Loading...
HomeMy WebLinkAboutApplication - 540 BOXFORD STREET 3/26/2015 TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER,MASSACHUSETTS 01845 Susan Y.Sawyer,REITS/RS 978.688.9540—Phone 978.688.$476—FAX Public Health Director E-MAIL:heahhde tL&townofnorthandover.com WEBS[TE:http://www.towtiofiiortliandover.coin SEPTIC PLAN SUBMITTAL FORM Date of Submission:,,, 3 .'. 6 ,­ Site Location: Engineer: �►V l C !v�S ('/t -16 New Plans? Yes_X $225/Flan Check# (includes 1st submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes k-� No Local Upgrade Form Included? Yes No Telephone 3 73 3 16 Fax#: E-mail: OA-, I c e 5� - C'.Y1 wI f . C:'©Y✓l Name: P56 6,�y ' a—� OFFICE USE ONLY When the submission is complete (including check): ➢ Date stamp plans and letter > Complete and attach Receipt "( � ' (J 15 A Copy File; Forward to Consultant. Enter on Log Sheet and Database OD UD 0 o CL 0 0 m Z Z ca •- - a c� El 1:1 O Z N 3 N O O n -� 0 m D V U) O m ° ?o El 3 r o LO -a _ U cB a a ❑ ❑ E CL O N d Z Z co t/1 co ❑ o Q m c U C 7 N o E _ ° ai Z N D � a 3 a co N o w a m d o U 2 W > Z O °o o Q 9 I- ❑ (n ° N > ❑ p W .° E y m <n vi U iri o c c 0 Q ;a >' Q o >' > Yy a c Ofn !- J In "= J LL O i+ _ Z Z Z Z E ❑ ❑ ® ❑ ❑ O U C N CO Q as ® ❑ ® ❑ o U) _ Cl. CI. (I. V U _0 c a (� > c c c }+ `- N Q _ m -0 �0 O z 0 o vn J N O O O CI.J N � � s z (� = 1- (n a`) Q o o o (� — N > 0 p C C O O 0 N N O N -°p 4- C N N ) � (0 LL E c c !- — c z o Q Y D O E c c �, LL U O co Z U cn U U) cn c9 tL Q U O M U N U Ir � NO a 0 O = p o Y C N cis n °' °' Z o rn N � m o N ® a) a L m o, (B M o 0 o ❑ co- a _N CL Q � Y w o N p c ❑ a O °' O U O ° U) � 0 0 to� a� H � o m C° 4i � a a) ° ° °o . °o .. a) a�°i a o n °' n w a) o Q 3 M ❑ a m Co a C: Z 4a a °' mn Q ,F m m `- J > (is C m>, >, — > O , _ �, m U) LL L LO � o 4O- N o ` cB m 4- 0 0 o. E a� � o c O � ❑ O N o 0 O o � mmn o N N O n °' n w m Z a N ❑ NO Q > u. r >+ o 12 o ❑ ►: o ° C _ J J } O Co W m >+ Q ® O to > Z an d a) a J U) C7 o o C- O J t y_ Q �_ w O Ym _ C N Q a) O •� •� p > > Q = z Cl) m o ❑ 4- 3 O r = W a> mn co mu c � � o o _ �, 0 3 � o c c c o o c � E E O E 0 E O D J ( J 0 0_ U' W M O O V U LL C) M cci U N `p On" O Q 0 w ( M O m m d d � N U (D O N O O 0. N ) O N U m a) U) _ F- C Q h o N o U) y w 44) (D d dd ao E LL L> Q M c' U ++ o LPL -J Q U E 0 0 (n LL L N .�..r y 2 _ . LL v y o W °° v � d E Q 'a t p N Q d Q Q w d 4a o ° cn �= d m V = N � (D � K (`) Cl) U1 O �+ O Z a �- �- Lo LO m -o N M'�O Or or N N gQ � = 02 o = '0 '> o 0 o _ cCZ � Xm Q U U o J m C C r O V) Q C Q E 0 _ o C co co 4 c ? 'a M CC aai a0 N w Q M V U LL 0 h. U a 0 0 00 O 2 p O c d O m A w w z O °) N (6 o ca) ® N m °> a U c ce) O @ ❑ p U) a 0 Mn Q '0 O O m J N 0 c N ❑ N O j O ° ° L V� O 0 LL m � a O a C 0 C CD a) EE N 00 o` � N m a)z a N 3 nw nom? ❑ Q w B Cl) 0 E (Z U) — ° j P a m o U) 00 z >, o 0) v o U) c >, E O d D `� 0 _ N LL L L C -fie _O O o O >a E N > o O p a C o 0 O U O O o r- m 11� m O Av+/ (co n 4? n 2 76 z (D W L6 ® C Q) CV m - N 0° > a .� m❑ U _ =3 L: 0 L- c c n o w >, Q El fn > .� Z c6 m �- O D J cn U) O O � 0 °o •° O OL d Q Cl) 3 = � O3 :° e Q t O Q 0 � ° ° Om o O.w a Z El a� CO r O oo o uoi cNOi 3 O C C: E d 0 o � °' o p m 0 O o a. 4- U' W M V U LL C) C-i cli Lri 'o U U 00 0 y o Y LO O 0) d V O N O v> Q U � 3 m O CL o od d w c o c d d E �o °� Li> U Q a - a o' L) m U o xQ 0 C F= LL -i � o O0 LL L .. a� a E U— v d N = N 0.0 `o G� E c N K v Q o0 v � r N � � a= C �j 0 N (D M N > U RSA 2N O }O N 0 02 C cn Q v _ O y. — _ U) O .c '0 '� o `o oC o Q o Z _-�' m U z 3 O r = Q c C: V- 0 ., o o- c Q ;= a) L i N i O O O d N W Q c� V V LL V m U COI U r � a, 0 00 C) 16 O Y c O A °? °�' Z O rn (U io co o N ® a) m 0) CL U C N O ❑ a N C] w C CL U) Y U >Q N Y a C f0 ❑ N O c N ;: G _j °' O °- tA m 0 a O LL ` d o 0 c 2 E A, o a) N W L E O O m N c aa)i _O _O d a) a a> o n w n w N _ m Q 3 O ❑ 3 E o zz 24 j a) N - �? o �A co N N @ J= °' € O = � fn lL co L v � C `1 _O O N o Q E z o 0 O a V Z) c E � o � O � G1 ❑ v O _ _ N N y0 O a) LO a) O O n v°'- n ,a? ca z G� N N ' 'd - Q a) LL d A-A N ? pOp ❑ u> G) o c } 3 o ° w Q V> U) 0> 0 Z N `-° d m c- _j U) O cC%) 3 = 03 � o a Q y- Q OQrn .� c� y O 0 _ _., Z � o El o d 4-- d 3 0 cn ca cu a C 0 r (n O o a j CL E 0 E = y c0i o � U � a o E ;, o O o ° U` o a `t- U` w O C) U LL U N M v Lri M O 3 - a y o U) O m ca a d ' _ vw ti o p y O c o U c V) o 0 a O N p in CL N N o N d y N C O C N++ En �! E E (n N t6 p O N 3 U LL> Q Q� N a c' > U .) O o U K J Z O `_� LL J U) 0 U LL L A+ d U- .2 _E£ O N K U d 4.0 � oc t ,Q v N N O ce) M N > U �� � W >- U) 0 Z 22 O O N //\ N _ O w Q = N ° O cu ` m Q z ai = M m V Z -0 fn cD G Q E O _ a) �. n cfl co fn L t N _0 _ o O d '� N w Q u U LL U ° M M - N a o ao N o CU (p a) D) O L 00 'O a) O Cfl v O U o 00 Lb � p tl Q m .� m m m > w CL _ _ _ _ J ^ ? Q C Q a' a� o a� d 0 J E ai U) 3 0 Q a� w a as `� N - � U) U) � O C W N K V- L O 0 m m @ C .F+ > 3 m C E 0 W v L' N O a 2 ° G1 a o o ¢ C N C c C L O a p o m 2 o to >1 N a� -n m (D 4) . O U) ++ > s? L) � ��( _� ?: O A CcC a c C n O 3 t� > O O N O O to O 4- N CU Z V/ • _ O G(n O N 0E El 4- -O 4-- "O -O 0 N o O 0 .2 > > O O CU -a o a) O 3 Z � N O 3 . — 0 3 r •� ) �+ O z O Z M O. 0) C r d o m o o Q) C U x Q a co j E 00 O U LL ro r f/7 C U U N N d O -O W o c a- N O (0 = O d Q1 O � � (3)r O-U C (/7 co O U) Oro >, c (� c (ll co 0 O . (�O O ® CO co G C +' E v ® E + = ro N qqq� 0-0 m U ` C w O Q s O (0 ro n *� ro QJ � = 0 w > c aro — ma) 2 in O c 2 r d ° c = a O U) < w 0- j > N 6Oi o o cp I c ' m r M 0 E O ' m/5 O O LG E 4� .!= O � E r a c — O I._ �. .W N O a) ® N = L 97 R. gcj `a) 0 W O j Q dy= e (n .0 U) U � s v ® ce) N - }' r N S O to > 0 = U O s > T n3 tll m} -0 0 '"w W 0 (0 r a) 0 O ro 0 ' E Q . �cu ® ,w o@ o R3 Z O O O c Qy (6 c m v O _ c QR Od „r `„ c d O pOp vi 0 7 a° 4=- U o Q' o n, 3 a�iro � U U LL LL igD—, o Commonwealth Of Massachusetts City/Town Of North Andover r Percolation t 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. Important:When A Site Information filling out forms ' on the computer, use only the tab Gordon Family Trust ------------ ----------- ___ __ key to move your Owner Name cursor-do not 602 Boxford St LOT 1 use the return key. Sttrere et Address or Lot# North Andover MA 01845 ---------------- ----------- rr� City/Town State Zip Code Philip Christiansen 978.373.0310 Contact Person if different from Owner Telephone Number B. Test Results 1/14/2015 9:26 1/14/2015 9:28 Date Time Date Time Observation Hale# 1-A 1-B Depth of Perc 6 + 16 =22 22 + 18 =40 Start Pre-Soak 9:26 ------------- 9:28 End Pre-Soak 9:41 _ 9:43 Time at 12" Time at 9" WOULD WOULD Time at 6" NOT MAINTAIN NOT MAINTAIN Time(9"-6") WATER WATER Rate (Min./Inch) <2 MIN/INCH {2 MIN/INCH ------- -- Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Philip Christiansen ----------- ---------- Test Performed By: Isaac Rowe Witnessed By: Comments: t5form12.doc•06/03 Pero Test•Page 1 of 1