Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Building Permit #Exception - 224 SUMMER STREET 5/1/2018
r TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Cf NCRTh 0 s p � Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �a I j� n PROPERTY OWNER �U -y) Q, C�� 5 Print� � I Print MAP NO.: PARCEL: y ZONING DISTRICT: 3'YPE AND USE OF-BUILDING ---------------.---_---.HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No.of units: j ❑ Repair, replacement ❑ Assessory Bldg ❑Commercial f ❑ Demolition i ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED C) Identification Please Type or Print Clearly) Y) OWNER: Name: am " Phone: I Address: o?at{ (Sur,,rY,er S� f ' CONTRACTOR Name:_e65-I' �c�a�w v-r�-► N Phone: I Address: 1 I Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: I ARCHITECT/ENGINEER Name: Phone: i Address: Reg. No. ' i FEE SCHEDULE.BULD/NG_fERM/T:$12.00 PER$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 3qL49 -4.5 FEE:$ Check No.: Receipt No.: Page I of 4 a TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ 11 Tobacco Art ❑ g Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor . Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM - --- —_ -- ---- - --- - -- --- - --------DATE REJECTED ----DATE APPROVED-------- -- PLANNING& DEVELOPMENT ❑ ❑ COMMENTS k E REJECTED DATE APPROVED CONSERVATI (� 1 COMMENTS DATE REJECTED DAAAPPROVED HEALTH ❑ ❑ 111L 74, pr r COMMENTS - - 4 FIRE DEPARTMENT - Temp Dumpster on site yes n Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/signature& Date Driveway Permit i i 1 r,. i CLcERF/ED PLOT P UN LOCMTED /1V0.�?r!`f...'h^!.r�a';v .� C,-//?/ST/.4N.5EN //4 VE.', ,UQl�EellIz-L, M \ ' °v CO f ti i 1 ap y�Sy f v 0 j EX IST. TND . L aT 3AB i a -- Q A = 43, r jr I N I N a. .f , � 0 UG 1. ROAO ZMPROvEM£NT G►LES S IVT 1^IqO. 1.1972 I 1,- l = I I8 •31 SVAV� � 1 ' S U M r—\� ER STR E'E-i Cz/ENT• . ORf3s....!��Ac?-Y... Rvs.T .. ...... ... .... . / CECT/FY rv4r TW6c ... ... ... .. . ..... ....... .. .. ... . OFF5ET5 . 5//OWN ,4eE FOR T1115 L OT IB(//L D/N(� 511O/N ON T11/,5 ZON/NC7DETERM/N.4 TION N /5 �v o /N PL 4N CONF02M5 TO T1.1E ONLY ,4N0 Qr� NO i E T TO BE ,4 FL DDD r ZON/N C BY- L.4GiiS OF TrS/E USED TO ES74BL/SN P�eO - 114Z•4,eD 1 To,w iv.... ... OF�vo�Tf,! ANDov6� PE,eTY L INE-5. ZONE. Town of North Andover NORT#1 Office of the Health Department 10 Community Development and Services Division 4 � .a 27 Charles Street °R4n0♦�'yqh North Andover,Massachusetts 01845 4SSACHUSE� Heidi GriffinTelephone(978)688-9540 g Acti Miblic Neahli Director Fax(978)688-954.2 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE October 15, 2003 This is to certify that the individual subsurface disposal system constructed O or repaired (X) by John Soucy at 224 Summer Street has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North.Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactoril Jona Marke Y Chairman,North Andover Board of Health BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 T VM OF NOP'T OF HUU-TF; �f- 2 2003 TOWN OF NORTH ANDOVER SEWAGE DI00 _ S STEM INSTALLATION CERTIFICATION The undersigned hereby reby certify that the Sewage Disposal System( )constructed; .(,x)repaired; by located at o2 2 11 SC-)^A AA was installed in conformance with the North Andover Board of Health approved plan, System Design Permit.# ,plan dated , with a design flow Of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR.15.000,Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection te: Gl 3 3 Engineer Representative I Installer Lic.#: Date: Engineer.g r. Date: � � O✓� n c TANGARD 13021 M41�FSFG!ST �C�\��� s'QNA� /trly 'i d L BOARD OF HEALTH0-N N a Location w O Z Permit # 0 3 Food Service $ up c Retail Food $ a a Z a Limited Retail $ � Z _ v? Seasonal $ _ a > u a� Di al Works InstallersCe $ a U.1 E... o `o Q i Disposal Works Construction $ � > 2 in _ 0 Q v .°_N0 Soil Testing r- 0c �, 1 —/ .0e Design Approval Permit $ s Y m i Q Z m 0O �` o Dumpster Permit $ v o Jc Burial Permit $ Q 3 0 o N t Swimming Pool Permit S a� !— a- N b Animal Permit $ LU >. N " Recreational Camp Permit $ z N Well Construction Permit $ I t H e oojea *** c0 `_^ OQ \Y`lJ `,, Funeral Directors Permit $ r _ "•.i�tiY� o 0 Massage Establishment License $ �Q J E 3 (U Massage Practice License $ aMo1 *** Q N a. Ln ! Suntanning Establishment $ Offal/Trash Hauler $ i other t ; 6853 Health Agent Vy ite - Applicant Yellow - Dept. Pink - Treasurer APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: t(., M-0-3 CURRENT INSTALLER'S LICENSE# LOCATION: t ( w,. •, $° , LICENSED INSTAL R: m NKK SIGNATURE: TELEPHONE#117 CHECK ONE: REPAIR: ZNEW CONSTRUCTION: IF NEW CONSTRUCTION,PLEASE ATTACH FOUNDATION AS-BUILT. i Administrative Use Only $175.00 Fee Attached? Yes� No Foundation As-built? Yes �- No Floor plans on ' e? Yes �—` No pp ate. A roval D • i � 07 ,' 1/n�S 'q�G'' f1X � v�1lG� (S S✓e� Pee P 7 t TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( )constructed; ( ) repaired; by d C located at L /ls« was installed in conformance with the North Andover Board of Health approved plan, System Design Permit.# ,plan dated , with a design flow Of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative Final inspection date: Engineer Representative Installer: Uc.#: Date: Engineer: Date: r 4 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the'North Andover licensed installer for the construction of the septic system for the property at .)u P"&,0___ relative to the application Of dated for plans by and dated with revisions dated I understand the following obligations for management of this project: 1. . As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable. 2. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile'5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to beP resent. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the, system,"and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersi Licensed SeP tic staller Date: Dispos 1 Works Construction Permit# ' Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer'<info@milldverconsulting.com> To: <pdellechiaie@townofnorthandover.com>; "'Brian LaGrasse"' <blag rasse@townofnorthandover.com> Sent: Monday, September 01, 2003 3:42 PM Attach: Summer#224 Final Const Insp.pdf Subject: Summer Street, 224 Final Construction Inspection Attached. The contractor needed to make one field change to the inlet tee which he began doing as I departed, so I think it is safe to say it was completed. I'll check next time I'm in the neighborhood. Dan 9/8/2003 Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer"<info@milldverconsulting.com> To: "'Pamela DelleChiaie"' <pdellechiaie@townofnorthandover.com> Cc: "'Heidi Griffin"'<hgdffin@townofnorthandover.com>; "'Brian LaGrasse"' <blag rasse@townofnorthandover.com> Sent: Friday,August 29,2003 12:23 PM Subject: RE:System Final Requests:224 Summer St. &45 Boston St. All set. Going to Summer Street this afternoon and Boston street on Wednesday. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@milliiverconsulting.com -----Original Message----- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com] Sent: Friday, August 29, 2003 11:22 AM To: Dan Ottenheimer Cc: Heidi Griffin; Brian LaGrasse Subject: System Final Requests: 224 Summer St. &45 Boston St. Importance: High Hi Dan, Two requests for you: John Soucy has a request for a System Final on 224 Summer St. He was hoping to have it done today, as he did not want to leave it open all weekend and risk getting the stone dirty. His cell#is: 603.216.7175 (left v.m. as well). John DiVincenzo has a request for a System Final on 45 Boston St.for next Wednesday, 9/3 noon. 4 Y y, @ Please call him at 978.807.9722. Please notify me with regard to whatever you schedule. Thank you for your assistance. Pam i 9/8/2003 Page 1 of 1 E Pamela DelleChiaie From: "Dan Ottenheimer"<info@milldverconsulting.com> To: <pdellechiaie@townofnorthandover.com>; "'Brian LaGrasse <blag rasse@townofnorthandover.com> Sent: Monday, September 01, 2003 3:42 PM Attach: Summer#224 Final Const Insp.pdf Subject: Summer Street,224 Final Construction Inspection Attached. The contractor needed to make one field change to the inlet tee which he began doing as I departed, so I think it is safe to say it was completed. I'll check next time I'm in the neighborhood. Dan 9/3/2003 �\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION METROPOLITAN BOSTON — NORTHEAST REGIONAL OFFICE MITT ROMNEY Y�{ ELLEN ROY HERZFELDER 1 Governor Secretary KERRY HEALEY ®Q \ ROBERT W. GOLLEDGE,Jr. Lieutenant Governor Commissioner July 15, 2003 Richard DeVincentis �_-- 224 Suminer Sheet North Andover,Massachusetts 01845 RE: CORRECTION TO STATEMENT OF TECIINICAL DEFICIENCY Application for BRPWP59b: Title 5 Variance 224 Summer Street,North Andover(17-Ipswich) DEP Transmittal No.W039249 Dear Mr.DeVincentis: On July 14,2003,the Metropolitan Boston-Northeast Regional Office of the Department of Environmental Protection issued a statement of technical deficiency for the above-referenced project. The Department has just learned of a typographical error in that statement._ Please delete the first bulleted deficiency and insert in its place the following: • The Alternative to Percolation Testing Policy,BRP/DWM/PeP-P00-4,dated September 8,2000, requires that applications for percolation variances include the Soil Evaluator's determination, along with the written concurrence of the Board of Health,as to whether the soils are uncompacted or compacted. The Soil Evaluator's determination has been submitted.The Department requires submittal of written documentation from the Board or its agent that the Board's agent concurs on the Soil Evaluator's determination of the soil compaction. The Department trusts that this error has not caused confusion. If you have any questions regarding this matter,please contact Claire A. Golden of my staff at(617) 654-6516. Very truly yours, Madelyn Morns MM/CAG/cg Deputy Regional Director \2003 variances)\w039249ctdI Bureau of Resource Protection cc: • Sandra Starr,R.S.,CHO,Director,Board of Health,27 Charles Street,North Andover,MA 01845 • Richard C.Tangard,P.E.,New England Engineering Services,Inc.,60 Beechwood Drive,North Andover,MA 01810 This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. One Winter Street,Boston,MA 02108•Phone(617)654-6500•Fax(617)556-1049•TDD#(800)298-2207 DEP on the World Wide Web: http://www.state.ma.us/dep i,"a Printed on Recycled Paper Town of North Andover �oRTN O��t�en 6'a•t• Office of the Health Department Community Development and Services Division 27 Charles Street Teo North *Py North Andover,Massachusetts 01845 usw�� Sandra Starr Telephone (978)688-9540 Public Health Director Fax(978) 688-9542 April 25, 2003 Ben Osgood, Jr. New England Engineering Services, Inc. 60 Beechwood Drive North Andover, MA 01845 Re: 224 Summer Street Dear Mr. Osgood: This letter confirms that at their regularly scheduled meeting on April 24, 2003 a duly advertised hearing was held to determine whether the North Andover Board of Health would consider a variance to 310 CMR 15.000,the State Environmental Code, to accept the results of a sieve analysis in lieu of a percolation test to determine the loading rate for a septic repair design at 224 Summer Street,North Andover. After deliberation the Board voted unanimously to approve the variance request and accept the sieve analysis results. Should you have any questions,please do not hesitate to call the Health office at the above number. Sincerely, Sandra Starr, R.S., C.H.O. Health Director Cc: File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 NEW ENGLAND ENGINEERING SERVICES INC BOAR')OF HEALTH MAR 3 41003 March 27, 2003 Sandra Starr,Administrator North Andover Board of Health 27 Charles Street North Andover, MA 01845 Re: 224 Summer Street, Septic system design Dear Sandra: Enclosed are the final soil evaluator sheets for the above referenced property.. Sincerely, Benjamin-2 C. Osgood,J IT President 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 jZ FORM 11 - SOIL EVALUATOR FORM Ty y Page 1 of 3 1200 �,� � No. `t Date: Z /4ey- Commonwealth of Massachusetts achusetts Massachusetts Soil Suitabilitv Assessment for On-site Sewage Disposal Performed By: ...... .....��� . J ...... ....... . lo, � Date: ///911Z-- Witnessed By: .............. �f1X/..... !, x..l................ ......... . Location Address or 27i� j��//I���`f,� ' owira's Nome. ielamoo) /D La I �w � Address,and �z.4 Telephone New construction ❑ Repair �7 Office Review Published Soil Survey Available: No ❑ Yes Year Published lel-W................. Publication Scale / Soil Map Unit 4,,E:;' Drainage Class 1/471- L................ Soil Limitations /..!. ...... Surficial Geologic Report Available: No R1 Yes ❑ Year Published Publication Scale GeologicMaterial (?Flap Unit) ..............................................................................I...................... ..... . Landform ..........................................I.............................................. Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes W] Within 500 year flood boundary No []Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) _.............. .. .............. ... .. _ .. Wetlands Conservancy Program Map (map unit) .......... ......................................... ........... Current Water Resource Conditions (USGS): Month/\/0dfi*gjm 2JW�" Range :Above Normal ❑Normal k�Belcw Normal ❑ Other References Reviewed: DEP APPROVED FORM• 12/07/45 4 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. On-site iew Rev A /� a Deep Note Number I Date: �.i '� Time: lt.- ��' � Weathe4e Location (identify on site plan) LST'., Land Use % � it`�,�L Slope M Surface Stones Vegetation LandformT /,g Position on landscape 75%,P.,6' 3'GOf'16,. Distances from: Open Water Body 2G''O'o feet Drainage way feet Possible Wet Area Z (5� feet Property Line feet Drinking Water Well 7/6 0 feet Other DEEP OBSERVATION HOLE LOG" Depth from Soil Horizon Soil Texture Soil Color Soil Other Q Surface (Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, /a Gravel) ev X71✓ �o9 is y�/L �y 6i3 �o --��i �� �S •may 4 �� Parent Material (geologic) 0& -% DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: R Estimated Seasonal High Ground Water: _ DEP APPROVED FORM• 12/07/95 FORM 11 - SOIL EVALUATOR FORNI Page 2 of 3 Location Address or Lot No. 204 vumw'w 511 �'�,�•Cr�l��1�., On-site Review Deep Hole Number .Z Date: ;X11 .71 Time: �,�D Weathere/Z>y- �p Location (identify on site plan) 7� :....T.....G'�7 . Land Use/5 !/ > ,%L. Slope {%y Surface Stones .. .:. . Vegetation Landform 47v1Z6v'o1- Position on landscape Distances from: Open Water Body2©� feet Drainage way . feet Possible Wet Area .150 0 feet Property Line �.�'� feet Drinking Water Well? 15-0 feet Other DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsel(i Mottling (Structure, Stones, Boulders, Consistency, % Gravel) .s MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) DepthtoSedrock: Depth to Groundwater: Standing Water in the Hole: 404e:' Weeping from Pit Face: " Estimated Seasonal High Ground Water: 26 i DEP APPROVED FORM• 12/07/95 i FORM II - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. -:07-!z Determination f Qr Seasonal High Water Table Method Used: i ❑ Depth observed standing in observation hole.................. inches ❑ Depth weeping from side of�observation hole............ ... inches Depth to soil mottles ...:.:! :. inches -.,or=-/ ��o f ❑ Ground water adjustment ................... feet 70te 2lv^ Index Well Number .................. Reading Date ................... Index well level ............. .... Adjustment factor ................... Adjusted ground water level ........................................................ i Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in 60 areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on 0519 V� (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signator4 � / Date i DEP APPROVED FORM•12/07/95 TOWN OF NORTH ANDOVER O� "°o`"q S e ti a b°�' ^r •6 OOp HEALTH DEPARTMENT 27 CHARLES STREET y •...no.s..s. NORTH ANDOVER, MASSACHUSETTS 01845 Sacwas�` Sandra Starr,R.S., C.H.O. Telephone(978)688-9540 Public Health Director FAX(978)688-9542 FAX Benjamin C.Osgood,Jr.,EIT From: Pamela for Sandra Starr TO: NEW ENGLAND ENGINEERING SERVICES,INC. 60 Beechwood Drive North Andover, MA 01845 978-685-1099 Pages: 2 Fac 978-686-1768 pate: ThurSC19"-, l�3, 903-' Septic Plan Response CC: Sandra Starr,R.S.,C.H.O. Re: Health Director O Urgent x For Review ❑Please Comment 0 Please Reply ❑Please Recycle •Comments: i Attached is the response from Sandra Stan regarding Septic Plans for the following property: A copy has also been mailed to the homeowner. Please call 978-688-9540 for assistance with any questions. Thank you. i Xc: Address File Chrono File Town of North Andover NORTij p�teo 6 Rh Office of the Health Department ;a Community Development and Services Division 27 Charles Street �l q° rto rP`� North Andover,Massachusetts 01845 �Ssac►+us�` Sandra Starr Telephone (978)688-9540 Public Health Director Fax(978)688-9542 I April 25, 2003 Ben Osgood, Jr. New England Engineering Services, Inc. 60 Beechwood Drive North Andover, MA 01845 Re: 224 Summer Street Dear Mr. Osgood: This letter confirms that at their regularly scheduled meeting on April 24, 2003 a duly advertised hearing was held to determine whether the North Andover Board of Health would consider a variance to 310 CMR 15.000, the State Environmental Code, to accept the results of a sieve analysis in lieu of a percolation test to determine the loading rate for a septic repair design at 224 Summer Street, North Andover. After deliberation the Board voted unanimously to approve the variance request and accept the sieve analysis results. i Should you have any questions, please do not hesitate to call the Health office at the above number. Sincerely, Y Sandra Starr, R.S., C.H.O. Health Director Cc: File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 SEPTIC PLAN SUBMITTALS LOCATION: 5Q M M F 2 '&TeE"N Map &Parcel NEW PLANS: YES $225.00/Plan Check#: REVISED PLANS: YES $ 60.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO DATE: 31. �?, DATE TO CONSULTANT: DESIGN ENGINEER:NrW CM4up Y-fJGA[L U &- Telephone#: q7 R- &c9("-176& When the submission is complete (including check),date stamp plans, COPY for Conservation,and place in existing file with green Design Approval form. 1 NEW ENGLAND ENGINEERING SERVICES INC ,c€ r'- MAR 2 5 2003 March 24, 2003 Sandra Starr,Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re:224 Summer Street,North Andover, Septic system design Dear Sandra: Enclosed are the following documents for the above referenced property. 1. 5 copies of septic system design plans,one with an original stamp. 2. Application for approval and required fee. 3. Copy of soil evaluator sheets. 4. Copy-of soil report from United Testing Service. This plan is being submitted for approval. The approval requires that a public hearing be held in regards to the Title 5 variance allowing the use of the sieve analysis to determine the loading rate of the soil in lieu of the percolation test. This letter will serve as a request that the Board of Health consider the variance request at an upcoming meeting. If you have any questions regarding the information submitted,please do not hesitate to contact this office. Sincerely, Ben3amiz . Osgood, ; ilT President 60 BEECHWOOD DRIVE-.NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 224 SUMMER STREET Ir _-A JS-2003-0618 Project Detail Report Printed On:Thu Jul 17,2003 GIS#: 2153 Project No: JS-2003-0618 Owner of Record DE VINCENTIS,RICHARD A& Map: 038.0 Date Submitted: Apr-25-2003 224 SUMNIER STREET Block: 01.72 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Work Location: 224 SUNIlVIER STREET Zoning: Proposed Use: District- land Use: - 101 JProposed Use Detail I ISubdivision Description DWC of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2003-0016 7/17/03-Thurs.-Received letter from DEP re:Statement of Technical Deficiency. Request for approval of this system cannot be approved at this time. 1. No particle size analysis was included in the application submitted. 2. Application signed by Ben Osgood,Jr. Homeowner must sign application on page 5,or authorize in writing that Mr.Osgood may sign the application. Please call Claire A.Golden at 617-654-6516 with any questions. Permit History Type: Permit No: Issue Date Status Work Category Project No: Description of Work: Design Approval-Plans BHP-2003-0190 Mar-25-2003 Open JS-2003-0618 Design Disposal Works Constructio 1291 Apr-25-2003 OPEN JS-2003-0618 DWC Repair Soil Tests BHP-2003-0189 Nov-06-2002 Open JS-2003-0618 Soil Testing 1�1 lq GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. Page 1 of 1 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: 6(e D BVI N C EN n S Phone D L/y g LOCATION: Assessor's Map Number 3 Parcel �a Subdivision — I`/ /4 Lot(s) 3A Street . U A4 M if-A s St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: v Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected G/ Date Approved Septic Inspector-Health Date Rejected Comments /V00 S Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Town of North Andover, Massachusetts Form No.2 oq MORTp BOARD OF HEALTH w a +r b.,,,,,.• DESIGN APPROVAL FOR ass `""5`t� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant /14f,!:� /02-5' Test No. A0 7J Site Location_ a� cJU�1lLli� Reference Plans and Specs./ J �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 HEALTH Fee 'o°A 5- Site System Permit No./65W i • COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS 01 DEPARTMENT OF ENVIRONMENTAL PROTECTION a, METROPOLITAN BOSTON — NORTHEAST REGIONAL OFFICE TOVl=1 MITT ROMNEY CF +ORT�I k 1 �'•'C Ri` ELLEN ROY HERZFELDER Governor 3C,'`�M OF HD-11 'uj Secretary KERRY HEALEY ROBERT W. GOLLEDGE,Jr. Lieutenant Governor �{ 1 7 2Q03 9 Commissioner July 14, 2003 Richard DeVincentis 224 Summer Street North Andover,Massachusetts 01845 RE: STATEMENT OF TECIINICAL DEFICIENCY Application for BRPWP59b: Title 5 Variance 224 Summer Street,North Andover(17-Ipswich) DEP Transmittal No.W039249 Dear Mr.DeVincentis: The Metropolitan Boston-Northeast Regional Office of the Department of En vironmental Protection has received and reviewed your application for approval of a variance pursuant to 310 CMR 15.410 and 310 CMR 15.412 with theabove transmittal number. The application contained written notification, dated April 25, 2003, stating that the North Andover Board of Health had approved variance to the following provision of the State Environmental Code: 310 CMR 15.104(4) as it relates to percolation testing. Accompanying the application were plans consisting of one (1)sheet,titled as follows: Title: Proposed Subsurface Sewage Disposal System Location: 224 Summer Street Municipality: North Andover Applicant: Richard DeVincentis Designer: Richard C. Tangard,P.E.No. 13021 Date: March 20,2003 Ari=engineer of the Department has reviewed the application and accompanying information, and it is the opinion of the Department that the request for approval of this system cannot be approved at this time for the following reasons: This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. One Winter Street,Boston,MA 02108•Phone(617)654-6500•Fax(617)556-1049•TDD#(800)298-2207 DEP on the World Wide Web: http://www.state.ma.us/dep Q* Printed on Recycled Paper Richard DeVmPae 2centis g July 14, 2003 • The Alternative to Percolation Testing Policy,BRP/DWM/PeP-P00-4, dated September 8,2000, i requires that applications for percolation variances include the particle size analysis conducted by a qualified soil laboratory. No analysis was included in the application submitted. • The application was signed by Ben Osgood,Jr. Either you must sign the application, specifically page 5, or you must authorize in writing that Mr. Osgood may sign the application on your behalf. In the opinion of the Department,the requirements for the approval of this variance as specified in 310 CMR 15.410 and 310 CMR 15.412 have not been satisfied based upon the information received to date. The applicant has not proved that the same degree of environmental protection provided by a fully complying Title 5 system can be provided by the proposed system with variance at this location or that denial of the requested variance would be manifestly unjust. In accordance with.310 CMR 4.00, you have sixty(60)days from the postmarked date of this letter in which to address the listed deficiencies. Within the sixty(60)day time frame,the applicant is advised to allow for the appropriate Board of Health action on the revised submittal since the Department of Environmental Protection's subsequent action may be its final action and, therefore, any further filing in this matter would be considered a NEW application. If the applicant cannot accommodate the schedule of the Board of Health within the sixty(60) day period, or for any other reason requires additional time,the applicant may,by written agreement with this Department,extend this schedule in accordance with 310 CMR 4.04(2)(0. The applicant is also advised that when the Department receives the newatiformation, it will initiate a second technical review,and has an additional sixty(60)days to rule upon the application. Should the application be deemed to be deficient for a second time, the application will be denied. . If the applicant elects to proceed on the record as it now stands,this letter constitutes a denial of this application and the requested variance. Any person aggrieved by the variance decision of the Department. of Environmental Protection may request an adjudicatory hearing on that determination in accordance with 310 CMR 1.00 and M.G.L. c. 30A. Please note that no official start date has yet been established for this application since no fee has been received for this application. If you have already submitted the fee,your application should be credited shortly for the payment. If you have not submitted the fee,please remit the$230 fee to DEP,P.O. Box 4062,Boston,MA 022-1-L---Your check should be made out to the Conrrnonwzalth of Massachusetts. Please note your Transmittal Number on the memo line of your fee check. The enclosed Supplemental Transmittal Form should be completed and included as a cover sheet with any future submittal to the Department relating to the above matter. You need only correspond to the. Northeast Regional Office at the above address. Please note that the Northeast Regional Office has relocated. The new address is: Department of Environmental Protection—Northeast Regional Office Bureau of Resource Protection One Winter Street, 5"'Floor Boston,MA 02108 Richard DeVincentis Page 3 July 14, 2003 If you have any questions regarding this matter,please contact Claire A. Golden of my staff at(617) 654-6516. Very truly yours, Madelyn Morris Deputy Regional Director Bureau of Resource Protection MM/CAG/cg \2003 variances l\w039249td l Enclosure cc: • Sandra Starr,R.S.,CHO,Director,Board of Health,27 Charles Street,North Andover,MA 01845 • Richard C.Tangard,P.E.,New England Engineering Services,Inc.,60 Beechwood Drive,North Andover,MA 01810 (w/encl.) G r Massachusetts Department of Environmental Protection Supplemental Transmittal Form (to accompanytsupplemental material to previously submitted applications) 1. Obtain from the upper right hand corner of the original application's pp 9 9 pp Transmittal Transmittal Form: Number W039249 2. a Facility Name: b Facility Address: Facility Information DeVincentis Dwelling 224 Sum�lmer Street c Facility Town/Cit d Telephone Number: North Andover 3. (a) Permit Name: (b) Permit Code: (from original aodication) Permit Information Title 5 Variance BRPWP59b c EOEA MEPA file #: d Telephone Number: 4. [ (a) Response to Request ® (b) Response to Statement of Check for Additional information Deficiency Reason For [ (c) Supplemental Fee ❑ (d) Withdrawal of Application Supplemental Payment Submission a Other leasespecify below): C 5.. (a) Name of individual or firm (b) Affiliation with application, i.e. Form preparing this submission: applicant, consultant to applicant: Prepared by c Contact Name: d Contact Telephone #: Revised 11/99 i L4 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION METROPOLITAN BOSTON — NORTHEAST REGIONAL OFFICE MITT ROMNEY TC -N0elt6 !�(^ 'rtki��S, '. / Governor i?! , OF HF-'J ELLEN ROY HERZFELDER i - Secretary �I KERRY HEALEY F n3 ROBERT W. GOLLEDGE,Jr. Lieutenant Governor 'i t�� ' ' `"' Commissioner 13, 2003 Richard DeVincentis 224 Summer Street North Andover,Massachusetts 01845 Re: Approval of Title 5 Variance for existing construction (BRPWP59b) Variance from Percolation Testing requirement 224 Summer Street,North Andover(17-Ipswich) DEP Transmittal No.W039249 Dear Mr. DeVincentis: Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.412,the No-,1heast Regional Office of the Department of Environmental Protection has completed its review of the above referenced application for approval of a variance granted by the North Andover Board of Health. The application contains a copy of the Board of Health's grant of a variance from the following provision of Title 5, 310 CMR 15.000: 310 CMR 15.104-Percolation Testing. Accompanying the application were plans consisting of one(1)sheet,titled as follows: Title: Proposed Subsurface Se-:-age Disposal System Location: 224 Summer Street Municipality: North Andover Applicant: Richard DeVincentis Designer: Richard C.Tangard,P.E.No. 13021 Date: March 20,2003 Based upon its review of the application, and in accordance with 310 CMR 15:410, the Department has determined both of the following: a) The applicant has established that enforcement of 310 CMR 15.104 would be manifestly unjust, considering all of the relevant facts and circumstances of this case. A percolation test could not be pelfomwd because of high groundwater. This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. One Winter Street,Boston,MA 02108•Phone(617)654-6500-Fax(617)556-1049-TDD#(800)298-2207 DEP on the World Wide Web: http://www.state.ma.us/dep iia Printed on Recycled Paper w � Richard DeVincentis Page 2 August 13, 2003 b) The applicant has established that a level of environmental protection that is at least equivalent to that provided under 310 CMR 15.000 can be achieved without strict application of 310 CMR 15.104 and 15.105. The applicant has established equivalent environmental protection as follows: A particle-size soil analysis in conformance with the Alternative Percolation Testing Policy was !i performed and, along with an evaluation of soil compaction, was used to determine soil classification, the effluent loading rate, and the design of the system. The system is designed in accordance with that policy. The soil was found to be loamy sand. This is a Class II soil. The soil contained 75.7 percent sand. The Board of Health agent has concurred, in a letter dated July 24, 2003, that the soil was unconnpacted. In accordance with the policy, the system was designed with a Long Term Acceptance Rate of 0.66 gallons per day per square foot. The Department, therefore, approves the Board of Health's grant of a variance from 310 CMR 15.104. _ �`°+(_ . Additi6ham,-N apartment imposes the following conditions as part of this approval: 1 ? z licar� shall obtain a Disposal System Contitruction.Permit DSCP noun the North Andover 7P. ' p ( )f' Boars ' f leajth.prior to commencement of construction of the s)jntem. The systein is not designed to accommodate a garbage disposal. As such, one shall not be used or F ins&lediat this�cccility. 3) There shall be Ad-oncrease in design flow to the upgraded subsurface sewage disposal system. The design flow for£the facility is 440 gpd. The facility consists of a four-bedroom house. 4) At the time of construction, if groundwater has receded to a point where percolation testing is feasible in the..opinion of the local approving authority, then confirmatory percolation testing must be conducted and, if necessary, the system design revised based on the actual percolation rate. 5) A copy of the as-built plans must be submitted to the Department within 30 days of the date of issuance of the Certificate of Compliance from the North Andover Board of Health. 6) Should this upgraded system fail, the owner shall immediately note the local Board of Health and the Department. 7) The applicant shall record inn the appropriate Registry of Deeds or Land Registration Office,prior to the issuance of the Certificate of Compliance, a copy of this approval letter in the chain of title to the property to be served by the system. This variance determination is an action of the Department. If the applicant is aggrieved by this determination, he may request an Adjudicatory Hearing in accordance with 310 CMR 1.00 and M.G.L. C.30A. A request for an Adjudicatory Hearing must be made in writing and postmarked within 30 days of the date of issuance of this determination. Pursuant to 310 CMR 1.01(6), the request must state clearly and concisely the facts that are grounds for the request and the relief sought. Tlne hearing request, along with a valid check payable to Commonwealth of Massachusetts in the amount of one hundred dollars($100.00), must be mailed to: i Richard DeVincentis Page 3 August 13, 2003 Commonwealth of Massachusetts Department of Environmental Protection P.O. Box 4062 Boston, MA 02211 The hearing request will be dismissed if the filing fee is not paid, unless the appellant is exempt or granted a waiver, as described below. The filing fee is not required if the appellant is a city or town (or municipal agency), county, or district of the Commonwealth of Massachusetts, or a municipal housing authority. The Department may waive the adjudicatory hearing filing fee for a person who shows that paying the fee will create an undue financial hardship. A person seeking a waiver must file, together with the hearing request as provided above, an affidavit setting forth the facts in support of the claim of undue financial hardship. Shouldyou have any questions regarding this matter,please contact Claire A. Golden, of my staff, at (617)654-6516. i Very truly yours, Madelyn Morris Deputy Regional Director Bureau of Resource Protection MM/CAG/cg \2003 variances 1\w03 9249p-app cc: • Sandra Starr,R.S.,CHO,Director,Board of Health,27 Charles Street,North Andover,MA 01845 • Richard C.Tangard,P.E.,New England Engineering Services,Inc.,60 Beechwood Drive,North Andover,MA 01810 • DEP/Watershed Permitting Program/Title 5 Section/Boston i i I I • I BOARD OF HEALTH r >j�OF a6 AN NORTH ANDOVER, MA 01845 978-688-9540 NOV - 6 200 APPLICATION FOR SOIL TESTS DATE: ©?s MAP &PARCEL: Mae 38 Pa«e.kl 21t)103y.o-ot-12. -ocoo,o LOCATION OF SOIL TESTS: OWNER: DeTEL.NO.: ADDRESS: Z-�Jy AAM N ENGINEER: kN&I A Ec/LI N Cs TEL. NO.: CERTIFIED SOIL EVALUATOR: CTAn�CrA D 1j�n�3v9/V(,v QsG p�2_ Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. 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$200.00 per lot for repairs or Lipgrades. (If time is not critical, fee for repairs is$75.00) GENERAL INFORMATION I. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval: Date Received: `f / Check Amount: o&& Check Date: 1/ u eA Nov-12-02 13 : 28 F- 07 n"1 J.. µ m 5 0 cr rziw. - •f r i t..{ ,•71' 74 FORM II - S.01L FvALLATOR F0R.%j Pax c 2 ii f 3 Location Address or Lot No. 2 S V,7"i-&. NOr2 777' /r/V 00Ao14,—fL_ On-site Review _ Deep Hole Number .L . . Date: Time: Weather - L n +!®Y �-� Location (identify on site plan) _ Land Use YA?<D Slope Surface Stones �r-tJ Vegetation S Landform Position on landscape (sketch on the back) Distances from: Open Water Body /00 feet Drainage way>-La-D feet Possible Wet Area %/Oofeet Property Line .!�P- 1' feet, Drinking Water Wel! _`�+/nQ ;eel 'Other 1'S r. DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Sod Color Soil !' Surface tlnches) Other (USDA) !Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravel) �1..:' �$' � (/ear��;5 • 6 0 - M � t•5>1 7M hQUIRED A1tV1:KYFKU)FUb�-V0i5PQSAL EA Parent Material(geologicl sa } Death to Groundwater Drve�� Standing Water in the Ho)e: ,�� -�es .c w ra,�Wseping from Pit floe: Estimated Seasonal High lGr'ound Water IT / 1010'V i=0rIZ1,+1 c 01 /3 DEP APPRON-F)FORM-12107115 d FOPUNI 11 - SOIL EVALUATOR FORM Page Z of 3 Location Address or Lot IJo. i r i On-site Review _ i i Deep Hole Number ` - Date: �4� 17� Time: Weather C-4�17�U 9/ j Location (identify on site pian) Land Use Slope----� p t% ) Surface Stones - A/?�/� Vegetation S 5 Landform _ Position on landscape (sketch on the back) Distances from; � �,�•� / Open Water Body 7/00 feet Drainage way < o A .feet Possible Wet Area /0feet Property Line 25 e-feet Drinking Water Well feet Other 1 i i DEEP OBSERVATION HOLE LOG' i i Depth from Soil Horizon Sol Texture Soil Color Soil Surface(inches) othoer (USDA) (Munsell) Mottling (Structure.Stones,Boulders.Consistency, % Graven i s ®,fes 37 Tn �Zg Parent Material(geologic) DRoB a c : & Alea Depth to Groundwater Starling Water in the Hole: p� Weepin Esg from Pit Face: Estimated Seasonal High Ground Water: �-� >� PC-, FOr=z,-"!cv ay: _ AN LLhu*wo , Gy� w;r sseP 13y J0lystf 4 , N VOVAtAll EXc'AVATo ;:Z DEP APPRONIM FORM-112107195 U^1/laf�v_tbs 11:'Lb 1ltS1334l711'� T.ANUARDR a1 FORM I1 SOIL EVALUATOR FORM l�P `.1 y Page 2 ur 3 Location Address or Lot No. f On-rite Review Deep Hole Number / .. T Date.. �/.! .f r" Time Weathers rkl r - Y Location (identify on site plan) .: .. Land Use -���+ ... Slope (%) Surface Stones Vegetation .::..:... . .. Position on landscape (sketch on the batik) -05—/' Distances from; Open Water Body feet Drainage way .. feet Possible Wet Area feet Property Line feet Drinking Water Well ::.....:. feat Other ...:..........:......................... I DEEP OBSERVATION HC?!.E LOGO Npth from Soil Horiuton ' Soil Texture Soil Color Soil Other Srrtece(inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistoncy, % Grxvell 4P S � � vvt r ✓1�1. - Parent Material(geologic) DeptmoBedroek; Depth to Groan water: Standing Water in the Hole: Gr ! Weeping from Pit Fect:: Estimated Seasonal High Ground Vlster._ i UEP AMROVED FORM-WOV95 i i Cl;LE7+:eL%J" L'L:1b 1)t3lJJ4bllb IACVGAf 1Jk. YRlat ."bL . q Z l FORINT It SOIL EVALUATOR FORM Page 21of3 l,,oeation Address or Lot an-site Review Deep Hole Number Time:. �'". Weath�c-�('�•�' ......`„/c.� Location (identifyon site plan) . . .0 r Land Use .. Slope Surface Stones Vegetation . G Landform Position on landscape ;sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other .. .:.: T DEEP OBSERVATION HOLE LOG` Depth from Soil Horicon Soil Texture So!l Color Soil other Surface(Inches) (USDA; (Munsell) Mottling (Struebue,Stones, Boulders, Consistency, % Gravel) fc �] r e c z f, ,, eft a�� .-;�,� �""�.•.•.- _ �� 4.ee � p 1 t!f ! Parent Material(geologic) DepthtoBodrock: Depth to Groundwater; Standing Water In the Male: � Weeping from Pit Face:_••-�'��, ___._-__.__ ' ts;imatcd Seasonal High Ground water- VEP APPROVED FO"i.W07195 o Of Muss .xs tts, hu. "The Construction Testing Pe.W LETTER OF TRANSMITTAL —SOIL TESTING RESULTS SAMPLE NO. S L`_C` PROJECT: �.�•�-� s u m e k LOCATION: DATE: 3 PROJECT NO. Sam le Submitted By ❑ UTS Representative: X Other: �ny - Date Submitted:>( SOURCE OF SAMPLE On-Site Existing @ Location: ❑ Off-Site Borrow from: PROPOSED USE: RATERIA1.SUBiuITTED AS ❑ Structural/Granular Fill: REQUESTED TESTING ❑ Ordinary Borrow: MHD MI.01.0 (Shall be approved by the Architect Gradation Analysis C3 Gravel Borrow: MHD MI-03.0 Type A _ B �. X Wash Sieve Analysis ❑ Processed Gravel for Base Course: A, M1.03.1 ° Modified Proctor ❑ Sarin Borrow: MHD M1.0-l.0 Te: A - B o Atterberg Limits .2 Q Permeability ❑ Reclaimed Pavement Borrow for Base Course: MHD M1.11.0 ❑ Crushed Stone: MHD M2.01.0 Other: ❑ Dense Graded Crushed Stone for Base Course: MHD Af2.01.7 ❑ Common Borrow: ❑ Drainage Fill: ❑ Other: MATERIAL CLASSIFICATION: PRO.IF,CT SPECIFICATION CONFORMANCE RESULTS ❑ Does conform: _ _ c) Does NOT conform... Basis: ❑ Marginally does not*conform... Basis: * M- .suggest the suitability of'thi.s soil be reviewed for approval by the Architect and Engineers-of-Record. ❑ No Specification provided to our office. ❑ Specifications provided to our office but sample not submitted to a specific use. ❑ Sample submitted without indication of intended use and without Specifications. ❑ REMARKS: John C. McCarthy Geotechnical Dept. Mgr. 5 Richardson Lane, Stoneham, Massachusetts 02180 (781) 438-7755 Fax (781) 438-6216 GRAIN SIZE DISTRIBUTION TEST REPORT - < - - - _ t N 00 O O a a O 100 c0 M N .- M Mco 90 80 70 tY Li z 60 w z 50 w U w 40 tl 30 20 I 10 0 200 100 10.0 1 .0 0 . 1 0 .01 0.001 GRAIN SIZE - mm i % +3" 7. GRAVEL % SAND % SILT % CLAY USCS LL PI • 0 . 0 17 . 4 62 . 5 17 . 5 2 . 6 SM j i SIEVE PERCENT FINER SIEVE PERCENT FINER Location : inches number • • size •ON SITE 1 .5 100.0 4 88 .0 1 97 .0 10 82 . 6 0 .75 95 . 6 20 74.7 Description : 0 . 375 92 .0 40 64. 1 •F-M SAND, LITTLE SIL 50 57 .8 LITTLE GRAVEL, T-CL/:"y 100 42 .6 GRAIN SIZE 200 26.0 D60 0.335 D 30 D 1 0 0.0202 Remarks : COEFFICIENTS #200 WASH SIEVE Cc 1 . 20 CU 16 . 6 UTS OF MASSACHUSETTS, INC. Project No. : 8099 5 Richardson Lane Project : 224 SUMMER STREET, NORTH ANDOVER , MA Stoneham, MA 02180 Date : 3/20/2003 Sample No . 8492 Project: 224 Summer St. , N. Andover, Ma / Sample No: 8492 SOIL TEXX`URAL T���GI-E Based on the fraction passing the no. 10 _ sieve sample contains 75.7% 'sand, 21.2% silt, 3. 1% .clay. J\J. USDA Textural class= Loamy Sand 100 80 90 , 70 la �tr� 60 .� Gv� 50 CO �(D Y .0 ss � c! Y 4 Ban clo. 20 10 - san lout ° ail to n CP 00 `o oo o percent sand s ' 0 (r Town of North Andover, Massachusetts Form No. 1 _ NORTH BOARD OF HEALTH O eo q o APPLICATION FOR SITE TESTING/INSPECTION SACHUs���y Applicant �`/� L NAME or ADDRESS TELEPHONE Site Location �� �r E ngi n ee r.s/�® �/�' NAME ADDRESS TELEPHONE Test/Inspection Date and Time C CHAIRMAN,BOARD OF HEALTH Fee �X.�• Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. E k_ / =MPwO;rr txr / C FUF *P(,) "Z.T i r /n O� "► f r OT / /N 3 7 F 01 QO G0R D,,-l- Uw<z-A.)i-1 SLOPE 96—:00leEAWENT _ 09 OF /50 y = 150 sIµ DES/GN ELEVWXON AT (TOP OF �57ONE) _ 2 C-7,5r';