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Home My WebLink AboutMiscellaneous - 991 JOHNSON STREET 4/30/2018 (2)< < f , f �, �i +l � l� � �, �� 1 _l� `� � .� North Andover Board of Assessors Public Access f t j KOR7y of��.o „cryo R � • +� �snc Nusr Return to the Home page clickon logo New Search Sales Summary Residence Detached Structure Condo Commercial Comparable Sales TOVM Of Noffth 'AJOKtovew Ufa of A ssesse s& Page 1 of 1 r Property Record Card Parcel ID: 210/107.A-0226-0000.0 Community: North Andover Location: 991 JOHNSON STREET Owner Name: DEMATTEO, JOHN E MAUREEN DEMATTEO Owner Address: 991 JOHNSON STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 7 - 7 Land Area: 1.03 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 1976 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 485,900 507,800 Building Value: 260,900 271,000 Land Value: 225,000 236,800 Market Land Value: 225,000 Chapter Land Value: LATEST SALE Sale Price: 225,000 Sale Date: 09/28/1994 Arms Length Sale Code: Y -YES -VALID Grantor: THOMAS, GREGORY Cert Doc: Book: 04135 Page: 0009 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=1181915 4/22/2008 Commonwealth of Massachusetts City/Town of RECEIVED System Pumping Record ,;UL 4 2014 Form 4 TOWN OF NORTH ANDOVER DEP has provided this form for use b local Boards of Health. Other for � 4.1 R P Y ay:�b��ti iX-e information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/ Right front of house, Left / I ht rear of ho , Left/ right side of house, Left/ Right side of building, Left / Right front of building, Left / Right rear of building, Under deck Address � )��-� City/Town 2. System Owner. Name State �kvv\'F Zip Code Address (if different from location) City/Town State Telephone Number B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): Date 2. Quantity Pumped Cesspool(s) eptic Tank Gallons ❑ Tight Tank 4. Effluent Tee Filter present? e ❑ No If yes, was it cleaned? es ❑ No: 5. Conditio 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locatio where contents were disposed: aL S. Lowell Waste Water (Y SignAtufe 4 Hauleq j Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts GEIVE® W City/Town of System Pumping Record Form 4�� DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left / Right front of house, Left M i ht rear of house Left / right side of house, Left / Right side of building, Left / Right front of building, Left / Right rear o building, Under deck Address Cityrrown State Zip Code 2. System Owner. Name Address (if different from location) Cityrrown B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): I`1 cc ny�l State `�� — 4GC�i Telephone Number (L_(- Date 2. Quantity Pumped: Gallons Cesspool(s) ETSeptic Tank ❑ Tight Tank 4. Effluent Tee Filter present? es ❑ No 5. Condition of 6. System Pumped By: If yes, was it cleaned? [9--YErs- ❑ No. Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location here contents were disposed: Lowell Waste Water Date _l(-.�—1,3 t5form4.doc• 06103 System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts E:; City/Town of a System Pumping Record Form 4 OVER DEP has provided this form for use by local Boards of H a sed, but the information must be substantially the same as that provided here. Befog Is form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left side of house, Right side of house, Left front of house, Right front of house, Left rear of hous , fight. r - ro ous . Left rear of building. Right rear of building. Address City/Town 2. System Owner: Name Address (if different from location) City/Town B. Pumping Record �^ 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): Date Cesspool(s) State A va Telephone Number — 2. Quantity Pumped Septic Tank Zip Code Gallons ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition ,of System: 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Location where contents were disposed: z,111 n /-,, Lowell Waste Water of t5form4.doc• 06/03 F5821 Vehicle License Number Date System Pumping Record • Page 1 of 1 y NO R Tly O�At�EO �6q� *6 O `� �H cocwuiw�c• 1• PUBLIC HEALTH DEPARTMENT Community Development Division CYE127IFICA�IE OFCO�L�GIA�VCE As of: IDecem6er 8, 2008 This is to cert that the individuaCsu6surface dzsposaCsystem received a SATIS FAC7ORT INSTEMON of the: Tuff System Repair of the Subsurface Sewage lnisposaCSystem By: James Kellett At: 991 Johnson Street Wap 107.,1; Parcel226 North Andover, W q 01845 The Issuance of this certificate shaCC not 6e construed as a guarantee that the system wi(C function satisfactorily. l Swan 2'. Sawyer (Public Wealth Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com s >_. Commonwealth of Massachusetts - Cit /Town of �� "� Y 0 • �oww RECEIVED Certificate of Compliance == Form s DEC 0 12008 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. r rh t t5form3.doc• 06/03 TOWN OF NORTH ANDUvthc DEP has provided this form for use by local Boards if HK TbWk+&�Ke used, but the information must be substantially the same as that provided here. Before using this form.. check with the local Board of Health to determine the form they use. This is to Certify that the following work on an On -Site Sewage Disposal System ❑ Construction of a new system ® Repair or replacement of an existing system ❑ Repair or replacement of an existing system component Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP) DSCP N Facility Owner Street Address or Lot # City/Town Designer Information: Benjamin C. Osgood Jr., P.E. DSCP Date M uiy's" State Zip Code New Enqland Enqineerinq Services. Inc. Nam Name of Co pa y a8 _ Signa r Date Installer Information: AIgnature7 tic,vw,., Name of Co /anyy X?_ Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system drill function as designed. Approving Authority Signature Date Certificate of Compliance • Page 1 of 1 RECEIVED DEC 0 1 2008 TO ,;N OF NORTH ANDOVER NEALTH DEPgRTMENT AS -BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, SERVE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERE TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION 99/ o�z�v/ 6 -777 - 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 I � � TOWN OF NORTH ANDOVER a gORTN Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 'A qvivw4w 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss" CH„g Susan Y. Sawyer, .REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORM, ADDRESS: INSTALLER:,_,/l DESIGNER:,,e PLAN DATE:, %MLt BOH APPROVAL DA u_' ON PLAN: `1"071,08 LOT: INSPECTIONS TANK INSPECTION:% 6206 )5 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: 14 16 SITE CONDITIONS Comments: SEPTIC TANK ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer ❑Topography not appreciably altered Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 156-b gallon tank has n installe —Nt O'loading M olithic construction Water tightness ooar�i� �� een-achiev d (Visual or Vacuum Test or Water held for 24hrs) Inlet tee installed, centered under access port Outlet tee (gas baffle or effluent filter) installed, centered under access port 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present Hydraulic cement around inlet & outlet Wastewater System Documentation — Feb 2006 Page 1 of 6 TOWN OF NORTH ANDOVER Ot NORTa Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 ",. •' NORTH ANDOVER, MASSACHUSETTS 01845 M'314U t� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: Comments: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Wastewater System Documentation — Feb 2006 Page 2 of 6 TOWN OF NORTH ANDOVER of NORT„ Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss"„CHU Susan Y. Sawyer, REBS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX D -BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYS TE A 911 Comments: Bottom of SAS excavated down to Loil layer, as provided on plan (�rtt ova V, Si ` Size of SAS excavated as per plan Title 5 sand installed, if specified on plan 3/4-1 Y2" double washed stone installed 1/8-1/2" (peastone) double washed stone installed Laterals installed and ends connected to header Laterals vented if impervious material above Orifices @ 5 & 7 o'clock positions Gravel -less disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan 40 Mil HDPE barrier installed Retaining wall (boulder / concrete / timber/ block) Final cover as per plan \4A, h 6-L Vt 6 R �,m 6'" sada— �s U° IVAW- A��. CroSh �'�- PA� 4� Wastewater System Documentation— Feb 2006 yy�� It J V � � � � age 3 6 � a�� TOWN OF NORTH ANDOVER NORTH °t 'y,7" �° j' O t,, '_"' O Office of COMMUNITY DEVELOPMENT AND SERVICES Z. HEALTH DEPARTMENT F 1600 OSGOOD STREET; Building 2-36 ",. •r NORTH ANDOVER, MASSACHUSETTS 01845CH q ACMUSE� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health .Director 978.688.8476 — FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation — Feb 2006 Page 4 of 6 w ' TOWN OF NORTH ANDOVER a NORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 "' NORTH ANDOVER, MASSACHUSETTS 01845 �'ss" CH„5 t� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Wastewater System Documentation — Feb 2006 Page 5 of 6 Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other) Foundation 10 (5) 20 (10) ❑ Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Wastewater System Documentation — Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER NORTa Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 0,90,'°o0 '° 1600 OSGOOD STREET; Building 2-36",..r NORTH ANDOVER, MASSACHUSETTS 01845 �'ss";CHU' � Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX SYSTEM ELEVATIONS Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW INVERT ON DESIGN PLAN FIELD INVERT ELEV. Wastewater System Documentation — Feb 2006 Page 6 of 6 t1ORTN J p Off'see° , 61 O�Q COCMIC M�WKrt 1• PUBLIC HEALTH DEPARTMENT Community Development Division July 29, 2008 Maureen DeMatteo 991 Johnson Street North Andover, MA 01845 RE: Approval of Subsurface Sewage Disposal System Plan for 991 Johnson Street, Map 107A, Parcel 226, North Andover, Massachusetts Dear Ms. DeMatteo, In regards to the property listed above the following variances were approved at recent regularly scheduled Board of Health meetings: July 24, 2008 Local bylaw variances 1) To allow an impervious barrier and segmental block retaining wall be used in lieu of a poured concrete wall NA 9.02 2) Reduction in offset distance between a wetland and a leach bed from 100 feet required to 75 feet NA 5.02 With these variances and the following conditions the plan submitted by New England Engineering Services, Inc. dated June 4, 2008, final revision date of July 21, 2008 has been approved. This plan is valid for two years from the date of this approval. The design has been approved for use in the construction of an onsite septic system for a 4 - bedroom house (maximum 9 -room). During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health prYwo such as sewage backup into the dwelling is occurring, the North Andover Board of He reduce the time period for which this plan is valid. This approval is subject to the following conditions: 1. It has been identified that there is only 1 test pit in the area of the leaching syst are required according to Title V. At the beginning of construction a test pit will be preformed to ascertain if any ledge is at that location. If conditions exist that require the engineer to relocate a portion of that project, the Health Dept. must be contacted immediately. If the soils are consistent with TP -2 no additional perc tests will be 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com required. 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe or imply compliance with any of the aforementioned requirement. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerel , S"san Sawyer, HS/RS Public Health Director Cc: Ben Osgood Jr., New England Engineering Services Atch: Septic Installer List 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Town of North Andover Licensed Septic $ystem Installers (Disposal Works Installer's) (Please note that the septic installer is licensed only -- not the company) 1 Five or more installations within the last Name 18 months Amor, Robert # of 0 Affiliated Company I R.T. Amor 1 Phone # 978-887-5468 2 Bateson, Todd Q 20 Bateson Enterprises, Inc. 978-475-1474 3 Beaulieu, Serge R. 0 Roadway Excavators 603.893.9189 4 Breen, Peter 0 Peter Breen Excavating, Inc. 978-682-7774 5 Briscoe, Daniel R. 1 Daniel R. Briscoe 978-372-2200 6 Busby, Philip A. Jr. 0 Busby Construction Co., Inc. 603-362-6015 7 Carr, John 0 Ramey Construction 978-633-6791 8 Colosi, Philip A. 0 Colosi Construction LLC 978-777-5679 9 Coyle, Kevin 0 Kevin Coyle i 603-944-8501 10 Currier, James H. 1 James H. Currier Construction Co, Inc978-774-6685 11 1 Daigle, Robert K. 1 Robert K. Daigle, Jr. 978-887-3703 12 DeLucia, Rocci Jr. 0 Frank DeLucia & Son, Inc. 978-686-8200 13 DiVincenzo, John L. 2 Andover Septic/AS Dev. Corp. 978-372-7471 14 Giard, Daniel 0 Daniel A. Giard Septic Service 978-686-7653 15 Hall, Bill, Inc. 0 Bill Hall, Inc. 1 1 978-689-3711 16 Hartigan, James 0 James Hartigan j 978-766-0087 17 Hoehn, Bruce 0 Bruce Hoehn! 978-372-8274 18 Hutton, Arthur 0 Hutton's General Construction, Inc. 978-685-2667 19 Innis, Robert L. 0 R.L.I. Corp. 978-663-6006 20 Jablonski, Chad 0 Jablonski & Sons 978-360-9358 21 Kellett, James 3 Kellett Excavating 781.953.7146 22 1 Marsh, Steve 0 The Westchester Co. 978-742-9778 23 Maynard, Dave 0 Maynard Construction 978-375-7228 24 Murray, David 1 Ranger Development Corp. I 978-360-8506 25 Osgood, Ben 1 New England Engineering 978-686-1768 26 Pearce, Warren 0 Pearce Construction 978-664-5264 27 Petrosino, Angelo 0 Angelo Petrosino 978-664-2030 28 lQuinlan, Timothy 0 Quinlan & Rand Builders 978-457-0528 29 Reilly, Mike 0 F.P. Reilly & Sons 978-475-1237 30 Sawyer, William T. 1 Arco Excavators, Inc. 603-642-8910 31 Shaw, John III 0 Wildwood Excavation, Inc. 978-474-8088 32 Soucy, John J. 8 Soucy's Sewer Service 800.541.9379 33 Sullivan, Jack 0 Jack Sullivan i 978-352-7871 34 ISurianello, Joseph 0 Ralph Surianello, Inc. 617-799-3900 35 Todd, Charles R. 0 Charles R. Todd Contractor, Inc. 978-667-4270 36 Waelty, Craig(Skip) 0 Craig Waelty i 978-664-2126 37 Watson, Joseph 0 JW Watson, Jr. Inc. ! 978-475-8581 38 Zaher, Charles 0 Charles Zaher 978-804-7786 39 Zaloga, Dave Total Installations 1/1/07- 7/7108 0 39 Dave Zaloga 1 603-765-9296 Note: The Septic Installer Exam is held in January. March, May. July and September of each year. You must call the Health Department to sign up for the exam at 978.688.9540. j The testing fee is $25. 1 1 i !Last Updated: 7/7/08 Last Updated: 7/7/2008 NEw ENGLANDENGINEERING SERVICES, IINTC. 1600 Osgood Street Building 20 Suite 2-64 North Andover, MA 01843 Tel: (978) 686-1768 • Fax: (978) 327-6138 www.neengineeringinc.com Susan Sawyer North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Re: 991 Johnson St, North Andover Septic system design Dear Susan: July 21, 2008 !Fr.EIVF JUL 2 4 2008 `2''f`5ya�r✓�— HEALTH DEPAR F"vl- U i Enclosed are 5 copies of revised plans for the above referenced septic system design. Changes have been made to address comments in your letter dated July 16, 2008. The changes/comments are as follows: 1. Label in dwelling on plan view has been revised to read "existing four bedroom house". 2. Metes and bounds of southwesterly property line have been corrected. 3. A graphic scale bar is located in the legend, above the title block. 4. An additional test hole can be performed in the system area. It is hereby requested that this plan be approved subject to performing a confirmatory test pit. 5. An additional percolation test can be performed at the same time as the deep hole test. It was my opinion that the percolation test done at test pit 2 was more representative of the soil in the area based upon the fact that where the percolation test was performed in test pit 1 the ground had previously been disturbed above the percolation test and may have been artificially compacted during the construction of the dwelling and the existing leach field. I hereby request that the plan be approved subject to the performance of an additional percolation test. 6. Wetland line has been labeled with information requested. 7. An additional local bylaw variance has been added to the plan requesting a reduction in the offset distance between a wetland and leach bed from 100' to 75'. 8. General note # 2 has been revised to specify that the effluent filter shall be inspected and cleaned every 6 months. 9. Buoyancy calculations have been revised using 100 lbs./cu. f t. No measures for ballast are required 10. The label for the distribution box has been revised to address requirement of a riser. 11. The impervious barrier line at the distribution box has been extended to the breakout elevation in the "system profile". 12. A leach bed configuration is used to conserve room and allow the system to be built in an area with a lower water table to minimize the mounding of the back yard. If you have any questions, or need additional information, please do not hesitate to contact this office. Sincerely, C Benjamin C. Osgood, Jr., P. . President RECEIVED JUL 2 4 2008 TOWN OF NORTH ANDOV.ER HEALTH DEFARTMi_NT f NORTIy 1 9 ♦ "s + k tss�G MUSE Health Department July 16, 2008 Benjamin Osgood, P.E. New England Engineering Services, Inc. 1600 Osgood Street - Building 20, Suite 2-64 North Andover, MA 01845 Re: Wastewater Treatment System Plan for 991 Johnson Street, Map 107A, Lot 226 Dear Mr. Osgood: The proposed wastewater system design plan for the above site dated June 4, 2008 has been reviewed. Unfortunately, the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item if applicable. 1. The design calculations use 4 bedrooms yet the site plan calls for an existing 3 bedroom house, please clarify 2. There is a typographical error on the berings on the southwesterly property line, please edit 3. Although not required, a scale bar is recommended 9 10. There is only one test pit in the leach area; this would require a Local Upgrade Approval, but seeing as ledge was encountered in the west end of TP -1, we believe it is in everyone's best interest to perform an additional test hole in the proposed system area The two perc tests were drastically different; as the proposed bed extends towards TP -1 and PT -1, it is advisable to use the slower perc rate or perform a confirmatory perc test Please indicate who delineated the resource area and when that delineation was performed As the leaching area is less than 100' from the wetlands a variance must be requested from the Local Bylaw (N.A. 5.02) Please specify the effluent filter is to be maintained at least annually (227(7)) The USDA lists soil weights of Sandy Loams and Loamy Sands to be 100 lbs./ cu. ft., please revise your buoyancy calculations for the septic tank and pump chamber and provide measures for ballast While a riser is depicted for the d -box on the "System Profile," please indicate such with notation 1600 Osgood Street HEALTH DEPARTMENT Building 20; Suite 2-36 E -Mail: healthdept@townofnorthandover.com North Andover, MA 01845 Phone: 978.688.9540 Page 1 of 1 Fax: 978.688.8476 J --J 1. On the "System Profile," it appears the impervious barrier stops at the base of the d -box, please depict it going to the top of the infiltrator 12. The design uses a bed configuration instead of trenches, and no explanation is provided as to why trenches are not used, please provide explanation Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerely, Susan Y. SawyertREHS/daRz Public Health Director cc: Owner File NEw IENGLA-ND IENGINEEPdNG SERVICES, INC. 1600 Osgood Street Building 20 Suite 2-64 North Andover, MA 01845 Tel: (978) 686-1768 • Fax: (978) 327-6138 www.neengineeringinc.com June 9, 2008 NEES Proj #1533 Ms. Susan Sawyer North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Re: 991 Johnson Street, No. Andover Local Health Bylaw Variance Request Dear Ms. Sawyer, The purpose of this letter is to request that the above referenced property be included in the upcoming Board of Health meeting agenda to discuss the following variance: Local Health Bylaw Variance Request Allow the use of an impervious barrier and segmental block retaining wall be used in lieu of constructing a poured concrete wall. (NA 9.02). If you have any comments or questions please do not hesitate to contact this office. Sincerely, BJamin C. Osgoo Jr. P. E. President TOWN OF NORTH ANDOVER Office of COMMI.INITY DEVELOPMENT .AND SERVICES HEALTH DEPARTMENT � p 1600 OSGOO.D STREET; BUILDING 20; SIJITE 2-36 NORTIJ A.NDOVE.R,M:1SS AC'IIUSETTS 01.845 $ACHu��` 978.688.9540 - Phone Susan Y. Sawyer, REHS/.RS 978.688.8476- FAX Public Heaith Director E-MAIL: healthdeptia tow nofnorthandovei- cons WEBSITE: htt:p:,,"./ivtivw.towt,ofiiortha€idover.coirz SEPTIC PLAN SUBMITTAL FORM Date of Submission:— I I'l,(c �, 200 S Site Location: I I 1 Jbhnnsoo S.+. I vAndw_IL Engineer: New Plans? Yes review only) 225/Plan Check # T(. Revised Plans?Yes $75/Plan Check # Site Evaluation Forms Included? Yes No Local Upgrade Form Included? Yes No RECEIVED JUN 13 2008 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT (includes 1St submission and one re - Telephone #: 9 7S' 6&0 - (71,0 g Fax #: E-mail: t i •CQ/X Homeowner Name: OFFICE USE ONLY When the submiss'on is complete (including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ L/ Enter on Log Sheet and Database ,.oRry Commonwealth of Massachusetts Map -Block -Lot '•.§�oa 107.A- 0226 - ----------------------- Board of Health Permit No ` North Andover BHP -2008-0201 ----P-20 ------------- °r b* .::.�.. _ • P.I. FEE ACWus4ia F.I. $250.00 ----------------------- Disposal Works Construction Permit Permission is hereby granted James Kellett ------------------------------------------------------------------- ;to;(Repair)___tvidu 991 JOHNS, - -------------------- as - ---------------- as shownari'ttre--applies Issued On: Sep -30-2008 C, ! NORTH Application for Septic Disposal System Construction Permit -TOWN OF *'• ,£ ORTH ANDOVER, MA 01845 no � CNus < Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Application is hereby made for a permit to: ❑ C nstruct a new on-site sewage disposal system* Repair or replace an existing on-site sewage disposal system* ❑ Repair or replace an existing system component — What? A. Facility Information 9q1 'tin sit S Address or Lot # City/Town 2.- *TYPE SEPTIC SYSTEM*: ❑ Pump Gravity (choose one) ***If pu p system, attach copy of electrical permit to application*** C1/;-' 5 P ? TOD Y'S D TE $ 250.00 — Full Repair $125.00 - Component ❑ Conventional System (pipe and stone system) Xinfiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 9 IneLv r{t.^ .fie AAA+tea Nage I L -1 Ct Address (if different from above) &, Andos-cam- M ,13 City/Town State Zip Code Telephone Number (Cell Phone # if possible please) 4. Desi ner Information Ye, #Al �>✓S Name Name of Company /60c) a'�ac S� Ad ress A al City/Town MIA & State Zip Code J -6b6 -/76Y Telephone Number (Best # to Reach) Application for Disposal System Construction Permit - Page 1 of 2 Telephone Number 3. Installer Information �A_ee �xcQ ?�i� `1,,n �� >� Name qao sa/rm Nanie of Company Add r ss 4, (ol 0/ Cityrr wn State Zip Code? Telephone Number (Cell Phone # if possible please) 4. Desi ner Information Ye, #Al �>✓S Name Name of Company /60c) a'�ac S� Ad ress A al City/Town MIA & State Zip Code J -6b6 -/76Y Telephone Number (Best # to Reach) Application for Disposal System Construction Permit - Page 1 of 2 p°RTFI Application for Septic Disposal System 3 c TODAY'S DATE AConstruction Permit - TOWN OF $ 250.00 - Full Repair ORTH ANDOVER, MA 01845 $125.00 -Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Building: residential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been ued by this Board of Health. Na6/ Date Applicgfigti Approved By: (�'oard of Health Representative) LO ` J - a8 Date on Disapproved forlhe following reasons: For Office Use Only: / L Fee Attached. Yes �/ 2. Project Manager Obli ation Form Attached. Yes 3. Pump Svstem? Ifso, Attach copy ofElectrical Permit Yes 4. Foundation As -Built. (new construction ronly, (Same scale as approved plan) 5. Floor Plans? (new construction only): No No Not No No Application for Disposal System Construction Permit • Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: J,5 �Ijob (Address of septic system) For plans by N Relative to the application of (Installer's name) Dated 3 d o ay s ate (Engineer) And dated �� 0? -ad? ngma ate With revisions dated (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer, I must call for any and all inspections. If homeowner, contractor, project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that reauesting an inspection, without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against me and/or MY companL- a. Bottom of Bed — Generally, this is the first (V5 inspection unless there is a retaining wall, which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection — Engineer must first do their inspection for elevations, ties, etc. As -built of verbal OK (or e-mail to: healthdeltntownofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade — Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board ofHealth staff or consultant. d. Installation of tank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer, I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor. or anv other persons shall absolve me of this obligation. A Undersigned Licensed Septic Installer: -Print) /a7 �J 'O11-0 # 7 �� y ame — rint (Today's Date) ® 4FI z Commonwealth of Massachusetts offi eial use Only Permit No. 2 �,2 Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEQ, 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: M — / " 6 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice off/ -his or her intention to perform the electrical work described below. Location (Street & Number) '?9 / `%O ft/:5�>g ST Owner or Tenant Telephone No. Owner's Address S Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Boz) Purpose of Buildingi(lJel /n/�" Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amos- 7- Volts Overhead -0 Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (,i f I kc is A t SLUE G o . _ a d CJfdiZ62 10AAlf Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans r o ota Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above ❑ n- E] Swimming Pool rid. nd. No. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o and D Initiating Devices No. of Ranges No. of Air Cond. Tons Tot No. of Alerting Devices No. of Waste Dis posers P eat Pump Totals: .... um... er Tons .......... o. o e - ontame Detection/Alerting Devices No. of Dishwashers S ace/Area Beating KW P g Local ❑ Municipal ❑ Other Connection No. of Dryers r'y Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters _ No. of No. of Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP T/ a ecommumcations irin No. of Devices or E uivalent OTHER: ' U C I _ g [ U U o Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work:- (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such co rage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pg. and p all`ie-s tofper'ury, hat the information on this application is true and complete. FIRM NAME: R V l WC' . i ,1,1 LIC. NO.: o�t Licensee:��'q M e SignaturIff LIC. NO.: (Ifapplicable, enter "Gxem t :n the lic a numb line1) Bus. Tel. No.• S^ a Address: .L t ^ b , 6; d Alt. Tel. No.. *Per M.G.L c. 147, s. 57-61, sec rity work requires De ent of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner'sent. Owner/Agent Signature Telephone No. PERMIT FEE. $ a Date ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................ bp� llk has permission to perform........... 4C wiring in the building of ......... UE 0- -P at .......... P9- Ll rlj .-C41;.V ,,rVorth Andover, Mass. Fee ... Lic. No Et cr�uciu.Irrsrecro Check # 8397 RECEIVED {\� } .11..)� N; 11 '.a l r-�. ,a -.— ^1 )i I 1 "'df t�Jl l r 1 .y....:.{ I LI' ;: i ! 'v`1 i_ `; i 4J MAY 0 92008 � w4v, � � f—, iV ,_.3 lv,! tI^ �it yg �p NORTH ANDOVER a . r' _:CS _. _ . _.. It . .....,.(` , .`'„ ," �;-',t,..�;{r n i� CONSERVATION COMMISSION ADPL I CATION FOR SOIL `TESTS DATE:_ _ Ha 5- MAP& PARCEL: LOCATION OF SOIL TESTS: q7_9 Stp APPLICANT: Contact #. ADDRESS.�• I 4 !�.� ill ��!►j� . .« i �d. �• CERTIFIED SOIL EVALUATOR: intended Use of Land: Residential Subdivi ' <:221_6 Family HoTfi?l Commercial IsThis. Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: In the Lake CochichewickWatershel? Yes No ►�` THE FOLLOWING MUST BE INCLUDED WITH THISFORM v v d MAY 0 6.� Or nlof�T........ of land ownership (Tax bill, or letter from owner permitting test) 8.5 x 11 Plot plan &Location of Testi ng(geaseindicatetest pit sites on the plan) Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of 360.00 per lot for repairs or upgrades. GENERAL INFORMATION Only Certified Soil Evaluators may perform deep hole i nspecti ons. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. At least two deep holes and two percolation tests are required for each septic system disposal area Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representativa Full paymentwill berequireiforall additional testswithin two weeks of testing. Within 45 days of testing, a scaled plan (no smaller than 1.--100 ) shadI be submitted to the Board of Health showing the location of all tests (including aborted tests), a Within 60 days of testing soil evaluation forms shall be submitted. t Please Do Not Write Below ThisLine /1 q MAY 2 9 2008 N.A. Conservation Commission Approval Date: TOVVN C:r HEAT Signature of Conservation Agent: Proof —�— Date back to Health Department: (stamp in): �,o' AV -AA �� l c "(,-e t3/ 5 4 P26 0 E 1,04 1,03 ac 1,03 ac Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. VQ Commonwealth of Massachusetts City/Town of 0 4O U6- Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. A. Site Information Maureen DeMatteo Owner Name 991 Johnson Street Street Address or Lot # No Andover City/Town Contact Person (if different from Owner) B. Test Results MA State Telephone Number 01845 Zip Code 5/16/08 9:36 Date Time TP#2 48"/19" 9:36 9:51 9:41 10:06 10:27 21 Min 7 min/inch Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Benjamin C. Osgood Jr. P.E. Test Performed By: Issac Rowe Mill River Consulting Witnessed By: Comments: t5form12.doc• 06/03 Perc Test • Page 1 of 1 5/16/08 9:26 Date Time TP#1 Observation Hole # 40"/15" Depth of Perc Start Pre -Soak 9:26 9:41 End Pre -Soak 9:41 Time at 12" 10:23 Time at 9" 11:08 Time at 6" 45 Min Time (9"-6") 15 min/inch Rate (Min./Inch) 01845 Zip Code 5/16/08 9:36 Date Time TP#2 48"/19" 9:36 9:51 9:41 10:06 10:27 21 Min 7 min/inch Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Benjamin C. Osgood Jr. P.E. 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O 3 rh W 0 cr S y CD y O 1 O CA CA co ID W 10O N NJ 'F1 �a O� C:7 4f 52' D� 0 „ppIIIIIIIIIIIIIIIIIII11lij�ll I��IIIIIIIIIIIIIIIIIIIII� 'n o o O �3 3 0 33 �h(D 0, o ft Cl) 3 Cr s �. _ fA N (D N 3 CD 3 �t O -z O COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION �[ f' TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: _991 Johnson Street_ _ North Andover_ Owner's Name: _John & Maureen DeMatteo_ Owner's Address: _991 Johnson Street North Andover, MA 01845_ Date of Inspection: _4/15/2008_ Name of Inspector: _Neil J. Bateson_ Company Name: _Bateson Enterprises Inc._ Mailing Address: _111 Argilla Road_ _Andover, MA 01810_ Telephone Number: _ (978) 475-4786_ RECEIVED APR 2 8 2008 TOWN OF'NORTH HEALTH DEPARTMENT ANDOVER CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority X F 'ls Inspector's Signature: Date: 4/15/2008 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. Notes and Comments: ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 0 , Page � of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _991 Johnson Street_ North Andover Owner: _ DeMatteo _ Date of Inspection: _4/15/2008 _ Inspection Summary: Check A, B, C, D or E / ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: 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. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If "not determined" please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is leveled or replaced ND explain: pumping more than 4 times a year due to broken or obstructed pipe(s). approval of the Board of Health): broken pipe(s) are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 The system required The system will pass inspection if (with Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _991 Johnson Street_ _ North Andover— Owner: _DeMatteo_ Date of Inspection: _4/15/2008 _ 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 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 . Page 4 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _991 Johnson Street_ _ North Andover_ Owner: _DeMatteo _ Date of Inspection: _4/15/2008 _ D. System Failure Criteria applicable to all systems: You must indicate "yes" or "no" to each of the following for all inspections: _Yes_ _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool No— Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool No_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _No_ Liquid depth in cesspool is less than 6" below invert or available volume is'h day flow. —No Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ No_ Any portion of the SAS, cesspool or privy is below high ground water elevation. No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. No_ Any portion of a cesspool or privy is within a Zone 1 of a public well. No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No— Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] _Yes_ (Yes/No) 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. You must indicate either "yes" or "no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 II 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: _991 Johnson Street _ _ North Andover _ Owner: _DeMatteo_ Date of Inspection: _4/15/2008 Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No Yes_ Pumping information was provided by the owner, occupant, or Board of Health _No_ Were any of the system components pumped out in the previous two weeks ? Yes Has the system received normal flows in the previous two week period ? _No_ Have large volumes of water been introduced to the system recently or as part of this inspection ? N/A _ Were as built plans of the system obtained and examined? _Yes_ _ Was the facility or dwelling inspected for signs of sewage back up ? _Yes_ _ Was the site inspected for signs of break out ? _Yes_ _ Were all system components, excluding the SAS, located on site ? _Yes_ _ 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 ? _Yes_ _ Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes No N/A_ _ Existing information. _Yes_ _ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 , Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: _991 Johnson Street_ _ North Andover - Owner: _DeMatteo _ Date of Inspection: _4/15/2008 _ FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): _N/A_ Number of bedrooms (actual): _4_ DESIGN flow based on 310 CMR 15.203 _N/A Number of current residents: _1_ Does residence have a garbage grinder (yes or no): _No_ Is laundry on a separate sewage system (yes or no): _No _ Laundry system inspected (yes or no): Seasonal use: (yes or no): _No_ Water meter reading: _Yes_ Sump pump (yes or no): -No=- Last No_Last date of occupancy: _ Current_ COMMERCIAL/INDUSTRIAL Type of establishment: Design flow (based on 310 CMR 15.203): _gpd Basis of design flow (seats/persons/sgft,etc.): Grease trap present (yes or no): _ Industrial waste holding tank present (yes or no): Non -sanitary waste discharged to the Title 5 system (yes or no): — Water meter readings, if available: _ Last date of occupancy/use: OTHER (describe): GENERAL INFORMATION Pumping Records Source of information: _Pumped last year, owner _ Was system pumped as part of the inspection (yes or no): _No_ If yes, volume pumped: _ gallons -- How was quantity pumped determined? _ Reason for pumping: _ TYPE OF SYSTEM _X Septic tank, distribution box, soil absorption system _ Single cesspool _ Overflow cesspool _ Privy _ Shared system (yes or no) (if yes, attach previous inspection records, if any) _ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank Attach a copy of the DEP approval Other (describe): Approximate age of all components, date installed (if known) and source of information 23 years old, owner _ Were sewage odors detected when arriving at the site (yes or no): _No Title 5 Inspection Form 6/15/2000 6 Page ,7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _991 Johnson Street_ _ North Andover _ Owner: _DeMatteo _ Date of Inspection: _4/15/2008_ BUILDING SEWER _ X _ (locate on site plan) Depth below grade: _16" Materials of construction: _X_ cast iron _X_ 40 PVC _other Distance from private water supply well or suction line: Comments (on condition of joints, venting, evidence of leakage, etc.) _ 4" cast iron thru wall, 3" PVC in house, no leaks visible SEPTIC TANK: X Depth below grade: _4" Material of construction: X_ concrete _ metal _fiberglass _polyethylene _other(explain) If tank is metal list age: _ Is age confirmed by a Certificate of Compliance (yes or no): _ (attach a copy of certificate) Dimensions: _10' x 5' x 4' Sludge depth: —1" _ Distance from top of sludge to bottom of outlet tee or baffle: _26" _ Scum thickness: _2"_ Distance from top of scum to top of outlet tee or baffle: _6" Distance from bottom of scum to bottom of outlet tee or baffle: 19"_ How were dimensions determined: _ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc. _ Inlet tee ok. Outlet tee corroded. Depth of liquid at invert. No evidence of leakage. _ GREASE TRAP: _(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Title 5 Inspection Form 6/15/2000 7 . Page.8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _991 Johnson Street _ _ North Andover_ Owner: _DeMatteo _ Date of Inspection: _4/15/2008_ 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/day Alarm present (yes or no): Alarm level: Alarm in working order (yes or no): Date of last pumping: Comments (condition of alarm and float switches, etc.): DISTRIBUTION BOX X_ Depth below grade _2'_ Depth of liquid level above outlet invert: —0 _ Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.) _ D -box level & distribution equal, has flow levelers. Evidence of leakage. D - Box badly corroded, needs replaced. Evidence of solid carryover. D -Box has riser cover 6" deep. _ PUMP CHAMBER: _ (locate on site plan) Pump in working order (yes or no): Alarm in working order (yes or no): Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): _ Title 5 Inspection Form 6/15/2000 Page 9 of I 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _991 Johnson Street _ _ North Andover– Owner: _DeMatteo_ Date of Inspection: _4/15/2008_ SOIL ABSORPTION SYSTEM (SAS): _X_ (locate on site plan, excavation not required) If SAS not located explain why: Type X Leaching pits, number: _2_ Leaching chambers, number: — Leaching galleries, number: _ Leaching trench, number, length: _ Leaching field, 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.): Soil ok. Vegetation ok. No sign of ponding to surface. Camera inside of both pits thru d -box outlets. Pit # 1 has liquid above invert 1". Pit # 2 holding liquid below invert. _ CESSPOOLS: Number and configuration: Depth – top of liquid to inlet invert: — Depth of sludge layer: Depth of scum layer: _ Dimensions of cesspool: — Materials of construction: Indication of groundwater inflow (yes or no): — 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.): Title 5 Inspection Form 6/15/2000 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: _991 Johnson Street _ _ North Andover__ Owner: _DeMatteo _ Date of Inspection: _4/15/2008_ SKETCH OF SEWAGE DISPOSAL SYSTEM. Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building A to 1 = 28" Ato2=33'1 A to D -Box B to .1 = 25" Bto2=25'1 B to D -Box Title 5 Inspection Form 6/15/2000 10 t • Page 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _991 Johnson Street _ _ North Andover_ Owner: _DeMatteo_ Date of Inspection: _4/15/2008 _ SITE EXAM Slope _ Yes _ Surface water _ No _ Check cellar _ Dry _ Shallow wells _ No _ Estimated depth to ground water _>6'_ Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record - If checked, date of design plan reviewed: Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health -explain: _ _ Checked with local excavators, installers- (attach documentation) X_ Accessed USGS database -explain: _Essex County Soil Map_ You must describe how you established the high ground water elevation: _ Essex County Soil Map, Sheet # 36, Canton Soil, Water >6' Deep_ Title 5 Inspection Form 6/15/2000 11 Summary Record Card generated on 4/10/2008 2:23:52 PM by Karen Hanlon Town of North Andover Tax Map # 210-107.A-0226-0000.0 991 JOHNSON STREET DEMATTEO, JOHN 991 JOHNSON STREET N. ANDOVER, MA 01845 Class 101 Single Family Size Total 1.03 Acres FY 2008 UB Mailina Index Name/Address DEMATTEO, JOHN 991 JOHNSON STREET N. ANDOVER, MA 01845 UB Account Maint. Account No Cycle Bldg Id. 14301.0 - 991 JOHNSON STREET 2100296 02 Cycle 02 UB Services Maint. Service Code MISCFEE ADMIN FEE WTR WATER UB Meter Maintenance Property Type Type Loan Number Active/Inact. From Payor Occupant Name Active/Inactive Last Billing Date 3/5/2008 Active Rate Charge Multiplier/Users 0.635/8 7.82 1/ 01 ALL METER SIZE 53.85 /1 Serial No Status Location 13242189 a Active ERT HH Date Reading Code 2/6/2008 404 a Actual 11/2/2007 389 a Actual 8/3/2007 345 a Actual 5/4/2007 291 a Actual 2/21/2007 279 a Actual 11/1/2006 267 a Actual 8/1/2006 239 a Actual 5/5/2006 190 a Actual 2/8/2006 170 a Actual 11/8/2005 152 a Actual 8/4/2005 120 a Actual 5/3/2005 105 a Actual 2/15/2005 92 a Actual 11/15/2004 57 a Actual 8/17/2004 40 a Actual 5/18/2004 23 a Actual 2/11/2004 6 c Correction C/O O+ERT 6=6 11/14/2003 11/14/2003 1250 n New Meter Page 1 1 Residential Until Brand Type Size YTD Cons METE METE w Water 0.63 0.63 0 Consumption Posted Date Variance 15 3/14/2008 -68% 44 1/15/2008 -19% 54 9/14/2007 256% 12 6/22/2007 56% 12 3/23/2007 -65% 28 12/22/2006 -45% 49 9/13/2006 139% 20 6/20/2006 19% 18 3/13/2006 -41% 32 12/14/2005 107% 15 9/12/2005 -4% 13 6/8/2005 -56% 35 3/15/2005 101% 17 12/17/2004 1 % 17 9/20/2004 7% 17 6/14/2004 160% 6 4/16/2004 0% 0 11/14/2003 0% Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating -Water& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 991 Johnson Street, North Andover Owner: DeMatteo Date of Inspection: 4/15/2008 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. 4445:___ Neil J. Bateson Bateson Enterprises, Inc. hit , Jew --� , 5NJ aeAD uM'MA C'w1:' lvi_ l� IJV ears " f- royN . m L - 1 ' J E�vill"Mm1mr-.3 !"9 mio- It 00 0 hit , Jew --� , 5NJ aeAD uM'MA Y , IJV ears " f- royN . Pug -aelqrs L It 00 0 DS�Aw W W M N �► Ohl 3 AS BUILT PLAN OF SUBSURFACE DISPOSAL SYSTEM. LOCATEDIN ki AS PREPARED FOR M�•r�C � a � � � � � e� / � �v ,,,log �, 5o tJ �-r2�-r . DATE: te•� I-qG SCALE: I'`. � MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS " PARK STREET• • ANDOVER. MASSACHUSETTS 01810-• O TEL (617) 473-3553, 373-3721 0 I.: J