing, the sums secured by this
Security Instrument shall be reduced by the amount of the Miscellaneous Proceeds multiplied by the
following fraction: (a) the total amount of the sums secured immediately before the partial taking, destruction,
or loss in value divided by (b) the fair market value of the Property immediately before the partial taking,
destruction, or loss in value. Any balance shall be paid to Borrower.
In the event of a partial taking, destruction, or loss in value of the Property in which the fair market
value of the Property immediately before the partial taking, destruction, or loss in value is less than the
amount of the sums secured immediately before the partial taking, destruction, or loss in value, unless
Borrower and Lender otherwise agree in writing, the Miscellaneous Proceeds shall be applied to the sums
secured by this Security Instrument whether or not the sums are then due.
If the Property is abandoned by Borrower, or if, after notice by Lender to Borrower that the Opposing
Party (as defined in the next sentence) offers to make an award to settle a claim for damages, Borrower fails
to respond to Lender within 30 days after the date the notice is given, Lender is authorized to collect and
apply the Miscellaneous Proceeds either to restoration or repair of the Property or to the sums secured by this
Security Instrument, whether or not then due. "Opposing Party" means the third party that owes Borrower
Miscellaneous Proceeds or the party against whom Borrower has a right of action in regard to Miscellaneous
Proceeds.
Borrower shall be in default if any action or proceeding, whether civil or criminal, is begun that, in
Lender's judgment, could result in forfeiture of the Property or other material impairment of Lender's interest
in the Property or rights under this Security Instrument. Borrower can cure such a default and, if acceleration
has occurred, reinstate as provided in Section 19, by causing the action or proceeding to be dismissed with a
ruling that, in Lender's judgment, precludes forfeiture of the Property or other material impairment of
Lender's interest in the Property or rights under this Security Instrument. The proceeds of any award or claim
for damages that are attributable to the impairment of Lender's interest in the Property are hereby assigned
and shall be paid to Lender.
All Miscellaneous Proceeds that are not applied to restoration or repair of the Property shall be applied
in the order provided for in Section 2.
12. Borrower Not Released; Forbearance By Lender Not a Waiver. Extension of the time for
payment or modification of amortization of the sums secured by this Security Instrument granted by Lender
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to Borrower or any Successor in Interest of Borrower shall not operate to release the liability of Borrower or
any Successors in Interest of Borrower. Lender shall not be required to commence proceedings against any
Successor in Interest of Borrower or to refuse to extend time for payment or otherwise modify amortization
of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or
any Successors in Interest of Borrower. Any forbearance by Lender in exercising any right or remedy
including, without limitation, Lender's acceptance of payments from third persons, entities or Successors in
Interest of Borrower or in amounts less than the amount then due, shall not be a waiver of or preclude the
exercise of any right or remedy.
13. Joint and Several Liability; Co-signers; Successors and Assigns Bound. Borrower covenants and
agrees that Borrower's obligations and liability shall be joint and several. However, any Borrower who
co-signs this Security Instrument but does not execute the Note (a "co-signer"): (a) is co-signing this Security
Instrument only to mortgage, grant and convey the co-signer's interest in the Property under the terms of this
Security Instrument; (b) is not personally obligated to pay the sums secured by this Security Instrument; and
(c) agrees that Lender and any other Borrower can agree to extend, modify, forbear or make any
accommodations with regard to the terms of this Security Instrument or the Note without the co-signer's
consent.
Subject to the provisions of Section 18, any Successor in Interest of Borrower who assumes Borrower's
obligations under this Security Instrument in writing, and is approved by Lender, shall obtain all of
Borrower's rights and benefits under this Security Instrument. Borrower shall not be released from
Borrower's obligations and liability under this Security Instrument unless Lender agrees to such release in
writing. The covenants and agreements of this Security Instrument shall bind (except as provided in Section
20) and benefit the successors and assigns of Lender.
14. Loan Charges. Lender may charge Borrower fees for services performed in connection with
Borrower's default, for the purpose of protecting Lender's interest in the Property and rights under this
Security Instrument, including, but not limited to, attorneys' fees, property inspection and valuation fees. In
regard to any other fees, the absence of express authority in this Security Instrument to charge a specific fee
to Borrower shall not be construed as a prohibition on the charging of such fee. Lender may not charge fees
that are expressly prohibited by this Security Instrument or by Applicable Law.
If the Loan is subject to a law which sets maximum loan charges, and that law is finally interpreted so
that the interest or other loan charges collected or to be collected in connection with the Loan exceed the
permitted limits, then: (a) any such loan charge shall be reduced by the amount necessary to reduce the charge
to the permitted limit; and (b) any sums already collected from Borrower which exceeded permitted limits
will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under
the Note or by making a direct payment to Borrower. If a refund reduces principal, the reduction will be
treated as a partial prepayment without any prepayment charge (whether or not a prepayment charge is
provided for under the Note). Borrower's acceptance of any such refund made by direct payment to Borrower
will constitute a waiver of any right of action Borrower might have arising out of such overcharge.
15. Notices. All notices given by Borrower or Lender in connection with this Security Instrument must
be in writing. Any notice to Borrower in connection with this Security Instrument shall be deemed to have
been given to Borrower when mailed by first class mail or when actually delivered to Borrower's notice
address if sent by other means. Notice to any one Borrower shall constitute notice to all Borrowers unless
Applicable Law expressly requires otherwise. The notice address shall be the Property Address unless
Borrower has designated a substitute notice address by notice to Lender. Borrower shall promptly notify
Lender of Borrower's change of address. If Lender specifies a procedure for reporting Borrower's change of
address, then Borrower shall only report a change of address through that specified procedure. There may be
only one designated notice address under this Security Instrument at any one time. Any notice to Lender shall
be given by delivering it or by mailing it by fust class mail to Lender's address stated herein unless Lender
has designated another address by notice to Borrower. Any notice in connection with this Security Instrument
shall not be deemed to have been given to Lender until actually received by Lender. If any notice required by
this Security Instrument is also required under Applicable Law, the Applicable Law requirement will satisfy
the corresponding requirement under this Security Instrument.
16. Governing Law; Severability; Rules of Construction. This Security Instrument shall be governed
by federal law and the law of the jurisdiction in which the Property is located. All rights and obligations
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contained in this Security Instrument are subject to any requirements and limitations of Applicable Law.
Applicable Law might explicitly or implicitly allow the parties to agree by contract or it might be silent, but
such silence shall not be construed as a prohibition against agreement by contract, In the event that any
provision or clause of this Security Instrument or the Note conflicts with Applicable law, such conflict shall
not affect other provisions of this Security Instrument or the Note which can be given effect without the
conflicting provision.
As used in this Security Instrument: (a) words of the masculine gender shall mean and include
corresponding neuter words or words of the feminine gender; (b) words in the singular shall mean and
include the plural and vice versa; and (c) the word "may' gives sole discretion without any obligation to take
any action.
17. Borrower's Copy. Borrower shall be given one copy of the Note and of this Security Instrument.
18. Transfer of the Property or a Beneficial Interest in Borrower. As used in this Section 18,
"Interest in the Property" means any legal or beneficial interest in the Property, including, but not limited to,
those beneficial interests transferred in a bond for deed, contract for deed, installment sales contract or escrow
agreement, the intent of which is the transfer of title by Borrower at a future date to a purchaser.
If all or any part of the Property or any Interest in the Property is sold or transferred (or if Borrower is
not a natural person and a beneficial interest in Borrower is sold or transferred) without Lender's prior written
consent, Lender may require immediate payment in full of all sums secured by this Security Instrument.
However, this option shall not be exercised by Lender if such exercise is prohibited by Applicable Law.
If Lender exercises this option, Lender shall give Borrower notice of acceleration. The notice shall
provide a period of not less than 30 days from the date the notice is given in accordance with Section 15
within which Borrower must pay all sums secured by this Security Instrument. If Borrower fails to pay these
sums prior to the expiration of this period, Lender may invoke any remedies permitted by this Security
Instrument without further notice or demand on Borrower.
19. Borrower's Right to Reinstate After Acceleration. If Borrower meets certain conditions,
Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior
to the earliest of: (a) five days before sale of the Property pursuant to any power of sale contained in this
Security Instrument; (b) such other period as Applicable Law might specify for the termination of Borrower's
right to reinstate; or (c) entry of a judgment enforcing this Security Instrument. Those conditions are that
Borrower: (a) pays Lender all sums which then would be due under this Security Instrument and the Note as
if no acceleration had occurred; (b) cures any default of any other covenants or agreements; (c) pays all
expenses incurred in enforcing this Security Instrument, including, but not limited to, reasonable attorneys'
fees, property inspection and valuation fees, and other fees incurred for the purpose of protecting Lender's
interest in the Property and rights under this Security Instrument; and (d) takes such action as Lender may
reasonably require to assure that Lender's interest in the Property and rights under this Security Instrument,
and Borrower's obligation to pay the sums secured by this Security Instrument, shall continue unchanged.
Lender may require that Borrower pay such reinstatement sums and expenses in one or more of the following
forms, as selected by Lender. (a) cash; (b) money order; (c) certified check, bank check, treasurer's check or
cashier's check, provided any such check is drawn upon an institution whose deposits are insured by a federal
agency, instrumentality or entity; or (d) Electronic Funds Transfer. Upon reinstatement by Borrower, this
Security Instrument and obligations secured hereby shall remain fully effective as if no acceleration had
occurred. However, this right to reinstate shall not apply in the case of acceleration under Section 18.
20. Sale of Dote; Change of Loan Servicer; Notice of Grievance. The Note or a partial interest in the
Note (together with this Security Instrument) can be sold one or more times without prior notice to Borrower.
A sale might result in a change in the entity (known as the "Loan Servicer") that collects Periodic Payments
due under the Note and this Security Instrument and performs other mortgage loan servicing obligations
under the Note, this Security Instrument, and Applicable Law. There also might be one or more changes of
the Loan Servicer unrelated to a sale of the Note. If there is a change of the Loan Servicer, Borrower will be
given written notice of the change which will state the name and address of the new Loan Servicer, the
address to which payments should be made and any other information RESPA requires in connection
U06MAll Initials.'
Ck-6A(MA) (0401) Page 11 of 15 Form 3022 1101
1763315
with a notice of transfer of servicing. If the Note is sold and thereafter the Loan is serviced by a Loan
Servicer other than the purchaser of the Note, the mortgage loan servicing obligations to Borrower will
remain with the Loan Servicer or be transferred to a successor Loan Servicer and are not assumed by the Note
purchaser unless otherwise provided by the Note purchaser.
Neither Borrower nor Lender may commence, join, or be joined to any judicial action (as either an
individual litigant or the member of a class) that arises from the other party's actions pursuant to this Security
Instrument or that alleges that the other party has breached any provision of, or any duty owed by reason of,
this Security Instrument, until such Borrower or Lender has notified the other party (with such notice given in
compliance with the requirements of Section 15) of such alleged breach and afforded the other party hereto a
reasonable period after the giving of such notice to take corrective action. If Applicable Law provides a time
period which must elapse before certain action can be taken, that time period will be deemed to be reasonable
for purposes of this paragraph. The notice of acceleration and opportunity to cure given to Borrower pursuant
to Section 22 and the notice of acceleration given to Borrower pursuant to Section 18 shall be deemed to
satisfy the notice and opportunity to take corrective action provisions of this Section 20.
21. Hazardous Substances. As used in this Section 21: (a) "Hazardous Substances" are those
substances defined as toxic or hazardous substances, pollutants, or wastes by Environmental Law and the
following substances: gasoline, kerosene, other flammable or toxic petroleum products, toxic pesticides and
herbicides, volatile solvents, materials containing asbestos or formaldehyde, and radioactive materials; (b)
"Environmental Law" means federal laws and laws of the jurisdiction where the Property is located that relate
to health, safety or environmental protection; (c) "Environmental Cleanup" includes any response action,
remedial action, or removal action, as defined in Environmental Law; and (d) an "Environmental Condition"
means a condition that can cause, contribute to, or otherwise trigger an Environmental Cleanup.
Borrower shall not cause or permit the presence, use, disposal, storage, or release of any Hazardous
Substances, or threaten to release any Hazardous Substances, on or in the Property. Borrower shall not do,
nor allow anyone else to do, anything affecting the Property (a) that is in violation of any Environmental
Law, (b) which creates an Environmental Condition, or (c) which, due to the presence, use, or release of a
Hazardous Substance, creates a condition that adversely affects the value of the Property. The preceding two
sentences shall not apply to the presence, use, or storage on the Property of small quantities of Hazardous
Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of
the Property (including, but not limited to, hazardous substances in consumer products).
Borrower shall promptly give Lender written notice of (a) any investigation, claim, demand, lawsuit or
other action by any governmental or regulatory agency or private party involving the Property and any
Hazardous Substance or Environmental Law of which Borrower has actual knowledge, (b) any
Environmental Condition, including but not limited to, any spilling, leaking, discharge, release or threat of
release of any Hazardous Substance, and (c) any condition caused by the presence, use or release of a
Hazardous Substance which adversely affects the value of the Property. If Borrower learns, or is notified by
any governmental or regulatory authority, or any private party, that any removal or other remediation of any
Hazardous Substance affecting the Property is necessary, Borrower shall promptly take all necessary remedial
actions in accordance with Environmental Law. Nothing herein shall create any obligation on Lender for an
Environmental Cleanup,
U06MA12 Initials:
CVA(MA) (0401) Page 12 of 15 Form 3022 1/01
8931 PG 1.129
1763315
NON-UNIFORM COVENANTS. Borrower and Lender further covenant and agree as follows:
22. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration following
Borrower's breach of any covenant or agreement in this Security Instrument (but not prior to
acceleration under Section 18 unless Applicable Law provides otherwise). The notice shall specify: (a)
the default; (b) the action required to cure the default; (c) a date, not less than 30 days from the date
the notice is given to Borrower, by which the default most be cured; and (d) that failure to cure the
default on or before the date specified in the notice may result in acceleration of the sums secured by
this Security Instrument and sale of the Property. The notice shall further inform Borrower of the
right to reinstate after acceleration and the right to bring a court action to assert the non-existence of a
default or any other defense of Borrower to acceleration and sale. If the default is not cured on or
before the date specified in the notice, Lender at its option may require immediate payment in full of
all sums secured by this Security Instrument without further demand and may invoice the
STATUTORY POWER OF SALE and any other remedies permitted by Applicable Law. Lender shall
be entitled to collect all expenses incurred in pursuing the remedies provided in this Section 22,
including, but not limited to, reasonable attorneys' fees and costs of title evidence.
If Lender invokes the STATUTORY POWER OF SALE, Lender shall mail a copy of a notice of
sale to Borrower, and to other persons prescribed by Applicable Law, in the manner provided by
Applicable Law. Lender shall publish the notice of sale, and the Property shall he sold in the manner
prescribed by Applicable Law. Lender or its designee may purchase the Property at any sale. The
proceeds of the sale shall be applied in the following order: (a) to all expenses of the sale, including, but
not limited to, reasonable attorneys' fees; (b) to all sums secured by this Security Instrument; and (c)
any excess to the person or persons legally entitled to it.
23. Release. Upon payment of all sums secured by Zhis Security Instrument, Lender shall discharge this
Security Instrument. Borrower shall pay any recordation costs. Lender may charge Borrower a fee for
releasing this Security Instrument, but only if the fee is paid to a third party for services rendered and the
charging of the fee is permitted under Applicable Law.
24. Waivers. Borrower waives all rights of homestead exemption in the Property and relinquishes all
rights of curtesy and dower in the Property.
U06MA13 Initials z—
U-6A(MA) (oaof) Page 13 of 16
Form 3022 1/01
1763315
BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this
Security Instrument and in any Rider executed by Borrower and recorded with it.
Witnesses:
BARBARA E SULLIVAN -Borrower
_ (Seal)
-Borrower
_ (Seal) (Seal)
-Borrower -Borrower
_ (Seal) (Seal)
-Borrower -Borrower
_ (Seal) (Seal)
-Borrower -Borrower
U06MA14
=04A(MA) (0401) Page 14 or 15 Form 3022 1101
COMMONWEALTH OF MASSACHUSETTS,
On this )I- day of Tj IT 2001
personally appeared BARBARA E SULLIVAN
EIK 892-:151 PG 131
1763315
M+ dd t c s ex County ss:
, before me, the undersigned notary public,
proved tome through satisfactory evidence of identification, which was/wem br;ve rs lice -Se
to be the person(s) whose name(s) is/are signed on the preceding document, and acknowledged to me that
he/she/they signed it voluntarily for its stated purpose.
My Commission Expires:
(Seal)
In
Notary Pub 'c
U29MA15
®-6A(MA) (0401)
Page 150116
MIC A L . ANDERSON
Notary Public
Commonwealth of Massachusetts
My Commission Expires
November27,2009
Form 3022 1/01
Exhibit A r"K 9.." PG 132
980 Winter Street, North Andover, Massachusetts
A certain plot of land situated in North Andover, County of Essex, Commonwealth of Massachusetts, being
Parcel "A" on a "Plan of land in North Andover, Massachusetts," as subdivided for Walenty Pas, made August
27, 1947, Ralph B. Brasseur, C.E., said plan is recorded with Essex North Registry of Deeds, as Plan number
1796. Said Parcel "A" is bounded and described as follows:
Northerly by land of Myron Killam 215 feet; Easterly by a brook 146 feet, more or less; Southerly by Parcel
"B" 193 feet all as shown on said plan, containing 0.695 acres more or less.
Being the same premises conveyed to the herein named mortgagor (s) by deed recorded with Essex North
District Registry of Deeds in Book 6914, Page 235.
+=+o=N Q /�• g G y . O 3, 7 S 6T � ; T� IS PLr•�.l � G[ KL F ►GATjo►.L I b V oT ,(
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AS tt1 LT PLAN
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SLJBSuRFACE DISPOSAL SYSTEM
LOCATED IN
AS PREPARED FOR
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DATE: `-f_ Z j -o7_ T�A l oy
SCALE: r y -O' �L 3
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS
66 PARK STREET 0 ANDOVER. MASSACHUSETTS 01610 or TEL (617) 473-3555, 373-37?1
DANIEL
KORAVOS
CIVIL u
No. 37752
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Owner
information is
required for
every page.
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
Commonwealth of Massachusetts &va aP 1k
Jiqi-
Title 5 Official Inspection Form 4
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner's Name
North Andover
Cityrrown
MA 01845
State Zip Code
8/30/2016
Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information
RECEIVED -
1. Inspector:
Warren Pearce Jr
Name of Inspector
Pearce Construction
Company Name
196 Park Street
B. Certification
MA
State
SI1959
License Number
SEP 2 9 2016
TOWN OF NORTH ANDOVER
01864
Zip Code
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 ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System . Page 1 of 17
Company Address
North Reading
City/Town
978-664-5264
Telephone Number
B. Certification
MA
State
SI1959
License Number
SEP 2 9 2016
TOWN OF NORTH ANDOVER
01864
Zip Code
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 ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System . Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
wM 980 Winter Street
Owner
information is
required for
every page.
r-roperry Haaress
Reem Property LLC
Owner's Name
North Andover
City/Town
t3. certification (cont.)
MA 01845
State Zip Code
8/30/2016
Date of Inspection
Inspection Summary: Check A,B,C,D or E / always complete all of Section D
A) System Passes:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for "yes", "no" or "not determined" (Y, N, ND) for the following statements. If "not
determined," please explain.
The septic tank is metal and over 20 years old" or the septic tank (whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
" A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins - 3/13 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System - Page 2 of 17
Owner
information is
required for
every page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner's Name
North Andover MA 01845 8/30/2016
City(Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont_):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if (with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed 0 Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if (with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b) that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins • 3113 Title 5 official Inspection Form: Subsurface Sewage Disposal System • Page 3 of 17
Owner
information is
required for
every page.
1
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner's Name
North Andover MA 01845 8/3012016
City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or "No" to each of the following for all inspections:
Yes
No
❑
®
Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑
®
Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑
®
Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑
®
Liquid depth in cesspool is less than 6" below invert or available volume is less
than Y2 day flow
t5ins • 3113
Title 5 Official Inspection Fonn: Subsurface Sewage Disposal System . Page 4 of 17
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ 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
If you have answered "yes" to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 5 of 17
Commonwealth of Massachusetts
---
Title 5
Official Inspection Form
'b
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property
LLC
Owner
information is
Owner's Name
required for
North Andover
MA 01845 8/30/2016
every page.
Citylrown
State Zip Code Date of Inspection
B. Certification
(cont.)
Yes
No
❑
®
Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑
®
Any portion of the SAS, cesspool or privy is below high ground water elevation_
❑
®
Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑
®
Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑
®
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 fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑
®
The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑
®
The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ 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
If you have answered "yes" to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 5 of 17
Owner
information is
required for
every page.
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner's Name
North Andover
Cityrrown
C. Checklist
MA 01845
State Zip Code
8/30/2016
Date of Inspection
Check if the following have been done. You must indicate "yes" or "no" as to each of the following:
Yes No
® ❑
Pumping information was provided by the owner, occupant, or Board of Health
❑ ®
Were any of the system components pumped out in the previous two weeks?
❑ ®
Has the system received normal flows in the previous two week period?
❑ ®
Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑
Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑
Was the facility or dwelling inspected for signs of sewage back up?
® ❑
Was the site inspected for signs of break out? -
® ❑
Were all system components, excluding the SAS, located on site?
® ❑
Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑
Was the facility owner (and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑
Existing information. For example, a plan at the Board of Health.
®
Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 . Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): 330
15ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 6 of 17
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non -sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available: —
l5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
'• -
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner
Owner's Name
information is
required for
North Andover MA 01845 8/30/2016
every page.
City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents:
0
Does residence have a garbage grinder?
❑ Yes ®
No
Is laundry on a separate sewage system? (Include laundry system inspection
❑ Yes ®
No
information in this report.)
Laundry system inspected?
❑ Yes ❑
No
Seasonal use?
❑ Yes ®
No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Well water in use, no meter.
Sump pump?
❑ Yes' ®
No
Last date of occupancy:
Unknown
Date
Commercial/industrial Flow Conditions:
Type of Establishment.-
stablishment:Design
Designflow (based on 310 CMR 15.203):
Gallons per day (gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non -sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available: —
l5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 7 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 980 Winter Street
Property Address
Reem Property LLC
Owner Owner's Name
information is
required for North Andover MA 01845 8/30/2016
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other (describe below):
General Information
Pumping Records:
Source of information: No records
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped:
gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Altemative technology. Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other (describe):
t5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
wM 980 Winter Street
Owner
information is
required for
every page.
Property Address
Reem Property LLC
Owner's Name
North Andover
City/Town
8/30/2016
State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
Installed 2002 per as -built.
Were sewage odors detected when arriving at the site?
❑ Yes ® No
Building Sewer (locate on site plan):
Depth below grade: 10 inchesfeet
Material of construction:
❑ cast iron ® 40 PVC ❑ other (explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
All OK inside house_
Septic Tank (locate on site plan):
Depth below grade:
Material of construction:
® concrete ❑ metal
6 inches
feet
❑ fiberglass ❑ polyethylene ❑ other (explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
10' 6" x 5' 8" x 5' deep
Sludge depth: 4 inches
t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 9 of 17
Commonwealth of Massachusetts
a - . Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Owner
information is
required for
every page.
t5ins • 3113
Property Address
Reem Property LLC
Owner's Name
North Andover
City/Town
D. System Information (cont.)
MA 01845
State Zip Code
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
Scum thickness
8/30/2016
Date of Inspection
32 inches
0 inches
Distance from top of scum to top of outlet tee or baffle 9 inches
Distance from bottom of scum to bottom of outlet tee or baffle 14 inches
How were dimensions determined? Tape Measurer
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tees are in place_ Liquid is at the proper level. Tank appears to be in good shape.
Grease Trap (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal
feet
❑ fiberglass ❑ polyethylene ❑ other (explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
Date
TiOe 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 10 of 17
0
1
' t
Commonwealth of Massachusetts
t Wu Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Owner
information is
required for
every page.
Property Address
Reem Property LLC
Owner's Name
North Andover
MA 01845 8/30/2016
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order:
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
❑ Yes ❑ No
* Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner Owner's Name
information is
required for North Andover MA 01845 8/30/2016
every page. City[Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0 inches
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D -box is level. Distribution appears equal- D -box is in ood shape.
Pump Chamber (locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner Owner's Name
information is
required for North Andover MA
01845 8/30/2016
every page. Cityrrown State
Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits
number:
❑ leaching chambers
number:
j leaching galleries
number:
❑ i leaching trenches
number, length:
® leaching fields
60'x 15'
number, dimensions:
❑ overflow cesspool
number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic
failure, level of ponding, damp soil, condition of
vegetation, etc.):
No surface sign of problems. No sign in D -box of back up.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth — top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 13 of 17
Owner
information is
required for
every page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner's Name
North Andover
MA 01845 8/30/2016
City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
l5ins • 3113 Title 5 Official Inspection Fonn: Subsurface Sewage Disposal System - Page 14 of 17
. A
ON i=
Owner
information is
required for
every page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
Property Address
Reem Property LLC
Owner's Name
North Andover
MA 01845
8/30/2016
City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
❑ hand -sketch in the area below
® drawing attached separately
t5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M 980 Winter Street
Owner
information is
required for
every page.
Property Address
Reem Property LLC
Owner's Name
North Andover
Cityrrown
D. System Information (cont.)
Site Exam:
®
Check Slope
®
Surface water
®
Check cellar
®
Shallow wells
Estimated depth to high ground water
MA 01845
State Zip Code
6+ feet
8/30/2016
Date of Inspection
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
00
If checked, date of design plan reviewed. 2002
Date
Observed site (abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health - explain:
Reviewed Files
Checked with local excavators, installers - (attach documentation)
Accessed USGS database - explain:
You must describe how you established the high ground water elevation:
Test hole data from design plan dated 2002. Site was built up for proper separation to ground water.
As -built certification dated 4-29-02 by Merrimack Engineering Services.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System . Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
980 Winter Street
E. Report Completeness Checklist
8/30/2016
Date of Inspection
® inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information — Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17
Property Address
Reem Property LLC
Owner
Owner's Name
information is
required for
North Andover MA 01845
every page.
City/Town State Zip Code
E. Report Completeness Checklist
8/30/2016
Date of Inspection
® inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information — Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17
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Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Public Health Director
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
05/03/02
This is to certify that
the individual subsurface disposal system
constructed (X) or repaired Q
by
Thomas Sawyer
at
980 Winter Street
Telephone (978) 688-9540
Fax(978)688-9542
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.
Brian J. LaGrasse
North Andover Health Inspector
BOARD OF APPEALS 688-9541 BUELDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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AS -BUILT CHECKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
INCLUDING RESERVE
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
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX =
ORIGINAL STAMP & SIGNATURE
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
LOCATION & ELEVATIONS OF BENCHMARK USED
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System (4 constructed;
( ) repaired;
_ (. i M60 E
located at I W Lel V L" 12, ET'
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit # , dated , with an approved design
flow of 35jo
gallons per day. The materials used were in conformance with those
specified on the approved plan; the system was installed in accordance with the
provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees
substantially with the approved plan. All work is accurately represented on the As -built
which has been submitted to the Board of Health.
Bed inspection date:
10®?,b -a I L,E�tc4 F -i Et -v
Final inspection date: Z4 -2,L4_ -o-2_ -,' k
Installer: 7 LicA
O. QL,'.�
Engineer Rep esentative
0 1 Q'ea�
Engineer Repres ntative
Date: p
: l6 ,
Design Engineer: D�,, ✓r �e..� Date:
r
it N & M Job number 1770/ 006� A
TOWN OF NORTH ANDOVER
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
Site:
96C7
Installer: 7d? i"! :74W
i>
Final Date:
Tel:
Date Yes No
A. Bottom of Bed
1. Excavation to proper depth
2. With trenches, sides of excavation are beneath B horizon
3. Edge of excavation specified distance from foundation, etc.
Comments: (Use back of sheet for diagrams.)
B. Retaining Wall
1. Wall height and width as specified
2. Waterproofed
3. Wall minimum 10' to leaching facility
4. Wall meets specifications of plan
Comments:
Initials
C. Building Sewer
I.
Pipe diameter minimum 4"
2.
Schedule 40 pipe
3.
Inlet to tank cemented
4.
Slope minimum 0.01 or 1/8" per foot minimum
5.
Pipe properly set on compact firm base
6.
Pipe laid on continuous grade in straight line
7.
Cleanouts precede all change in alignment and grade
8.
Manholes at any 90° change
9.
10' minimum offset to water line
Comments:
D. Septic Tank �f
1.
Level
2.
1,500 gal minimum
3.
Gas baffle present on outlet
4.
Manhole to w/in 6" of grade
6 r,
5.
Manholes over center and each tee
6.
3-20" manholes
7.
Outlet line cemented
u,,s
8.
2" – 3" drop from inlet to outlet
-
9.
Pipe set
✓
10.
Compact base with 6" of 3/4" crushed stone under tank
11.
Tank is watertight
12.
Tees 12" off side of tank
f
Initials
N & M Job number 1770/
Date Yes No
Comments: Initials
E. Pump Chamber
1. If separate from tank, compact base with 6" of/<" stone underneath
2. Minimum 2" pipe to d -box if gravity system
3. 20" access manhole
4. Tank level
5. Watertight
6. Tank size agrees with plan specification
7. Manhole to grade A
8. Check valve and bleeder hole present w.
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
i v
I. 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
9. First 2' from box laid level
Comments:
G. Soil Absorption system 1 okfA%
1. All stone double -washed – %- – 1 '/2"
- 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. Toe of slope stops minimum 5' from edge of property;
5a. if not, then swale.
Comments:
to
N & M Job number 1770/
Date Yes No Initials
H. Leach Trenches
I. Minimum 2 trenches
2. Length of trenches agrees with plan. (Max. length 100')
3. Width of trenches agrees with plan Minimum 2'; maximum — 4'.
4. Vent present if>50 feet or specified
5. Minimum distance between trenches 10'
6. Pipe slope minimum 0.005 or 6" per 100'
7. Depth of trenches below outlet invert minimum of 6".
8. Pipes set on stable base.
Comments:
I. Leach Field
1. Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6" per 100'
3. Separation between pipes 6' maximum
4. Pipes connected at end & vent end raised
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
Comments:
J. Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between 12" and 48" wide
4. Access manholes on each pit
5. Pipes cemented with hydraulic cement
6.
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
6. Grading meets 3:1 slope
7. Minimum of 9" of fill graded over system
NOONAN & Mc DOWELL, INC.
25 Bridge Street, Suite 6, Billerica, MA 01821-1023
Voice (978) 667-9736 Fax (978) 671-9565
Email: nm@netway.com
Date August 2, 2001
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, MA 01845
RE.: Subsurface Sewage Disposal System
Plan Review, 1770/026
980 Winter Street
Assessors Map 104B, Lot 3
Dear Members of the Board,
Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated 7/16/01,
By Merrimack Engineering Services. 11
It is our opinion that the proposed design will meet the requirements of Title 5 and the North
Andover Board of Health `By -Laws" if the following is addressed:
1)
Show setback from septic tank to wetland. NA8.03a-c
2)
Show setback from leaching area to wetland on West side of Winter Street.
NA8.03a-c.
--i► 3)
Show D -Box at least 2 feet from beginning of leaching line to ensure sufficient
space for first 2 ft level.
4)
Profile is not drawn to scale. Plan must be revised to comply with 220 (4)(0), NA
8.02c.
_— 5)
Provide a vent detail.
6)
Relocate pump chamber to reduce fill over top. 221(7). If Item 4 above were
performed the Design Engineer would have seen this flaw in his design.
7)
Add proposed driveway NA8.02y
8)
Add break-out contour/spot shots (103x1 & 103x4), 220(4) (g)
9)
Identify on plan view where bench mark is located 220(4)(q).
10)
Provide a note on plan listing requested variances 220(4)(p).
11)
It is assumed that the leaching facility is within a water supply area,. tributary and
public well unless stated otherwise. Provide necessary documentation and/or
notes. 220(4).
12)
Provide a note stating, "At time of installation inspection by Board of Health the
existing septic tank liquid level shall be below the bottom of the outlet tee".
--�r 13)
Distribution header pipes for the leaching system should have some slope. Having
none can cause flow problems for outer distribution lines.
14)
Provide pump performance curve 220(4)(r). The operating curve for various
discharge rates must be plotted on manufacturer's pump performance curve. The
velocity within the force main shall also be submitted.
Respectfully,
Land Surveyors Civil Engineers Environmental Planners
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessaryapprovals/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
APPLICANT 'Y� /'�� c�l�N/ '�✓ vi � L� � PHO
LOCATION: Assessor's Map Number z__41 1/ 5 PARCEL
SUBDIVISION LOT (S) .
STREET
ST. NUMBER
****** *********************************OFFICIAL USE
ONLY***********************************
RESMMEN94rONVOF TOWN AGENTS:
CONSERY&ION fflWNISTRATOR DATE APPROVE=D
r _
DATE REJECTED
COMMENTS — (� IUI i (C_96/ k-1 -9 7'k1A i'r
vlA kU A
TOWN PLANNER
COMME
DATE APPROVED
DATE REJECTED
FOOD INSPECTOR -HEALTH DATE APPROVED
�j DATE REJECTED
SEPTIC INSPECTOR -HEALTH
COMMENT
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECT , R
Revised 9\97 jm
kc,4
TE
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Health Director
October 30, 2001
Bill Dufresne
Merrimack Engineering Services
66 Park Street
Andover, MA 01810
Re: 980 Winter Street
Dear Mr. Dufresne:
Telephone (978) 688-9540
Fax(978)688-9542
This is to notify you that the revised plans dated 10/18/01 for 980 Winter Street have
been approved.
If you have any questions, please do not hesitate to call the Board of Health Office at
978-688-9540.
Sincerely,
may' �s
Sandra Starr, R.S., C.H.O.
Health Director
Cc:
File
Barrett
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535
BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: 9-1 %—D/ CURRENT INSTALLER'S LICENSE#
LOCATION: 9'00 zd-z"arei
LICENSED INST
SIGNATURE:
CHECK ONE:
REPAIR: d
S
TELEPHONE# Q'jg
zoz - 60c?'10
NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
$160.00 Fee Attached?
Foundation As -Built?
Floor Plans?
Administrative Use Only
Yes V/ No
Yes No
Yes No
Approval C��
Date: ( o�
BOARD
Q`? 2001
r
}
s . ..-..,...tee.. -.i
INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction of the septic system for the
property at %80 A4j .Si . relative to the application
of ,1r` dated la—l?-41 for plans and
dated _% -- d -7 / with revisions dated
I understand 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 Tile 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 Board of Health, 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.
3. Asthe 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.
Undersigned icensed Se is Installer
Date: Q —/9-o/
Disposal Works Construction Permit #
Form No. 3
Town of North Andover, Massachusetts
BOARD OF HEALTH ,
O A
F '
•yq-o,-;,;�.-s,� DISPOSAL WORKS CONSTRUCTION PERMIT
SSACMUSE
Applicant A), 6 P TELEPHONE
NAME ADDRESS
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Site Location cm
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Permission is hereby granted to Construct ( ) or Repair ( an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
Fee��
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CHAIRMAN, BOARD OF HEALTH
D.W.C. No..
Town of North Andover, Massachusetts
BOARD OF HEALTH
APPLICATION FOR SITE TESTING/INSPECTION
Form No. 1
19
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Applicant
NAME ADDRESS TELEPHONE
Site Location r}��
Engineer
NAME ADDRESS TELEPHONE
Test/I nspection Date and Time
CHAIRMAN, BOARD OF HEALTH
Fee ` Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
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Appli
Site Location
Town of North Andover, Massachusetts
BOARD OF HEALTH r�
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DESIGN APPROVAL FOR
SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Reference Plans and Specs
Test No.
Form No. 2
ENGINEER - ESIGN- DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
Fee L/�/o D
C IRMAN, �BOARDOF HEALTH
Site System Permit No. ll'
NOONAN & Mc DOWELL, INC.
25 Bridge Street, Suite 6, Billerica, MA 01821-1023
Voice (978) 667-9736 Fax (978) 671-9565
Email: nm@netway.com
Date O/I
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, MA 01845
RE: . Subsurface Sewage Disposal System
Plan Review, 1770/ Q
V5 0 Ay
Assessors Map jn -- -, Lot
Dear Members of the Board,
Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated
by
It is our opinion that the proposed design will meet the requirements of Title 5 and the North
Andover Board of Health `By -Laws" if the following is addressed:
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Respec lly, � ��°.�� /V'1
John L. Noonan, P.L.S.-P.E.
G: office/forms/tonarev
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Land Surveyors Civil Engineers Environmental Planners
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SEPTIC PLAN SUBMITTAL FORM
LOCATION:'�?r1�
NEW PLANS: YES $160.00/Plan
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REVISED PLANS:57 $ 60.00/Plan * oc Pevul
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SITE EVALUATION FORMS INCLUDED: YES
DATE: &--I -d (
DESIGN ENGINEER: 4-4 OPrL rel 4�G I nJ MMMA )r-4
DATE TO CONSULTANT:
When the submission is all in place, route to the Health Secretary.
MODELS:
LE31 M 115V, 10.5a, Manual
LE31 A 115V, 10.5a, Automatic
Automatic models feature a mercury -free wide angle
float with series plug -allows for manual operation of
pump separate from switch.
FEATURES:
• Vortex impeller, made of high temperature *RYTONO,
permits passage of solids without clogging
• Cast iron construction with all stainless and
brass fasteners
• 416 stainless Ptegl rotor shaft .
* Oil -filled, thermally protected1motor
• Permanently lubricated bearings
• Unitized shaft seal
* 10' U.L. approved power cord with quick disconnect
design allows replacement of cord in seconds
without breaking seals to motor (20' optional)
* 1-1/2" FNPT discharge
*RYTON® is a registered trademark of the Phillips 66 Company
EviomSERIES
PUMP
The pump(s) shall be model
as manufactured by Liberty Pumps, Bergen, NY,
or equal.
The pump(s) shall have a capacity of GPM at
a total dynamic head of feet. Motor size shall
be 1/3 horsepower, single phase, 60 hz. and 115
volt operation.
MOTOR
The pump motor shall be of the submersible
type, oil filled, hermetically sealed and shall be
thermally protected. The overload element shall
automatically reset when motor cools. Motor
windings shall be of the class A insulation rating
The rotor shaft shall be made of 416 stainless
steel and shall be supported by lower bronze
and upper sleeve bearings.
TECHNICAL SPECIFICATIONS
IMPELLER
The pump shall have a VORTEX style impeller
made of high temperature *RYTONO, capable of
passing a minimum 3/4" spherical solid.
SEAL
The shaft seal shall be of the carbon/ceramic
unitized design, with BUNA N elastomers and
stainless housings.
EXTERNAL CONSTRUCTION
The pump volute, legs and motor housing
shall be heavy gray iron castings, class 25 or
better. All castings shall be enamel coated before
assembly. All fasteners shall be of 300 -series
stainless steel or brass.
LEVEL CONTROL
The pump shall be controlled by an adjustable
mercury -free switch sealed in PVC float, and shall
have a series plug for manual by-pass operation.
MODELS HP VOLTS PHASE AMPS DISCHARGE AUTOMATIC IMPELLER
LE31 M 1/3 115 1 10.5 1-1/2" FN PT NO VORTEX
LE31 A 1/3 115 1 10.5 1-1/2" FN PT YES VORTEX
10' cord standard on above models.
For 20' option, add a "-2" suffix to model number. Example: LE31 A-2
DIMENSIONAL DATA- PERFORMANCE CURVE
Weight: LE31 M: 31 LBS.
Height: 9.6"
Major Width: 9.8" (manual models)
Maximum fluid temperature 145 degrees F.
'RYTON® is a registered trademark of the Phillips 66 Company
® PIYIA
S� Certified Ce
City of LA certification available MEMBEF
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Liberty Pumps • 7307 Lake Rd • Bergen, New York 14416 • Phone (716) 494-1817 Fax (716) 494-1839 7240-81/94
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Liberty Pumps • 7307 Lake Rd • Bergen, New York 14416 • Phone (716) 494-1817 Fax (716) 494-1839 7240-81/94
NOONAN & Mc DOWELL, INC.
25 Bridge Street, Suite 6, Billerica, MA 01821-1023
Voice (978) 667-9736 Fax (978) 671-9565
Email: nm0,netway.com
Date August 2, 2001
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, MA 01845
RE: Subsurface Sewage Disposal System
Plan Review, 1770/026
980 Winter Street
Assessors Map 104B, Lot 3
Dear Members of the Board,
Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated 7/16/01,
By Merrimack Engineering Services.
It is our opinion that the proposed design will meet the requirements of Title 5 and the North
Andover Board of Health "By -Laws" if the following is addressed:
1) Show setback from septic tank to wetland. NA8.03a-c
2) Show setback from leaching area to wetland on West side of Winter Street.
NA8.03a-c.
3) Show D -Box at least 2 feet from beginning of leaching line to ensure sufficient
space for first 2 ft level.
4) Profile is not drawn to scale. Plan must be revised to comply with 220 (4)(0), NA
8.02c.
5) Provide a vent detail.
6) Relocate pump chamber to reduce fill over top. 221(7). If Item 4 above were
performed the Design Engineer would have seen this flaw in his design.
7) Add proposed driveway NA8.02y
8) Add break-out contour/spot shots (103x1 & 103x4), 220(4) (g)
9) Identify on plan view where bench mark is located 220(4)(q).
10) Provide a note on plan listing requested variances 220(4)(p).
11) It is assumed that the leaching facility is within a water supply area, tributary and
public well unless stated otherwise. Provide necessary documentation and/or
notes. 220(4).
Land Surveyors Civil Engineers Environmental Planners
12) Provide a note stating, "At time of installation inspection by Board of Health the
existing septic tank liquid level shall be below the bottom of the outlet tee".
13) Distribution header pipes for the leaching system should have some slope. Having
none can cause flow problems for outer distribution lines.
14) Provide pump performance curve 220(4)(r). The operating curve for various
discharge rates must be plotted on manufacturer's pump performance curve. The
velocity within the force main shall also be submitted.
Respectfully,
JA L. Noonan, P.L.S.-P.E.
G: o ffice/boh/ 1770026
Land Surveyors Civil Engineers Environmental Planners
2
CHECKLIST FOR NORTH ANDOVER -
SEPTIC SYSTEM PLANS
N & M Job 1770/ © Z -
The following is a checklist that incorporates all Title 5 and local regulations for septic plans.
Name of Applicant: -,5' jEU v A- Rf- S
Plan Date: /a n / Revision Date:
Name of Designer:
Date of Review:
Property Address: 9 S 0 tv '5 Map: 0�1 Lot: "
BOH Reviewer: r�/
1
G-- Type of Plan (new or pgrade):
Number of Bedrooms in Assessor's Records: gpd) Garbage Disposal Allowed:
General Information: N.A. = North Andover Septic Regulations Other numbers refer to Title 5
OK Problem N/A
Street number and map/lot - 220(4)(u)
Maximum scale of 1 "=40' for plot plan - 220(4)
Maximum scale of 1 "=20' for profile and component details - 220(4)
Legal boundaries of the facility being served - 220(4)(a)
q-�
Names of abutters from recent tax map - NA 8.02j
Number of bedrooms, design calcs., - NA 8.02i
Name & address of record owner & applicant - NA 8.02k
Name & address of designer - NA 8.021
Holder and location of all easements - 220(4)(b)
Date plan drawn & any revision date - NA 8.02m
All dwellings and buildings, existing and prQpeseA-220(4)(c)
;7-
Location of all existing or proposed impervious areas - 220(4)(d)
All distances on site plan - NA 8.03a -c
— �—
Elevation of proposed driveway - NA 8.02t
Location and elevation of foundation drain - NA 8.02y
Location and dimensions of the system incl. (new const.) - 220(4)(e)
�---'
Limits of excavation of leach area on site plan - NA 8.02z
Locus plan - 220(4)(t) (Not to scale)
North arrow - 220(4)(g)
Existing and proposed contours - 220(4)(g)
Locations and logs of deep holes - 220(4)(h)
Locations and logs of percolation tests - 220(4)(i)
Date(s) of soil testing - 220(4)(h) & (i)
Existing grade elevation of each deep hole - 220(4)(h)
Elevation of percolation tests - N.A. 8.02n
Name of approving authority representative - 220(4)(h) & (i)
1�
Name of soil evaluator - 220(4)0)
Soil logs and perc test logs match BOH records
Locations of waterlines, drains, and subsurface utilities - 220(4)(m)
Observed and adjusted g.w. elevation in the vicinity of the system - 220(4)(n)
Complete
profile of the system to scale - 220(4)(o), NA 8.02c
Cross section of leaching facility - NA 8.02w (Not to scale)
—�
Location of benchmark(s) within 50-75 feet of facility - 220(4)(q)
-�-�
Note listing all variance requests with proper citations - 220(4)(p)
Local upgrade approval request form submitted - 403(1)
Original R.S./P.E. stamp, signature & date - 220(1) & (2)
If P.E., discipline specified within stamp. MGL C. 112 s. 81M
-'
sfc. supplies (w/in 400'), pub. wells (w/in 250'), pvt. wells (w/in 150') - 220(4)(
Location of watercourses, wetlands, wells, etc. Win 150' of system - NA 8.02r
Wetland disclaimer - NA 8.02s
44_/_
RLS plan reference & certification required (prop line setbacks) - 220(3)
Use approvals / standards checked for I/A system - DEP docs.,
Ll Perc rate >30 MPI - not allowed for new, LUA for upgrade - 245(1)&('3)
Perc rate > 60 MPI - must use modified tight tank or UA technology - 245(4)
_Proposed system qualifies as "shared" system - 002 (definitions)
C/ Flow is over 2,000 gpd - No R.S. allowed - 220(1)
Design flow was set in accordance with code - 203
Existing system location and note on proper abandonment - 354
G-- Leaching facility at least 1' above Base Flood elevation - NA 9.05
All piping Sch 40 minimum - NA.10.01
Gam- asement floor minimum F above groundwater elevation - NA 5.04
c� Foundation drain present with elevation - NA 8.02y
On-site Soil and Groundwater Review
OK —Problem N/A
Proper deep observation hole logs on plan-- 220(4)(h)
L"- All deep holes and peres shown, including aborted tests - NA 8.02n
Soil evaluation forms submitted within 60 days of field work - 018(2)
Proper percolation test log - 220(4)(i)
Ample deep observation holes in primary disposal area (minimum 2) - 102(2)
��Ample deep observation holes in. sa€ondar*&sposal area (minimum 2) - 102(2)
�l Ample perc testing (one in each disposal area, 3 in prim. > 2,000 gpd) - 104(4)
Deep hole testing conducted within two years - NA 7.05
Hole Identification Numbers:
ground elevation el.
acceptable soil el. �^
Leach facilitv invert 61. fig
ground water el. _
refusal el.
bottom of leach facility el.
thickness of acceptable soil
before & after soil R&R
separation to groundwater
separation to refusal
soil class
perc rate
loading rate s
septic tank below g.w. table (yes or no)
pump tank below g.w. table l (yes or no)
1.f in fill -255(l)
Setback Distances (Given in feet) 15.21 1
YES NO
OK Problem N/A
Is the lot in the Lake Cochiewick Watershed? NA 6.00 & 5.02
Property line
Cellar wall
Septic Tank
10
10
Leach Facility
10
20
N
T
C�Inground pool 10
20
b foundation
10
10
Deck, on footings, etc. 5
10
Waterline 10
10
Private drinking well 75
100
"Irrigation well 75
100
Wetlands 75
100
Public
well 400
400
Wetlands bordering surface 150
150
water Supply or trib. (in Watershed)
Trib. To Surface Water supply 325
325
Reservoirs 400
400
Tributaries to reservoirs 200
200
Drains (wat. supply/trib.) 50
100
--�
Drains (intercept g.w.) 25
50
Foundation drains 10
20
�—
Drains (Other) 5
10
- L
��---
Drywells 20
25
Downhill slope 15' to 3:1 slope
w/o barrier
Building Sewer
OK Problem
N/A
Grease trap required for certain uses (check 230 for details)
Pipe diameter listed (4" minimum) - 222(l)
Pipe schedule listed - 2(3)
Pipe cast it nor" 4 PVC – A 11.02
Watertigh joints s eci - 222(3) & (4)
P' a laid n com act, base - 222(5)
i el ' -
ai on co nuous ade in straight line 222(7)@
l n is prec a all changes in alignment and grade - 222(8)
lout
ZIM=hole
provided eve 100 f 8
ry
at any 90 d a ignment change - 222(8)
ert elevati building:
ert
a ation at septic tank:
of run:
Slope: (minimum of 0.01 - 0.02 desired) - 222(6)
10' offset to private well or suction line - 222(2)
3
I
4
Septic Tank
OK Problem N/A
Tank is accessible - 228(3)
No str ctures above 228(3)
Ta n accio oda primary & reserve — NA 9.04
20 % f flow req ' ' ed given. 1500 min.) - 220(4)(f) & 223)(1)(a)
3" d p fr m inl too flet - 227(5)
inim of 4' li id de th - 223(2)
3" air space above tees 'ffles (minimum) - 227(4)
9"air space above flow line (minimum) - 227(4)
Tees are not to be replaced by baffles - 227(1)
Tees extend 6" above flow line - 227(1)
Inlet tee extends 10" below flow line (minimum) - 227(6)
Outlet tee extends 14" below flow line (more for deeper tanks) - 227(6)
Gas baffle installed on outlet - 227(4)
Access �}anh cover above center of tank & each tee (except 2 compart) 228(2)
3-2b" 2=e 228(2)
1 childproof, 24" riser/manhole Win 6" of final grade if <1000gpd- 228(2)
Inlet and outlet tees on center line - 227(l)
Soil compaction below tank specified (if soil is non-native) - 221(2)
6" of <=3/4"stone beneath tank specified - 221(2) & 22 8(1)
If > 1,000 gp AND not a single f ell. must be 2 tks or 2 comp. - 223(1)(b)
If plan spec' es disposal ust be to s in series or 2 compart. tank - 223(1)(c)
Buoyancy lcs. require if to at or elow water table - 221(8)
Tank is tertig t - 2 (1)
9" of co er over (mini um) - 8(1)
H- 10 oading (min.) - H-20 if tra c - 226(3)
Top of tank <=36" below grade - 221(7)
All pumping to tank (if applies) in accordance with - 229
Tank is set to keep old system in service during install if possible
Distribution Box (Check here if not present: 1
OK Problem N/A
�f ~
Inlet elevation:
Outlet elevation:
_
0.17' drop from inlet to outlet (minimum) - 232(3)(b)
6" sump (minimum) - 232(3)(e)
1'
All outlets at same elevation - 232(3)(b)
4aS �—
Outlet pipes laid level for first 2 ft. - 232(3)(c)
Pipe Sch 40 - NA 10.01
l
Number of outlets: Number of laterals:
Size of outlets:
Inlet baffle/tee min. 1" over outlet invert for all d -boxes - 232(3)(a),
Soil compaction below distribution box specified (if soil is non-native) - 221(2)
6" of stone beneath distribution box specified - 221(2)
Box is watertight - 221 (1)
Top of box <=36" below grade - 221(7)
Buoyancy calculations required if box is at or below water table - 221(8)
Pump Chamber (Check here if not present: )
OK Problem N/A
Volume specified: 220(4)(r)
Pump on elevation- 220(4)(r)
Pump off elevation: 220(4)(r)
Alarm on elevation: 220(4)(r)
Number of cycles per day - 220(4)(r) (also 254(1)(d) if gravity from d -box)
Minimum 2" delivery line to d -box if gravity - 254(1)( c)
rressure aosea i.r. a now >_ /,uuu gpa - LJ4(1)(a) & 1J4k2)(a)
Cycles per day is consistent with chamber volume - 23 1
Volume calculations include flowback volume - 2') 1(2)
24 hour storage capacity above pump on elevation - 231(2)
Number of pumps: 2 if system serves >2 dwelling units - 231(6)
Capacity of pump(s) - gpm @ ' TDH - 220(4)(r)
Pump can pass 1 1/4 "solids (minimum) - 231(7)
Pump controls specified - 220(4)(r)
Alarm equipment specified - 231(2)
Alarm is in building and powered on separate circuit from pump - 2') 1(9)
Pump sequence correct (off -lead on -lag on-alan-n on) - 231(8)
Pump performance curves included - 220(4)(r)
Manual operating switch - NA 12.01
Check valve, bleeder hole - NA 12.01
1 childproof, 24" riser/manhole to final grade - 2'31(5),
Soil compaction beneath pump chamber specified (if soil is non-native) - 221(2)
6"of <=3/4"stone beneath chmbr. specified - 221(2) & 228(1),
Buoyancy calculations if chamber is at or below water table - 221(8)@
9" of cover over chamber (minimum) - 228(1)
H- 10 loading (min.) - H-20 if traffic - 226(')),
Chamber is watertight - 221 (1)
Top of chamber <=36" below grade - 221(7)
Leaching Facility (general - complete for all designs)
O Pr m N/A
50%1 —ifgarbage disposal
Trenches to be used whenever possible - 240(6)
No vehicle or imperv. area above 11. unless unavoidable - 240(7); NA 13.02
Vented if under impervious cover - 241 (1)
Vented through same pipes as distribution system - 241 (1)(a)
Vent protected from precipitation/animal entry - 241 (1)(b)
Vent is placed beyond traffic or impervious area - 24 1 (1)(c)
All lines connected to vent if bed or trenches - 241(1)(d)
9" cover over peastone - 240(9)
Reserve area provided (new construction) - 248(1)
622!!�— Reserve 4' from primary leach area — NA 9.04
4'(5' if perc rate <=2 MPI) separation to g.w. - 212(a) & (b)
4' (down to 2' with variance or I/A - upgrades only) of natural soil under 11.
GW separation is adjusted to highest existing grade if facility cuts into a hillside
Pipe slope minimum of 0.005 - 251(9)
Require 5' removal and replacement if in fill - 255(5)
�— Top of leach facility <= 36" below grade - 221(7)
Final grade over 11 minimum 0.02 ft/ft -240(10)
Surface & subsurface drainage away from 11. - 240(1 1) & 245(5)
L, Minimum design flow 440 gpd without deed restriction — NA 13.01
G ° 3:1 slope where grading required - 255(2)
Toe of fill slope stops 5' from property line or swale installed - 255(2)
Impermeable barrier if < 3:1 slope or < 15 feet to—3:lslope - 255(2)
Impermeable barrier/retaining wall poured concrete — NA 9.02
Retaining wall stamped by P.E. - 255(2)(b)
Top of retaining wall >= top of peastone elevation - 255(2)(f)
10' offset from edge of leach facility to edge of ret. wall - 255(2)(g)
Perc test(s) done in most restrictive layer - 104(2)
Perc test 4' below leaching elevation — NA 7.06
Design flow listed and required/provided leach area given - 220(4)(f)
Leach pipes SCH40 PVC — NA 10.01
Leach pipes minimum 4" diameter except for dosed system — NA 14.04
Leach lines capped, vented, or connected together - 251(9)
�'xessure dosing guidance followed if pressure distribution - 254(2)(c ),
Pressure dosing required over 2,000 gpd or with I/A remedial use - 231(1)
5
Leaching Trenches (Check here if not present: )
OK Problem N/A
Number of trenches:
Minimum of 2 trenches - NA 9.01
Depth of trenches (max -247(l)
Width of trenches n., 4' max.): - 251 (1)(b)
Length of tr es (100' max.): - 25 1 (1)(a)
Trenc are vented (when > 50') - 251 (11)
nches follow contour lines - 251(2)
Trench spacing 3 times effective width or depth mum- 251 (1)(d)
In fill or reserve between trenches, 10' - A 14.01& 14.03
Available leach area given (Min. 5 0 .£) - NA 9.01(2)
Bottom = L x # — s.f.
Sidewall = L x D x# x 2= s. f.
Effective leach are ven
Loading or:
Effe ' e area = total area s.f. x LTAR ' — g/day
Effe * e area is >= design flow of facility being se
1/8"- 1/2" 2x washed peastone.- 247(2
Trench depth of 3/4" to 1 1/2" doubl ed stone - 247(1)
Leach Fields (Check here if not present: 1
OK Problem N/A
Final Grading
OK Problem N/A
Slope over leach area minimum of 0.02 feettfoot — 240(10)
Grading shall divert drainage away from leach area —240(11)
Grading slopes away from dwelling
5/24/01 f./office/forms/tonackltr.doc
0
Number of fields: (need dosing chamber if> 1, 231 (1))
Length (100' max.): - 252 (2)(b)
'
Width:
Total area: L x W = s. f.
[/^
Minimum 900 square feet - NA 9.01(1)
Distribution lines connected with solid pipe — NA 15.01
Effective leach area given
—�
Loading factor:
—!l
Effective area = total area s.f x LTAR = g/dav
Effective area is >= design flow of facility being served
_
Minimum of two distribution lines - 252(2)(a)
6' line separation (max.) - 252(2)(d)
4'.maximum separation from edge of field to line - 252(2)(e)
10' minimum separation between adjacent leach fields - 252(2)0
Between 6" and 12" of 3/4 - 1 1/2" stone beneath field - 252(2)(g) & 247(2)
2"of 1/8"-1/2" 2x washed peastone.- 247(2)
Final Grading
OK Problem N/A
Slope over leach area minimum of 0.02 feettfoot — 240(10)
Grading shall divert drainage away from leach area —240(11)
Grading slopes away from dwelling
5/24/01 f./office/forms/tonackltr.doc
0
Project Request Record
Town of North Andover
Client Id: ToNA Card Id: ToNA Date:
Client/Company Name: Board of Health
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Project Id: 1770 Project Title: Town of North Andover, Board of Health
(JOB NO) �7 (PROJECT NAME & STREET ADDRESS)
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MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS a PLANNERS
66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL (978)475-3555,373-5721 • FAX (978) 475-1448 • E-MAIL: merreng@aol.com
TO: North Andover Board of Health
FROM: Bill Dufresne/Merrimack Engineering
DATE:
v 10
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OWNER (NAME & ADDRESS) e':rFn'L_ .>,, 1�6
Members of the Board:
An upgrade sewage disposal system plan dated: 7-- l(.-, -%�;)l has been
submitted for the above referenced site. Pursuant to Title 5, and the North Andover
Board of Health Regulations, Local upgrade approval and/or variances are being sought
from the following sections.
3)
Please consider these requests for approval on your earliest available meeting agenda.
We respectfully request your consideration of these matters.
Very truly yours,
MERRIMACK ENGINEERING SERVICES
William Dufresne
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BOARD OF HEALTH TEL. 688-9540
NORTH ANDOVER, MASS. 01845
APPLICATION FOR SOIL TESTS
DATE: 5r ZY�-
LOCATION OF SOIL TESTS: 6LM�
Assessor's map & parcel number.
OWNER: �p � .�<,.--
�54_�-_/��- TEL. NO.:
--
ADDRESS:
ENGINEER: HE121 i "A c -IC- kj -;TEL. NO.:
CERTIFIED SOIL EVALUATOR: ?7I t�V [24r VE�j�
Int o nd: residential subdivision, single family home, commercial
air testing 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 1275,00 per lot forspew 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.
v•
SEPTIC PLAN SUBMITTAL FORM
LOCATION: GI go t 0 —Ie R°i SJNL'C7 -L
NEW PLANS: YES fOO/?Plan
G'�4
REVISED PLANS: YES
SITE EVALUATION FORMS INCLUDED: S NO
DATE:-22�—OI
DESIGN ENGINEER:
DATE TO CONSULTANT:
When the submission is all in place, route to the Health Secretary.
TC'joA pr
�uL 2 g 200
WELL OWNER RESPONSE CARD
My private drinking water well is within 100 feet of a right-of-
way and I request that my well location be incorporated in the
operating plan of herbicide applicators who maintain the corridor.
TYPE OF RIGHT -OF -WA
NAME of WELL OWNER:
LOCATION OF WELL
(Street Address)
SIGNED:
.• N.
IF AVAILABLE PLEASE COMPLETE THE FOLLOWING INFORMATION:
,p
Well Depth: /'- feet
Installation Date:
Distance Between Well Head and Edge of Right -of -Way: CI feet
0
TOWN U�' DEC 0 6 2005
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HEALTH DEPARTMENT
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TOWN U�' DEC 0 6 2005
• N LX_Y�
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HEALTH DEPARTMENT
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