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North Andover, MA 01845
Ms. Sandra Starr, R.S., C.H.O.
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover,MA 01845
April 24, 2001
Dear Ms. Starr:
Due to an oversight on my part,I neglected to submit the$60.00 fee for the revised plans dated
2/8/01 for the repair of the septic system for 360 Forest Street. Enclosed is a check for this
amount. Please accept my sincere apologies.
Yours truly,
Frederick W. Dekow, M.D.
-
'1'oWn of No rtll And®ver NORTFr
Of SSIEO 16�'Y
Office ®f the Health Department r
o p
Community Development and Services Divisi®n '
William J.Scott,Division Director �R °�'I '� '' "
27 Charles Street �9SSAC►+us�`�y
North Andover,Massachusetts 01845
Sandra Starr Telephone (978) 688-9540
Health Director Fax(978)688-9542
March 2, 2001
Bill Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 01810
Re: 360 Forest Street
Dear Bill:
This is to notify you that the revised plans dated 2/8/01 for the repair of the septic system
for 360 Forest Street have been approved. A variance to depth of ground water from four
feet to three feet was granted March 1, 2001.
Please note that because of ground water variance, there may be no additional rooms
added on to the structure as long as lot served by on-site subsurface sewerage disposal
system.
If you have any questions, please do not hesitate to call the Board of Health Office at
978-688-9540.
Sincerely,
Sandra Starr, R.S., C.H.O.
Health Director
S S/smc
cc: Dekow
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535
MER IMAC K ENGINEERING IN EI VI ;E , INC,
PROFESSIONAL ENGINEERS a LAND SURVEYORS 0 PLANNERS
66 PARK STREET•ANDOVER,MASSACHUSETTS 01810-TEL(978)475-3555,373-5721 ®FAX(978)475-1448^E-MAIL merreng @aol.com
February 8, 2001
Ms. Sandra Starr, R.S., C.H.O.
Health Director
Town of North Andover
27 Charles Street
North Andover, MA 01845
RE: 360 Forest Street
Dear Ms. Starr:
We are in receipt of your review letter dated December 14, 2000 for the above referenced
project. You noted 3 technical deficiencies. Our response to these deficiencies are as
follows:
1. We adjusted our local upgrade request for groundwater-offset from 3.5 ft. to
3.0 ft. to meet the offset from the highest existing grade. The entire leach field
cannot be raised as designed because grading would extend beyond the
property limits (note the narrowness of the lot) also raising the system would
cause drainage problems at the building foundation and the front stairs would
become buried.
2. 310 CMR 15.232 (3)(2) requires an inlet tee or baffle extended 1 inch above
the outlet invert. Note the plan profile specifies a tee to be installed inside the
D. Box which will extend 1 inch above the outlet invert as such this
requirement has been met.
3. Only one test pit was performed within the system location because the
proposed system is halfway within the existing system location thus precluding
us from conducting a second deep hole. We request this requirement be
waived given the space limitation on site.
We hope we have adequately addressed your concerns regarding this design. Please contact
us if you have any further comments or concerns.
Very truly yours,
MERRIMACK ENGINEERING SERVICES
William Dufresne
Project Manager I 20N
cd
Town of North Andover -oF tk0NT b_q�
Office of the Health Department
o
Community Development and Services Division
William J. Scott/Division Director
OAATE° Fy.(5
27 Charles Street �pSSgcwU
North Andover,Massachusetts 01845
Sandra Starr Telephone(978)688-9540
Health Director Fax(978)688-9542
December 14, 2000
William Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 01810
Re: 360 Forest Street
Dear Bill:
This is to inform you that the proposed plans for the site referenced above have been
disapproved and have technical deficiencies as followed:
Groundwater separation not adjusted to the highest existing grade as required by
- 310 CMR 15.240 (1). It appears that the leeching field needs to be raised by
approximately 0.55 feet.
• Inlet baffle not provided for distribution box as required for a dosed system in 310
CMR 15.232 (3)(a).
• Minimum of two deep observation holes not provided as required by 310 CMR
15.102 (2).
If you have any questions,please do not hesitate to call the Board of Health Office.
Sincerely, n
Sandra Starr,R.S., C.H.O.��°�
Health Director
cc: Dekow
file
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535
Ctec-13-00 05:27P Paul D. Turbide, PE/PLS 978-465-0313 Pd02
December g, 2000
Sandra Starr
Forth Andover Board of Health Administrator
Office of Community Development and Services
30 School Street
North Andover,MA 01845
Title V review for SDS upgrade at 360 Forest Street
Dear Sandra,
Enclosed find our review of the"Checklist for North Andover Septic System Plans" for
the septic system upgrade at the above-mentioned site. The following is a list of
technical deficiencies that Port Engineering has found.
• Groundwater separation not adjusted to the highest existing grade as required by
310 CMR 15.240 (1). It appears that the leeching field needs to be raised by
approximately 0.55 feet.
• Inlet baffle not provided for distribution box as required for a dosed system in 310
CMR 15.232(3)(a).
• Minimum of two deep observation holes not provided as required by 310 CMR
15.102 (2).
If you have any questions or comments please feel free to contact me.
lncerely
Pat
•;(� fin'- 'F,) ,�, .
T1;�r. a; .
1= i t•
Paul D. T rbi e,PE/PL
PORT
INGINIERING1
Civil Engineers&
Land Surveyors
One Harris Street
Newburyport,WA
01950
(978)465-8594
1\Seiver KNA13W2884Torest St 36ODOC
SEPTIC PLAN SUBMITTAL FORM
LOCATION: o 7°(" �-1 -C
NEW PLANS: $125.00/Plan
REVISED PLANS: YES $ 60.001P1an
SITE EVALUATION FORMS INCLUDED; (! NO
DATE: 11-2-1
DESIGN ENGINEER:_ "fQf
jjA�b9cAL taLI , IBC
DATE TO CONSULTANT:
*If you want your plans expedited, please submit three plans and included a
stamped envelope with the correct amount of postage to mail playas to Port
Engineering.
When the submission is all in place, route to the Health Secretary.
Page 1 of 5
9A-APPLICATION FOR LOCAL UPGRADE APPROVAL
Commonwealth of Massachusetts
North Andover, Massachusetts
Application for Local Upgrade Approval
Title 5, 310 CMR 15.000
DEP approved form required by 310 CMR 15.403(1)
To be submitted to Local Approving Authority/Board of Health: For the upgrade of a
failed or non-conforming system with a design flow of<10,000 gpd, where full
compliance, as defined in 310•CMR 15.404(1), is not feasible.
To be submitted to DER For the upgrade of a failed or non-conforming system with a
design flow of 10,000 up to 15,000 gpd and/or for upgrade of state of federal facility,
where full compliance, as defined in 310 CW 15.404(l), is not feasible.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that
includes the addition of new design flow to a cesspool or privy or the addition of new
design flow above the existing approved capacity of a system constructed in accordance
with either the 1978 Code or 310 CMR 151000.
1) Facility/System Owner:
Name: Frte o D&k-cvA
Address: 3&V Fc,ttcy'f" �trte /Ne,-AtjWvEw-- M _ 0iVK
Phone#:
Address of facility:
2) Applicant(if different from above)
Name: ?A ref s
Address:
Phone#:
3)Aesidential pe of Facility:
Commercial School Institutional
(Specify)
Page 2 of 5
4) Type of Existing System:
_privy cesspools) ✓ conventional system
other(describe)
Type of soil absorption system(trenches, chambers, pits, etc.) r e'W52
5) Design Flow Based on 310 CMR 15.203:
a) Design flow of existing system` le gpd
Approved: des Approval date: I'l M,
no Why:
b) Design flow of proposed upgraded system bpd Why --
c) Design flow of facility AIA. gpd
6) Proposed upgrade of existing system is:
a) -%/VNoluntary
required by order, letter, etc. (attach copy)
Required following inspection required by 31 CMR 15.301
(provide date inspection form was submitted to the approving authority)
(date)
b) Describe the proposed upgrade to the system:
I-1� 1 c�(.�ri,._ ✓Ju r-►n C ���- r fi.lH G��Fac►5 r /�oc�C� T�tn/k-Tlsc ci�i�!)
t..�i,J Gv� � L.��� 1✓i�-►J
c) Which of the following are applicable to the proposed upgrade?
Reduction of setback(s)(list setbacks to be reduced with proposed setback
distances)
Percolation rate of 30-60 minutes per inch(state actual perc rate)
M Up to 25%reduction in subsurface disposal area design requirements (state
required& proposed size)
Relocation of water supply well (identify well, describe relocation)
�! Reduction of required separation between bottom of SAS & high/
groundwater(specify proposed reduction&perc rate) q '
Page 3 of 5
Other requirements of 310 CMR 15.000 that cannot be met(specify sections
of the code)
System upgrades that cannot be performed in accordance with 31 CMR 15.404 &
15.405, or in full compliance with the requirements of 310 CMR 15.000, require a
variance pursuant to 310 CMR 15.410-15.417.
7) If the proposed upgrade involves a reduction in the required separation between
the bottom of the soil absorption system and the high groundwater elevation, an
Approved Soil Evaluator must determine the high ground water elevation
pursuant to 310 CMR 15.405(1)0(1). The evaluator must be a member or agent
of the local approving authority:
Distance from soil absorption system to high groundwater 4,5 feet
As determined by:
Evaluator's name: �7�k2 i2 �T ✓L1'L
Evaluator's Signature:
Date of evaluation: y-2--�-
8) Notice to Abutters:
No application for upgrade approval in which the setback from property lines or a
private water supply well is reduced shall be complete until the applicant has
notified all abutters whose property 9or well is affected by certified at least ten
days before the Board of Health meeting at which the upgrade approval will be on
the agenda. Such notice shall include the date,time and place where the upgrade
approval will be discussed.
If the department is the approving authority,then such notice to abutters must be
completed prior to the date of submission of the application to the department.
The notices to abutters shall include a copy of the completed application form and
shall reference the standards set forth in 310 CMR 15.402 through 15.405.
Page 4 of 5
List of affected abutters:
Abutter Name Date notified
Address
Abutter Name Date notified
Address
Abutter Name Date notified
Address
Abutter Name Date notified
Address
9) Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible
(each section must be completed):
a) An upgraded system in full compliance with 310 CMR 15.000 is not feasible:
1N
Ki us—'JJAC jAiQIAC5T oK 474—rGH C iit.S 1 N51M LL"
fn IV C01,2 L2-1 hrwC �i 111� IVIA9113:Z s 1, LtolC-Lc� I�rIJST1GtJC77N(fi
vtj:�T�bj L16 141.ELL1'- T-L He-,L tt P-eak-c4. r 12 w i yeHsur
b) An alternative system approved pursuant to 310 CMR 15.283-15.288 is not feasible.
0:92
c) A shared system is not feasible.
d) Connection to a sewer is not feasible.
10) An application for a disposal system construction permit, including all required
attachments (e.g. plans & specifications, site evaluation forms), must accompany
this application. Is the DSCP application attached?
yes ✓no
Page 5 of 5
11) Certification
"I, the facility owner, certify under penalty of law that this document and all attachments,
to the best of my knowledge and belief, are true, accurate, and complete. I am aware that
there may be significant consequences for submitting false information, including, but not
li4top ies or fine and/or imprisonment for knowing violations."
Signature bate
'Print Name
�i I u 12-u�rsU
Name of Preparer Date
Telephone No. &Address of Preparer
NOTE: Title 5,310 CMR 15.403(4) requires the system owner or operator to submit
to the Department a copy of the local upgrade approval upon issuance by the Board of
Health and prior to commencement of construction.
FORM O - I<yr RELEASE FORM
INS ® RIONS:
appr�vls This fora is used to verify/Permits from Boards and Depa Y that all necessary
have// bf en obtained. ants having
landOW er from compliance width not relieve the a Jurisdiction
re °�4, ions or Y aPPlicable loccal�c t
and/or
requirements. ®r° state 1
****************Applicant fills out this se
APPLICANT:
Phone
LOCATION: Assessor ' s
Map Number Z6 ; Parcel
Subdivision
Street Lots)
St. Nuuibex' E%?
Official Use
Only********************
RE COMMENDATIONS OF TOWN AG
ENTS:
Conservation Administrator Date Approved
Comments Date Rejected
LA.-Town Planner Date Approved
Date Rejected
Comments
" Food Tns ctor- Date Health Approved
Date Rejected
��6 is nspector-Health Date Approved
�-- Date Rejected
Comments
Public Works water conn
sewer �`-
� ections
- driveway permit
Fire Department
Received by Building Inspector
---- Data
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WELL DATABASE
ADDRESS:
AGE OF WELL: WELL DRILLER:
WELL PERNUT r: WELL LOCATION:
NIA,
WELL PERN[IT DATE: DEPTH OF WELL:
r'
TYPE OF WELL: a.. DRILLED b. DUG c. UNKNOW
TYPE OF WATER BEARING ROCK:
WATER ANALYSIS DATE: H MANG NESE: Y N
HIGH IRON: Y N O'T'HER.CONTAMI2��1`�IT ; Y N
„ P.
WELL DATABASE
ADDRESS:
AGE OF WELL: `7 WELL DRILLER:
WELL PERi�ET#: WELL LOCATION:
WELL PERMIT DATE: ? DEPTH OF WELL: 77
TYPE OF WELL: a.. DRILLED b. DUG c-,c- O0 Y`N�)
TYPE OF WATER BEARING ROCK:
WATER ANI ALYSIS DATE: HIGH MANGANESE: Y N
HIGH IRON: Y N OTHER CONTA:Iv HANTS: Y N
: Town of North Andover, Massachusetts Form N®.2
Q aoRrH BOARD OF HEALTH
o`t..o , 9ao
L �
p
' � 6
��'bq,;p';,t•''•' DESIGN APPROVAL FOR
: ,ss'"""S SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant /--/C '-°° Test No. f
d
Site Location
Reference Plans and Specs. ? s.
ENGINEER DESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
CHAIRMAN,BOARD OF HVALTfl
�l
Fee
Site System Permit No.