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HomeMy WebLinkAboutPass - Title V Inspection Report - 437 SUMMER STREET 6/22/2021 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ti. Property Address Owner Owner's Name information is A ) f�� F°1���-� — required for every V e2 �L State Zip Code Z` Code Date of nspe ion Y S ---_-- page. City/Town Inspection results must be submitted on this form. Inspection forms may no �„ Itered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information _ 2 filling out forms on the computer, use only the tabJS� key to move your Name of Inspector cursor-do not �n� use the return key. Company ame- 77 'A\—VQ --- ---- Comp Addre City/Town _ State Zip Code Telephone Nuf5ber License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and mainten inc of on-site sewage disposal systems. After conducting this inspection I have determined that the s em: 1. Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails _ u _ � I ector's nature Date The sy em inspector hall submit a py of this inspection report tot a Approving Authority (Board of Health or DEP)wi in 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp doc•rev.7/262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 C Commonwealth of Massachusetts 1, Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address C u g�-n - Owner Owner's Name information is ` f _f>n e--\ required for every �:/\ page. City/Town State Zip Code Date of I pe n C. Inspection Summary inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) Sys m 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: 2) 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): t5insp-doe-rev.7Q6M18 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 ---��-- Prope Address j1Z Owner Owner's Name information is 4/4 Q ii � �► required for every '�Y r' // l�[� r State \ Zip Code Date of In cbo page City/Town C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ 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): 3) 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. a. 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: Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 18 t5insp.doc•rev.726/2018 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments Pro pe Address Owner Owner's Name information is required for every 7 V -- -- page. Cit /Town ( State Zip Code Date Inspe ion C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) 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 Title 5 Official Inspection Form:Subsurface sewage Disposal System•Page 4 of 18 t51nsp.cloc•rev.7/2 6120 1 8 Commonwealth of Massachusetts p Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Addrese Owner Own Name information is required for everypage- City/Town City/Town State Zip Code Date of I pectio C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ 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 '/2 day flow ❑ 52/1 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. ❑ L�7/ Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply wel:i. ❑ 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 2000 gpd- 10,000 gpd. ❑ ❑� 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. 5) 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 CA. 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 5nsp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner OWFTgrs Name information is r y� c} �r� — r required for every M'"�Utd/ ------ page. City/Town State Zip Code Date of Insp ion C. Inspection Summary (cons.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section C.4 above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no" for each of the following for aH inspections: 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? El this 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)1 t5insp.doc•rev.7t26r2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form cb Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Pro arfy Address f&—Y%- 1 ce-✓t — Owntr Owner's&ame information is required for every page. City/Town S ate Zi Code Date of thspkfion D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms). Description: l Number of current residents: Does residence have a garbage grinder? ❑ Yes No Does residence have a water treatment unit? ❑ Yes VNo If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes Ej�/No information in this report.) �-,/- Laundry system inspected? ❑ Yes !!Q No Seasonaluse? ❑ Yes No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? Yes ❑ No Last date of occupancy: Date t5insp.doc-rev.7/26/2018 Tore 5 Ofrici&Inspection Form.Subsurface Sewage Disposai System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form is Subsurface Sewage Disposal System Form -Not for Voluntary Assessments q� Prop Address — It2k<3UAA 7, f Owner Owner's Name �/ A information is t required for every --T /"7 — X's A I page. City/Town State Zip Code Date of Ins ctio D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): — Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: — - — Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: J Was system pumped as part of the inspection? `v❑'/Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? ---- Reason for pumping: ---- C,' � t5insp.doc•rev.7/2612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 C� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Proppe dress LXS a-PI '3Cc?� �rP Owner Owner's Name information is /� + � required for every � y Kjt{90 v� page. City/Town State Zip Code Date of In dio D. System Information (cont.) 4. Type of ystem: 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)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): Approximate age of all components, date installed (if known)and source of information: ag t � Were sewage odors detected when arriving at the site? ❑ Yes V'No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron �4O PVC ❑ other(explain): Distance from private water supply well or suction liner Comments (on condition f joints, venting, evidence of leakage, etc.): n L ---_ Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 t5insp.doc•rev.7/26/2018 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4l 3 7 S'c�wtr7✓1-?it �—�= Property Address S E��aA--v cam/ ro Owner Owne�3 Name information is A, 0�n required for every ��/A page. Cityftown State Zip Code Date of Inpl5ection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: feet 7Ma ial of construction: concrete ❑ metal ❑ 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: /r Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle �r 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 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.): IV t5insp.doc•rev.V26f2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property d ess la�OL41 Owner Owner's Name information is ,(? //�A , l c required for every 1T C� page. City/Town State Zip Code Date of Ins io D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet 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: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate o site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: -- Capacity: gallons Design Flow: gallons per day t5insp.doe•rev.7rMQ018 Title 5 official Inspection Fonn:Subsurface Sewage Disposal System•Page 11 of 18 C� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 117 -7 Property Ad ress �— 1 S]C_4L4 4L,.;—b Owner OwnOwn e information is V-eA required for every e page. CityJ I own State Zip Code Date of Inspe ion D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ,� Yes ❑ No Alarm level. -- Alarm in working or r. Yes ❑ No Date of last pumping: Date [ Comments (condition of alarm and float switches, etc.): nn Attach copy of current pumping contract(required). Is copy attached? e"Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan).- Depth of liquid level above outlet invert 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.): An) so.Qt432s n� t5insp.doc•rev.7l26=18 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 12 of 18 C� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments L 1 3 ay^ -Vvv_v� _ Prope=S<2_LA ess �,ZCCe-'—L. Owner Owner's ame information is required for every page. Cityfrown tate Zip Code Date rlopecti n D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: Y s ❑ No* Alarms in working order: Yes ❑ No* Comments(note condition of pump chamber; condition of pumps and appurtenances, etc.): 0 -- — W �vr�LJ r`3 t<i- _ * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: I leaching fields number, dimensions: f � � ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: — --- t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form Ia Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Q4 ti L*—V►-' w►..-cam ' - Prope Address Owner s Na e information is A�` required for every ,y page. City/Town State Zip Code Date of Ins ion D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): (� � 12. Cesspools (cesspool must be pumped as part of inspection) (locate on sit pla ) 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): tsmsp.doc•rev.7/262018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 t�" Commonwealth of Massachusetts ?= Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . % 4/.3 Prope ddress LAC 6LVi 4�— Owner Owner's Name information isA41 required for every /�� Kam!' � �"�1 d �� � t page. City/Town State Zip Code Date of Insp ion D. System Information (cont.) 13. Privy(locate on site plan): 71, Materials of construction: Dimensions -- Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5msp.doc-rev.712612018 TWe 5 Offidai Inspection Forth.Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form tI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Pro erty Address � � �� Owner Owner's Name information is 6� A2. V A. .ii [1 1J✓_ ` required for every � Wd_l. A page. City/Town taS to Zip Code Date of InsoedioA D. System Information (cont.) 14. 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 ✓ C G t5in5p.doc-rev.7/2 61201 8 T le 5 Official spection orrn:Subsurface Sewage Disposal System-Page 16 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name information is required for every State Zip Code Date of Inspection page. City/Town D. System Information (cont.) 15. Site Exam: �;�Chh ck Slope FChe ce water k cellar ow wells 41, `/,S'�?,, Estimated depth to high ground water: feetet Pleas dicate all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked, date of design plan reviewed: pate Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. Title 5 Official Inspection Form_Subsurface Sewage Disposal System-Page 17 of 18 t5insp.doc•rev.725f2018 Summary Record Card generated on 6/3/2021 12:53:53 PM by Karen Hanlon Page 1' Town of North Andover Tax Map # 210-107.A-0083-0000.0 Parcel Id 17908 437 SUMMER STREET SCANDORE, JOSEPH 437 SUMMER STREET N.ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1.15 Acres FY 2021 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until SCANDORE,JOSEPH Payor Active 437 SUMMER STREET N.ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/inactive Bldg id. 14284.0-437 SUMMER STREET Last Billing Date 3/9/2021 2100279 02 Cycle 02 Active UB Services Maint. Account No.2100279 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.63 5/8 7.82 1/ WTR WATER 01 ALL METER SIZE 34.20 /1 UB Meter Maintenance Account No.2100279 Serial No Status Location Brand Type Size YTD Cons 16336702 a Active HH#437 METE METE w Water 0.63 0.63 9 Date Reading Code Consumption Posted Date Variance 6/2/2021 2066 a Actual 11 35% 3/1/2021 2055 c Correction 9 3/16/2021 -74% 11/18/2020 2062 m Manual estimate 35 12/16/2020 -13% MSG 8/4/2020 2027 a Actual 35 9/9/2020 163% 5/4/2020 1992 a Actual 13 6/10/2020 33% 2/4/2020 1979 a Actual 10 3/16/2020 14% 11/4/2019 1969 a Actual 9 12/23/2019 -20% 8/2/2019 1960 a Actual 11 9/26/2019 -20% 5/2/2019 1949 a Actual 13 6/13/2019 -17% 2/4/2019 1936 a Actual 17 3/19/2019 4% Summary Record Card generated on 6/3/2021 12:53:53 PM by Karen Hanlon Page 2 Town of North Andover Tax Map # 210-107.A-0083-0000.0 Parcel id 17908 437 SUMMER STREET SCANDORE, JOSEPH 437 SUMMER STREET N.ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1.15 Acres FY 2021 11/2/2018 1919 aActual 16 12/12/2018 -39% 8/2/2018 1903 a Actual 26 9/20/2018 84% 5/3/2018 1877 a Actual 14 6/20/2018 -10% 2/2/2018 1863 a Actual 16 3/28/2018 12% 11/1/2017 1847 aActual 14 12/29/2017 -29% 8/2/2017 1833 a Actual 20 9/20/2017 21% 5/2/2017 1813 a Actual 16 6/26/2017 -8% 2/2/2017 1797 a Actual 18 3/14/2017 -6% 11/2/2016 1779 a Actual 19 12119/2016 -66% 8/3/2016 1760 a Actual 56 9/21/2016 72% 5/4/2016 1704 a Actual 33 6/21/2016 43% 2/2/2016 1671 a Actual 23 3/28/2016 -21% 11/2/2015 1648 aActual 28 12/30/2015 -37% 8/5/2015 1620 a Actual 46 9/14/2015 117% 5/5/2015 1574 a Actual 21 6/22/2015 12% 2/3/2015 1553 a Actual 19 3/20/2015 -6% 11/3/2014 1534 aActual 20 12/15/2014 -48% 8/4/2014 1514 aActual 38 9/11/2014 174% 5/6/2014 1476 a Actual 14 6/12/2014 -26% 2/4/2014 1462 a Actual 20 3/17/2014 -15% 10/31/2013 1442 aActual 22 12/20/2013 -46% 8/2/2013 1420 a Actual 40 9/18/2013 111% 5/6/2013 1380 a Actual 19 6/18/2013 2% 2/7/2013 1361 a Actual 21 3/13/2013 -21% 10/31/2012 1340 aActual 24 12/13/2012 -35% 8/3/2012 1316 a Actual 38 9/26/2012 24% 5/3/2012 1278 a Actual 29 6/20/2012 20% 2/6/2012 1249 a Actual 27 3/14/2012 -10% 11/1/2011 1222 aActual 28 12/15/2011 -27% 8/2/2011 1194 a Actual 38 9/14/2011 34% 5/4/2011 1156 a Actual 28 6/13/2011 11% 2/4/2011 1128 a Actual 27 3/15/2011 -33% 11/1/2010 1101 aActual 38 12113/2010 32% 8/3/2010 1063 a Actual 29 9/13/2010 53% 5/4/2010 1034 a Actual 19 6/9/2010 -16% 2/2/2010 1015 a Actual 23 3/11/2010 -10% 11/2/2009 992 a Actual 25 12/11/2009 -2% 8/4/2009 967 a Actual 26 9/11/2009 26% 5/4/2009 941 a Actual 20 6/16/2009 -11% 2/4/2009 921 a Actual 23 3/16/2009 -2% 11/5/2008 898 aActual 24 12/10/2008 -38% 8/4/2008 874 a Actual 39 9/12/2008 88% 5/2/2008 835 a Actual 19 6/18/2008 -24% _ d 'siewart'rts rviie J Andover*ic Strathamllitllwsti(, RrvkRarn (9711 12.7471 197h)475 2$93 f003)772-S! (978)452-9022 i .18 Sarah R'tnhail 9rort,!lrarf ford,H,4 011135 u P k PAY FROM T IS E31LL ' '�" .., 4 33 b 3 .: Septic Tank Pumping and Ctaomnq 3 -�� Tore the night way' Not Assponsible for Covers nr Irrigation SYsfeM4 { AM pM Y lA. to" E r pd 3�Gtie'KUMs ,.6 iiix iCarnxarut .)Ww+ - y° :3 tlYYwaa J teacr<iadtrt:u�;k � .�Tr�(Hovri -� - 1.y GaeaR P�fiU'tiaTtiv.' rJ r1x£rq Y9s�tt a stS� ' spov po"Chamtot aRM y1 C,,,4w .11Pafi=ty �€- �3 !�Crsanaa tTatl i.7 E�W.fl6Y3M � �J rURX II a c;��n n�n�a 1 ray a dcr� a via ��� a rrt8,'%a Tsai a Ua't t€orazf b`dYD 9t JOt �v i a s rrracW i J,ktrckn f(Xi6p ss^]SDoitawt i IWOgaeWA !?IOWAV ws a t xw ..;I wndcau a van�ssc _ 'v`�" �7�i fit, ��''. l�. �ru. ,,y���,- a�o6�x J CSC' .3 dmnr ., arc 4— .,. J!.-alum '" o J C**ruaWI#f : 3 a�idtYM$G§N Q E41N m iteesan l t J 4mCar a F,artaNe Turil Ran€ aPtur;s Rtpab��^^�W�� m� `:7 Yda.WV T*" J 41ael a :3 FWwn .. + n,�le�Ct a PW th-0— : i i t f€'` z) A +.,Y.«.,ea, �I. ,q€ s�; '-'`:` ,. -z,f:°v ° � a PAYMENT DUE IN FULL x� Y UPON COMPLETION77, «.4 �t�� II r���i g��,1yM�'V��� >wa was✓wa bslr+�tan ap hapax «TMrncrs7+»ear #A»'�aaa„a.�a.x� ,I of.NORT.,y 9 { 0 ,•- s * Town of North Andover HEALTH DEPARTMENT ,SSACMUSt" CHECK#: 6 DATE: 2 `'7 LOCATION: 5Z.3 2 H/O NAME: C.n CONTRACTOR NAME: Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ TrasWSolid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ; Title 5 Report P0,55 $��_ ❑ Other:(Indicate) $ 1 I Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer