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Home My WebLink AboutMiscellaneous - 0 Ogunquit RoadN 7YJ Z�57.s�fl �L\ Commonwealth of Massachusetts W City/Town of North Andover Certificate of Compliance ^M , • •' Form 3 Installer Information: Peter Breen Name SigAatureV A�l 11�s_ Name of Company Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc• 06/03 Certificate of Compliance • Page 1 of 1 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. This is to Certify that the following work on an On -Site Sewage Disposal System Important: When filling out ® Construction of a new system forms on the ❑ Repair or replacement of an existing system computer, use ❑ Repair or replacement of an existing system component only the tab key to move your cursor - do not Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): use the return key. DSCP Number DSCP Date tQ Peter & Kerry Breen Facility Owner A 9.2uDgunqu.it-Ro Street Address or Lot # North Andover MA 01845 City/Town State Zip Code Designer Information: Greg Hochmuth The Neve -Morin Group, Inc. Name Name of Company Signa ure Date Installer Information: Peter Breen Name SigAatureV A�l 11�s_ Name of Company Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc• 06/03 Certificate of Compliance • Page 1 of 1 '10 174 Date.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... has permission to perform..7�?nF.,aw--e ..... P-Pe� ....... 6W.wf. iJ. wiring in the building of ........... Mor- . D.4.1 ... W / .......................... at ........... 41v— i ... ........ orth Andove�r,,�Mass. are e:, Fee ...... �:rnT=. Lic. .. . .. ...... .. ........ . ............. .. �;� iNs� E�* ;RICAL INSPECTO Check # �?,5 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance-withthe-provisions of M.G.L, c.143, §.3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be Med - On the prescribed form. After a permit application has been accepted by an Inspector of Wiresappointed pursuant to M. GI c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c.143, § 3L. e Permits shall_be limited as to the time of ongoing construction. activity, and maybe.deemed_bythe.Insp.ector_of_Wires abandoned.and.iiwalidaf he_... or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the. permit application. 14. ❑ The Permit Extension Act was created by Section 173 of 6hajger�L40 of the Acts of2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote &growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain -permits •and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008.and extending through August 15, 2012. 8 — Permit/Date Closed: / ' T%-7-` ❑ Permit Extension Act — Permit/Date Closed: *** Note: ]Reapply for new pernriif 5- Commonwealth of Massachusetts Official Use Only Elm Department of Fire Services Permit No. 0 Occupancy and Fee Checked %W1 BOARD OF FIRE PREVENTION REGULATIONS [Rev. ]/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MF f), 52[if CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL MFORMATIOA9 Date: 07/c City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 9 f Q 60A)a0 I.7 P<:) Owner or Tenant /-It ( M4,rJ 1,4 L.1 A)C l Telephone No. Owner's Address S A & G Is this permit in conjunction with a building permit? Yes M No ❑ (Check Appropriate Box) Purpose of Building I1\�6000N D 60,,2 6_ POO(- Utility Authorization No. Existing Service .2-0C3 AmpsI / IX 0 Volts Overhead ❑ Undgrd No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t, -,j;- tS# FCEC T P_LC t c_ W i &i,1 a G,v I n Ua iTC Sw J W► xn.1%' POO(— ,,jo Do:%1 - OVAI -✓P FcE-C- c i-1 - -k elr-EF� c Arn77,4 Completion of the following table may be waived by the Inspector of Wires No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KW ........ ' "" No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water, Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: 4f— Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Ele trical Work: QO (When required by municipal policy.) Work to Start: % e // Inspections'to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE )�J BOND ❑ OTHER ❑ (Specify:) 1 certify, under thepains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: G C - LIC. NO.: /12es819 Licensee:%�i9�/, tom- %) 1///✓C��/Tls Signature l� LIC. NO.: 7�7Y (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.. `�78' 7�?G37 Address: /� Q /3elc x'73 �•2oak /"/Is 11H ('.?o33 Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one)❑ owner ❑ owner's. a ent. Owner/Agent Signature Telephone No.PERMIT FEE: $ 07/07/2011 To Whom It May Concern. I, Ali Mandalinci, have relieved Victor Piniero of Pine Electric of all electrical duties associated with the property 99 Ogunquit Road located in North Andover, MA. Subsequently I have hired Dave DeVincentis to complete all remaining work. Thank you,...---- Ali ou,...-- Ali Mandalinci 978-764-8867 Grant, Michele From: Grant, Michele Sent: Thursday, December 13, 2012 11:26 AM To: Sawyer, Susan Cc: Blackburn, Lisa Subject: 99 Oquinquit Road Hi Sue, New homeowner of 99 Oquinquit called. Has owned the New Construction for 2 years. Peter Breen is the builder and Septic installer. Owner has had a MULTITUDE of different issues with the home including owed money. His septic Tank is 3 feet underground. I looked at the plan and was designed to have a riser put on it and he didn't. Michele E. Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrantAtownofnorthandover.com Web www.TownofNorthAndover.com t�2c7 2-e— i I PUBLIC HEALTH DEPARTMENT Community Development Division TFE11COPY - - C'�E1271�F-ICA7E OF CO�l�ll�'LIANCE- As of.- November f: November 23, 2010 This is to cert that the individuafsu6surface disposaf system receiveda SA`I rSFAC`70RT 1XSPECY 0X of the: Construction of an On Site Sewage DisposaCSystem By: (Peter Breen .Got 5 Wap -090.,X; Parcel— 0074 210/090.A-0074-0000.0 WorthAndover, 9W,9 01845 The Issuance of this certificate shaft not 6e construed as a guarantee that the system zviff function saj*factorify. Su an T Sa&6er, RF_„7h (Pu6ficYfeaCth Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 10/12/2022 00:27 FAX U002/002 TO%N OF NORT14 ANDOVER p!'AD oc� Office of COl� MUN ITX DEVELOPMENT .SND SERI, ICES �' •`;+: `'' HEALTH DEPARTMENT /9_ 4 4M OSGOOD STREET' - NORTH ,kNDOVER, MASSACHUSETTS 01845 �' s"„c„u�*�h Susan Y. Sawyer, REHS/R9 x'$,688.9540 — Phone 978.fi88.847fi — FAX Health Director E-MAIL; healthde t,atown fnorthandotier.com TOWN OF NORTH ANDOVER SEPTIC DYSPOSAL SYSTEM - INSTALLATION CHER FICA —" -The 5ind1 �szgned hereby certify that the Sewage Disposal by (Print Name) structed; (-) re fi•HP�t�r�4��R located at - v �S' /q 2 1� 0 Se., /t om l (Installation Address) was installed, in conformance with the North Andover Board of health approved plan, originally dated t / 17- / o-1 550 and last Revised on T_ , 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 S 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: 3 IS 10 Final inspection date: rJ/l 0 10/11/10 Installer; :Ind - Print Name (Signature) Frlaittecr•^ _ {'Signueurc) Gni And - Pridt Name; Engineer epresentative (Signature) Gre3�-b�,,..�fh And - Print Name Enginee epresentative (Signature) CS e 4 4,2n- 'i ,, And - Print Name Date,—/ Zr0 Date: INorth Andover Board of Assessors Public Access Page 1 of 1 NORTH North Andover Board of Assessors Oft"�O '�•t•A 3r .� u. ...,_ •e oL MATCHING PARCELS gsw`HU Click on a column title to sort data by that column Click Seal To Return 8 items found, disifflavin2all items.1 Fiscal Year Parcel ID St.No. I Street Owner Name 2010 210/090.A-0002-0000.0 16 OGUNQUIT ROAD LACEY, WILLIAM J, MARY H LACEY for. Parcels 2010 210/090.A-0055-0000.0 25 OGUNQUIT ROAD DRAGOSITS, THOMAS, DRAGOSITS, _ . _Search - — - — DONNA SUE 2010 210/090.A-0077-0000.0 70 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH Search for Sales ANDOVER 2010 210/090.A-0075-0000.0 85 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0074-0000.0 99 OGUNQUIT ROAD BREEN, PETER R, KERRY M BREEN 2010 210/090.A-0076-0000.0 100 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/105.A-0001-0000.0 115L-4 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0073-0000.0 116 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 8 items found, displaying all items.1 http://csc-ma.us/PROPAPP/newSearch.do;jsessionid=45251ACED201120053EC57C 195... 11/23/2010 10/12/2022 00:27 FAX 0002/002 TORN OF NORTH ANDOVER Office of COMMUNITY DEVELOPNIENT AND SERVICES � •`;+.,• �,`� °4� HEALTH DEPARTMENT 1�?4 4M OSCOOD STREET ► i ; t . NORTH ANDOVER, MASSACHI;SETTS 01845 Susan Y. Sawyer, REHS/RS 97$.688.9540 - Phone 978.688.8476 - FAX Public Health Director E-MAIL: healthde t,dtown fnorthandorer.com W EBSITE: f nm TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLA, The undersigned hereby certify that the Sewage Disposal by i e_T (Print Name) I IFICATI13N ,apstructed; ( } re AiQRTa,��©pV F��PARr.:__ located at _ r _ S' 1q. 2 1 0 S' n q) ( (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated 1117-10-1 and last Revised on N /A , with a design flow of 550 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: 3 i8 1 O Final inspection date: �rj 5Z 1 O £ 10/11/10 Installer: And - Print Name (Signature) Ersainenr: � ��.. (Sianueurr} Gn=.i And - Print Name Engineer epresentative (Signature) Grcti !-}oc�w•�f1� And - Print Name Engine��resentative (Signature) re 6yr ,And - Print lame Date:, Z t/qz"-0 Date; _-.��,j12-1 f0 . North,Andover Board of Assessors Public Access Page 1 of 1 NORTH North Andover Board of Assessors MATCHING PARCELS S"CHOSQ Click on a column title to sort data by that column Click Sea] To Return 8 items found, dis la in all items.1 Search for Parcels Search for Sales Fiscal Year Parcel ID St.No. Street Owner Name 2010 210/090.A-0002-0000.0 16 OGUNQUIT ROAD LACEY, WILLIAM J, MARY H LACEY 2010 210/090.A-0055-0000.0 25 OGUNQUIT ROAD DRAGOSITS, THOMAS, DRAGOSITS, DONNA SUE 2010 210/090.A-0077-0000.0 70 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0075-0000.0 85 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0074-0000.0 99 OGUNQUIT ROAD BREEN, PETER R, KERRY M BREEN 2010 210/090.A-0076-0000.0 100 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/105.A-0001-0000.0 115L-4 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0073-0000.0 116 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 8 items found, displaying all items.l http://csc-ma.us/PROPAPP/newSearch.do;j sessionid=45251 ACED201120053EC57C 195... 11/23/2010 Y NORTH r • Town of North Andover HEALTH DEPARTMENT S�cwu CHECK #: SJR DATE: LOCATION:/ H/ O NAME:�_- CONTRACTOR NAME:-,, •/��-u y�- 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 $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Sustems: ❑ Septic - Soil Testing $ a, -Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other: (Indicate) $ cam" " 144 , Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer 0 TON' "NOF NORTH ANDOVER 14ORt'q I P i t Office of COMMUNITY DEVELOPMENT AND SERVICES � _u HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 '*�°•. K-.--� yy�Ry� NORTH ANDONIR, MASSAC'HLSETTS 01W I'lu 973.648.9541- Phone Susan Y. Saiwer, REMRS978.683.3476-FAX Pubic Health Director E-MrAIL: healtlidept,rvtowiiofiioitliiiido-or.rotii NNIBSITE: SEPTIC PLAN SUBMITTAL FORM Date of Submission: January 12, 2007 Site Location: Lot 5 - 99 Ogunquit Road Engineer: The Neve -Morin Group, Inc. FEB 0 8 2007 L!IHA�,'—+� r...i A11D0VEREF�f:Tki T St New Plans? Yes ®$225/Plan Check # (includes 1 submission and one re -review only) Revised Plans? Yes R$75/Plan Check # Site Evaluation Forms Included? Yes ® No ❑ Local Upgrade Form Included? Yes ❑ No Telephone #: 978-887-8586 Fax #: 978-887-3480 E-mail: Joanne(a,nevemorin.com Homeowner Name: Peter & Kerry Breen OFFICE USE ONLY When the submigion is complete (including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ Enter on Log Sheet and Database F:Uoanne\Breen_684-5 _Septic Plan Submittal Form.doc FORM 11— SOIL EVALUATOR FORM No. 684 Commonwealth of Massachusetts North Andover, Massachusetts Pagel of 3 Date: 12/12/06 Soil Suitability Assessment for On-site Sewaze Disposal Performed By: Steven D'Urso Date: 5/25/95 Witnessed By: . Sandy Starr Date: 5/25/95 Location Address or Ogunquit Road Lot # Lot 5 New Construction 0 Repair Owner's Name Peter & Kerry Breen Address and 770 Boxford Street North Andover, MA 01845 Telephone # 978-687-7774 Office Review Published Soil Survey Available: No = Yes 0 Year Published 1981 Publication Scale 1" = 1320' Drainage Class B Soil Limitations Surficial Geologic Report Available: No 0 Yes 0 Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No Yes X Within 500 year flood boundary No X Yes Within 100 year flood boundary No X Yes Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range: Above Normal Normal 0 Below Normal Other References Reviewed: Soil Map Unit CcC FORM 11— SOIL EVALUATOR FORM Page 2a of 3 Location Address or Lot No. Lot 5 Ogunquit Road On Site Review Deep Hole Number OP 95-6 Date 5/25/95 Time 10:00 am Weather Location (identify on site plan) See Plan Land Use Residential Slope (%) 8-15% Surface Stones Few l' — 3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) See Plan Distances from: Open Water Body 1001+ feet Drainage Way feet Possible Wet Area 1001+ feet Property Line 10'+ feet Drinking Water Well 1001+ feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM —12/7/95 DocumenQ DocumenQ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Bounders, Consistency, % Gravel) 0-5" A FSL 10YR3/3 5-36" Bw FSL 10YR5/8 ESHWT 36-128"+ C1 SL 2.5Y5/4 @ 48" *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM —12/7/95 DocumenQ DocumenQ FORM 11— SOIL EVALUATOR FORM Page 2b of 3 Location Address or Lot No. Lot 5 Ogunquit Road On -Site Review Deep Hole Number OP 95-7 Date 5/25/95 Time 10:00 am Weather Location (identify on site plan) See Plan Land Use Residential Slope (%) 8-15% Surface Stones Few I' — 3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) See Plan Distances from: Open Water Body 1001+ feet Drainage Way feet Possible Wet Area 1001+ feet Property Line 10' + feet Drinking Water Well 1001+ feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM —12/7/95 DocumenC DocumenQ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Bounders, Consistency, % Gravel) 0-5" A FSL 10YR3/3 5-42" Bw FSL 10YR5/8 ESHWT 42-120"+ C1 SL 2.5Y5/4 @ 48" *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM —12/7/95 DocumenC DocumenQ FORM 11— SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5 Ogunquit Road Determination for Seasonal High Water Table OP 95-6, OP 95-7 Method Used: Depth observed standing in observation hole inches Depth weeping from side of observation hole inches X Depth to soil mottles 48 inches Groundwater adjustment feet Index Well Number Reading Date Index Well Level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in 11/94 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. Signature Steven D'Urso (Deceased) Date 12/12/06 DEP APPROVED FORM —12/7/95 Document6 FORM 12 — PERCOLATION TEST Location Address or Lot No. Lot 5 Ogunquit Road COMMONWEALTH OF MASSACHUSETTS North Andover, Massachusetts Percolation Test* Date: 9/12/95 Time: 10:00 am Observation Hole # P 5-1 P 5-2 Depth of Perc 32+18 34+18 Start Pre-soak 2:21 2:35 End Pre-soak 2:36 2:50 Time at 12" 2:36 2:50 Time at 9" 2:49 3:03 Time at 6" 3:11 3:20 Time 9"-6" 22 minutes 17 min/inch Rate Min./Inch 8 min/inch 6 min/inch *Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed Performed by: Witnessed by: Comments: Steven D'Urso Sandy Starr DEP APPROVED FORM —12/07/95 DocumenN FORM 11 — SOIL EVALUATOR FORM No. 684 Commonwealth of Massachusetts North Andover, Massachusetts Date: 9/20/05 Pagel of 3 Soil Suitability Assessment for Onn--,site SewameDisDisposal Performed. By: Isaac Rowe Date: 9/20/05 Witnessed By: Randy Burley (Mill River Consult) Date: 9/20/05 Location Address or Lots 5,6 & 9 Ogunquit Rd. Owner's Name Peter & Kerry Breen North Andover, MA 01845 Lot # Address and 770 Boxford Street North Andover, MA 01845 Telephone # 978-687-7774 New Construction 0 Repair 0 Office Review Published Soil Survey Available: No 0 Yes Year Published 1981. Publication Scale 1" = 1320' Drainage Class B Soil Limitations Surficial Geologic Report Available: No 0 Yes Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No Yes X Within 500 year flood boundary No X Yes Within 100 year flood boundary No X Yes Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Soil Map Unit CcC Range: Above Normal Normal Below Normal Other References Reviewed: FORM 11— SOIL EVALUATOR FORM Page 2a of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road On -Site Review Deep Hole Number OP 05-1 Date 9/20/05 Time 10:00 am Weather Cloudy 75 Location (identify on site plan) See Plan Land Use Residential Slope (%) 8-15% Surface Stones Few P — 3' Dia. Vegetation Woods Landform Drumlin. Position on landscape (sketch on the back) See Plan Distances from: Open Water Body 1001+ feet Drainage Way feet Possible Wet Area 1001+ feet Property Line 10' + feet Drinking Water Well 1001+ feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 60" DEP APPROVED FORM— 12n195 Document2 Document2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stories, Bounders, Consistency, % Gravel) 0-12" A FSL 10YR3/2 12-36" Bw FSL 10YR5/8 36-60" C1 FS 2.5Y6/4 ESHWT @ 60" 60-10811+ C2 SL 2.5Y5/6 *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 60" DEP APPROVED FORM— 12n195 Document2 Document2 FORM 11 — SOIL EVALUATOR FORM Page 2b of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road On -Site Review Deep Hole Number OP 05-2 Date 9/20/05 Time 10:00 am Weather Cloudy 75 Location (identify on site plan) Land Use Residential Slope (%) 8-15% Surface Stones Few F-3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) See Plan Distances from: Open Water Body 100' + feet Drainage Way feet Possible Wet Area 1001+ feet Property Line 10' + feet Drinking Water Well 100'+ feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM — 12n195 DocumenQ DocumenC Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Bounders, Consistency, % Gravel) 0-12" A FSL 10YR3/2 12-30" Bw FSL 10YR5/8 30-120"+ C1 SL 2.SY5/6 ESHWT 48" *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM — 12n195 DocumenQ DocumenC FORM 11 — SOIL EVALUATOR FORM Page 2c of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road On -Site Review Deep Hole Number OP 05-3 Date 9/20/05 Time 10:00 am Weather Cloudy 75 Location (identify on site plan) See Plan Land Use Residential Slope (%) 8-15% Surface Stones Few 1'-3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) See Plan Distances from: Open Water Body 1001+ feet Drainage Way feet Possible Wet Area 1001+ feet Property Line 10' + feet Drinking Water Well 100' + feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial Till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 36" DEP APPROVED FORM — 12n195 DocumenQ DocumenQ DocumenQ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Bounders, Consistency, % Gravel) 0-18" Fill & Ap 18-28" Bwb FSL 10YR4/6 28-102"+ Cl LS 2.5Y5/6 ESHWT 36" *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial Till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 36" DEP APPROVED FORM — 12n195 DocumenQ DocumenQ DocumenQ FORM 11— SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road Determination for Seasonal High Water Table OP 05-1 Method Used: Depth observed standing in observation hole Depth weeping from side of observation hole X Depth to soil mottles Groundwater adjustment Index Well Number Adjustment factor Reading Date inches inches 60 inches feet Index Well Level Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in Spring 20011 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. SignatureD ate 9 DEP APPROVED FORM - 12n195 Document6 FORM 1 I — SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road Determination for Seasonal High Water Table OP 05-2 Method Used: Depth observed standing in observation hole Depth weeping from side of observation hole X Depth to soil mottles Groundwater adjustment Index Well Number Adjustment factor Reading Date inches inches 48 inches feet Index Well Level Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in spring 20011 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. Signature Date( ds DEP APPROVED FORM - 12n195 Document6 FORM I I - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road Determination for Seasonal High Water Table OP 05-3 Method Used: Depth observed standing in observation hole inches Depth weeping from side of observation hole inches X Depth to soil mottles 36 inches Groundwater adjustment feet Index Well Number Reading Date Index Well Level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in Spring 20011 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. —, Signature / Date '? WA5- DEP APPROVED FORM- 12n195 Document6 DelleChiaie, Pamela From: Sawyer, Susan Sent: Wednesday, March 17, 2010 10:25 AM To: DelleChiaie, Pamela; Grant, Michele Subject: FW: Lot 5 Ogunquit Road FYI, I spoke with Kathy at Neve and told her I was concerned about the bed at lot 5. 1 had heard from our building dept that the hoe was filled with water and we want to be sure the installer takes care in prepping the hole for sand and doesn't just dump it in. She will pass the message on to Greg H. Susan From: DelleChiaie, Pamela Sent: Wednesday, March 10, 2010 11:02 AM To: Sawyer, Susan; Grant, Michele Subject: FW: Lot 5 Ogunquit Road FYI Only for whoever gets to do the BB inspection. O From: John Morin [mailto:John@NeveMorin.com] Sent: Wednesday, March 10, 2010 10:56 AM To: DelleChiaie, Pamela Subject: RE: Lot 5 Ogunquit Road Hi Pam, It is fine for Peter to draw the benchmarks on the plan. thanks John M. Morin, P.E. THE NEVE-MORIN GROUP, INC. 447 Boston Street, US Route 1, Topsfield, MA 01983 p 1978.887.8S86 f 1978.887.3480 w I www.nevemorin.com From: DelleChiaie, Pamela [mailto:pdellech@townofnorthandover.com] Sent: Wednesday, March 10, 2010 10:43 AM To: john@nevemorin.com Subject: FW: Lot 5 Ogunquit Road Hi John, Peter is coming to pick up the plans today. He said he could draw in the benchmarks on the plan. Is that sufficient? We will all be on the same page? Please verify. I asked Peter to call you directly if he needed to, but he said he is all set. Please verify and let me know so there are no problems when construction begins. i We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous Health Department Assistant TOWN OF NORTH ANDOVER Health Department 1600 Osgood Street Building 20; Suite 2-36 - worth Antlover, MA 01845 97'8.688.9540 - Phone 978.688.8476 - Fax pdellechiaie@townofnorthandover.com - E-mail http://www.townofnorthandover.com/Pages/index - Website Notes: If copied to BOH Members — Reference Copy Only — no response requested at this time From: Sawyer, Susan Sent: Tuesday, March 09, 2010 4:15 PM To: 'John Morin' Cc: DelleChiaie, Pamela Subject: RE: Lot 5 Ogunquit Road Ok, but remember the approved design does not show it. thx From: John Morin [mailto:John@NeveMorin.com] Sent: Tuesday, March 09, 2010 4:05 PM To: Sawyer, Susan Cc: 'Greg Hochmuth' Subject: Lot 5 Ogunquit Road Hi Susan, We did set a couple of benchmarks for Peter when we did the construction layout for the foundation. Any questions let me know. Thanks John M. Morin, P.E. THE NEVE-MORIN GROUP, INC. 447 Boston Street, US Route I, Topsfield, MA 01983 p 1978.887.8586 f 1978.887.3480 w I www.nevemorin.com P` TOWN OF NORTH ANDOVER t µOR7{ Office of COMMUNITY DEVELOPMENT AND SERVICES 3 ° ` °A"°a. 6L �r o., �6 o HEALTH DEPARTMENT A 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845�q-4A u'�'�t� SI Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORI ATION ADDRESS: A LOT: INSTALLER: DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION:�� h5r 11; DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned []Internal plumbing all to one building sewer []Topography not appreciably altered Comments: SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation — Feb 2006 Page 1 of 6 pti TOWN OF NORTH ANDOVER T!{ Office of COMMUNITY DEVELOPMENT AND SERVICES 3 Tto HEALTH DEPARTMENT p 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER MASSACHUSETTS 01845 ''�S "°^ "P• qty � SacHuSti Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ 'Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation — Feb 2006 Page 2 of 6 p TOWN OF NORTH ANDOVER � iOR7N Office of COMMUNITY DEVELOPMENT AND SERVICES 3 ° 6.1107" HEALTH DEPARTMENT p 1600 OSGOOD STREET; Building 2-36 "► o, "°« NORTH ANDOVER, MASSACHUSETTS 01845 �qs iS NCHUSti Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX D -BOX Comments: SOIL ABSORPTION SYSTEM/ 12 OV a� Y\ �Ij� �W Comments: /Cj W� � /, V V Cot V�1/\_ Installed on stable stone base Inlet tee (if pumped or >0.087foot) Hydraulic cement around inlet & outlets Observed even distribution Speed levelers provided (not required) Bottom of SAS excavated down toc soil layer, as provided on plan i, �/�1 Size of SAS excavated as per plan C�pLfu, Title 5 sand installed, if specified on plan ?"I" ��► l� r 3/4-1 Y2" double washed stone installed 1/8-1/2" (peastone) double washed stone installed Laterals installed and ends connected to header Laterals vented if impervious material above Orifices @ 5 & 7 o'clock positions Gravel -less disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan 40 Mil HDPE barrier installed Retaining wall (boulder / concrete / timber/ block) Final cover as per plan Wastewater System Documentation — Feb 2006 Page 3 of 6 L x 3� OyLt JAI Ll J 1'b P TOWN OF NORTH ANDOVER F NoR7{{ Office of COMMUNITY DEVELOPMENT AND SERVICES tl 6 .P_ +.. .6 (• HEALTH DEPARTMENT p 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER MASSACHUSETTS 01845 �qS "° � StCHUgE Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX PRESSURE DISTRIBUTION Comments: -- inch manifold laterals installed with end sweeps size: material: Squirt test ft in height Equal distribution to all laterals orifice size inch as per plan CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation — Feb 2006 Page 4 of 6 r TOWN OF NORTH ANDOVER °4 NaRTH 9 Office of COMMUNITY DEVELOPMENT AND SERVICES o `'`��°� HEALTH DEPARTMENTp *_ 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER MASSACHUSETTS 01845"Ss acHus Susan Y. Sawyer, REHS/RS 978.688.9540 —Phone Public Health Director 978.688.8476 — FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA S.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Wastewater System Documentation — Feb 2006 . Page 5 of 6 Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Bank' 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) ISO 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other) Foundation 10 (5) 20 (10) ❑ Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA S.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Wastewater System Documentation — Feb 2006 . Page 5 of 6 AV TOWN OF NORTH ANDOVER F %40RTH Office of COMMUNITY DEVELOPMENT AND SERVICESo0 HEALTH DEPARTMENT p 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 M95SACHUSE��h Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX SYSTEM ELEVATIONS Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW INVERT ON DESIGN PLAN FIELD INVERT ELEV. Wastewater System Documentation — Feb 2006 Page 6 of 6 4661 NORTH � ,!) - • Town of North Andover HEALTH DEPARTMENT ,SSACHU CHECK #: JDI DATk-J2:�• LOCATION: q Ila 61n, , �/ Q?m H/ O NAME: WJ'? CONTRACTOR NAME: i 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 $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Sustems: ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ Healtlent'Initials White - Applicant Yellow - Health Pink - Treasurer yf N4RTM Commonwealth of Massachusetts Map -Block -Lot o 090.A0005 + y o ----------------------- Board of Health Permit No North Andover BHP -2010-0516 ",� ..:.:.� •` • P.I. FEE F.I. $250.00 �ss,cwuyt� DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted -Peter-Bre-en - -- --------------------------------------------------------------------------------------------- to (Construct) an Individual Sewage Disposal System. at No 99 OGUNQUIT ROAD �� ------------------------- k s -Co as shown on the application for Disposal Works Construction Permit No. BHP- ---10-051 Dated .—March -0-9,20-10 ---------------------------------------------- Issued On: Mar -09-2010 Board of Health . "aRt" , Commonwealth of Massachusetts Map -Block -Lot ro ' `•,foot 090.A0005 Board of Health ----------------------- North Andover �•-•.°-••`� CERTIFICATE OF COMPLIANCE CW S THIS IS TO CERTIFY,That the Individual Sewage Disposal System (Construct) by Peter Breen Installer at No 99 OGUNQUIT ROAD has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. -BHP-2010-051_- Dated ---March-0-9,-2-0-10 ------ ----------------------------------------------------- ----------- Printed - On: Mar -09-2010 Board of Health --------------------------------------------------------------------------------- :0 Tot Application for Septic Disposal System - =Construction Permit —TOWN OF '' ORTH ANDOVER. MA 01845 TODAY'S DATE V $ 250.00 — Full Repair $125.00 - Component Important: Application is hereby made for a permit to: When filling out forms on the ©'Construct a new on-site sewage disposal system* computer, use ❑ Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component — What? cursor - do not use the return key. A. Facility Information %`I L5u4 i2v ?' 4a-aC 04x'107 - Address or Lot # A"12�e�� City/Town 2.- *TYPE OF SEPTIC SYSTEM*: ❑ Pump ❑ Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. Owner Information Name 7 ?D Bd Address (if different from above) 62 City/Town 3. Installer Information 6/Gl-� Name 4. •144- OI KY!� State Zip Code I ;1 Telephone Number Name of Company /y_ ✓Y) o'(F ys' City/Town State Zip Code Designer Information t/I C" c- r4o r ", 61.0 u t9 Name `/`/ % D/,91 13vs7-0-7 Address e Io' City/Town �&-Ir' 6: 7S- o Telephone Number (Cell Phone # if possible please) Name of Company M A __6* State Zip Code 4' ? F s F ) Fr�G D Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 i MORTN Application for Septic Disposal System 0 TODAY'S DATE AConstruction Permit -TOWN OF •"NORTH ANDOVER, MA 01845 $ 250.00 -Full Repair �', '••^• ''< $125.00 - Component SSACNUSt PAGE 2 OF 2 A. Facility Information continued.... 5. Type of Building: residential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. E_;t)I d,- . /a Name Date Applic on Approved By: (Board of Health Representative) Date Application Disapproved for the following reasons: For Office Use Only: L Fee Attached. Yes No 2. Project Manager Obligation Form Attached. Yes No 3. Pump System? If so, Attach copy ofElectrical Permit Yes No 4. Foundation As -Built? (hew construction ronly): (Same scale as approved plan) Yes No 5. Floor Plans? (hew construction only): Yes No Application for Disposal System Construction Permit • Page 2 of 2 'SEPTIC 'SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS r v' As the North Andover licensed installer for the construction for the septic system for the property at: 06y�Q��i 12�4G( (Address of septic system) n Relative to the application of Pe i v��✓v (Installer's name) Dated 3 j o ay s ate For plans by And dated With revisions dated I understand the following obligations for management of this project: (Engineer) ngma ate (Last revised date) 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer, I must call for any and all inspections. If homeowner, contractor, project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against me and/or my company a. Bottom of Bed — Generally, this is the first (15� inspection unless there is a retaining wall, which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection — Engineer must first do their inspection for elevations, ties, etc. As -built of verbal OK (or e-mail to: healthdept cQtownofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade — Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install seutic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board of Health staff or consultant. d. Installation of tank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer, I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer: (Today's Date) ame —Print) (Name — Signe North Andover Board of A Ssessors Public Access .1 t ,►ORTH dL ,SSwCHUbt� Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 North Andover Board of Assessors roperty Record Card Parcel ID :210/090.A-0074-0000.0 FY:2010 Community: North Andover SKETCH No Sketch Available PHOTO No Picture available Location: 99 OGUNQUIT ROAD Owner Name: BREEN, PETER R KERRY M BREEN Owner Address: 770 BOXFORD STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 8 - 8 Land Area: 2.89 acres Use Code: 130 -RES -DEV -LAND Total Finished Area: 0 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 244,400 218,600 Building Value: 0 0 Land Value: 244,400 218,600 Market and Value: 244,400 Chapter Land Value: LATEST SALE Price: 100 Sale Date: s Length Sale B-NO-INTRACORP Grantor: Doc: 9564 Book: 11/08/1984 00066 Page: 0261 http://csc-ma.us/PROPAPP/display.do?linkld=1516593&town=NandoverPubAcc 3/9/2010 North Andover Board o0 Assessors Public Access �} Page 1 of 1 http://csc-ma.usIPROPAPPInewSearch.do;j sessionid=96823 8FC2l A317875A3 B50OD6A54... 3/9/2010 North Andover Board of Assessors NOwry J. "°*,;��-•�'r " MATCHING PARCELS SSS"C14"5 Click on a column title to sort data by that column Click Seal To Return 8 items found, displaying all items.1 Fiscal Year Parcel ID St.No. Street Owner Name 2010 210/090.A-0002-0000.0 16 OGUNQUIT ROAD LACEY, WILLIAM J, MARY H LACEY 2010 210/090.A-0055-0000.0 25 OGUNQUIT ROAD DRAGOSITS, THOMAS, DRAGOSITS, Search for Parcels DONNA SUE 2010 210/090.A-0077-0000.0 70 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER Search for Sales 2010 210/090.A-0075-0000.0 85 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0074-0000.0 99 OGUNQUIT ROAD BREEN, PETER R, KERRY M BREEN 2010 210/090.A-0076-0000.0 100 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/105.A-0001-0000.0 115L-4 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0073-0000.0 116 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 8 items found, displaying all items.1 http://csc-ma.usIPROPAPPInewSearch.do;j sessionid=96823 8FC2l A317875A3 B50OD6A54... 3/9/2010 n ttORTIi O �tLED 16,j �O 32 E.t F 6 AA� COC IC lwKw 1 T ArEo 4_ PUBLIC HEALTH DEPARTMENT Community Development Division — C'E1�71f�'ICA7� OFCO�I�I�GIA�VCE As of: November 23, 2010 This is to cert that the individuaCsu6surface dzsposat system received a SATIS FAC7ORT IMT ECTIOAr of the: Construction of an On Site Sewage D'sposaiSystem By: Peter Breen At: .Got 5 Wap -090.A; ('arcef— 0074 210/090.A-0074-0000.0 XorthAndover, gwx 01845 I)Y The Issuance of this certificate shaft not 6e construed as a guarantee that the system wiff function sa.p�factoriCy. Su, an T Seer, ROi fu6CicYleaCth Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 10/12/2022 00:27 FAX 2002/002 TO'W'N OF NORTH ANDOVER Noerti ' Office of COMMUNITY DEVELOPMENT AND SERVICES � :Av `� HEALTH DEPARTMENT + � 1�?4 4M OSGOOD STREET NORTH ,kNDOVER, MASSACHUSETTS 01815 �'�s"„�,�„�►�� 9'$,688.9540 — Phone Susan Y. Sawyer, REHSIRS 978.6$$.$476 —FAX Public Health Director E-;LiAIL; healthdent,2towno orthandovor,com W EBSITE: cnm TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATIO -- - - -- — --Tlfe tin-&rsigned hereby certify that the Sewage Disposal by (Print Name) ,TIFICATTON' 6pstructed; ( ) rep ired; NS�RT� A TH located at - S q- 2 1 0 SGJ /2 q'j f 7— (Installation (Installation Address) , was installed in conformance with the North Andover Board of Health approved plan, originally dated 11 17-1 0-1 and last Revised on _ NT_ ,with a design flow of 550 gallons per day. The materials used were in conformance with those specified- oh the approved plan; the system was installed in accordance with the provisions of 310 CMR. 15MO, 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: 3 le 10 Final inspection date: rJ rJ I O E 10/1110 Installer f And - Print Name (Sign (2.ature Frfgi'neer /�., {'Sionuture) Gni And, Print Nurne Engineer epresentative (Signature) Gr« And - Pr9t Name Enginee epresentative (Signature) G "e4 -f v1'4' And - Print Name } Date:, f North Andover Board of Assessors Public Access Page 1 of 1 NORTH North Andover Board of Assessors 9 MATCHING PARCELS SSACHU Click on a column title to sort data by that column Click Seal To Return 8 items found, dis la in all items.1 Fiscal Year Parcel ID St.No. I Street Owner Name 2010 210/090.A-0002-0000.0 16 OGUNQUIT ROAD LACEY, WILLIAM J, MARY H LACEY Search 2010 210/090.A-0055-0000.0 25 OGUNQUIT ROAD DRAGOSITS, THOMAS, DRAGOSITS, .for-Parcels--- DONNA SUE 2010 210/090.A-0077-0000.0 70 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH Search for Sales ANDOVER 2010 210/090.A-0075-0000.0 $5 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0074-0000.0 99 OGUNQUIT ROAD BREEN, PETER R, KERRY M BREEN 2010 210/090.A-0076-0000.0 100 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/105.A-0001-0000.0 115L-4OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0073-0000.0 116 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 8 items found, displaying all items.1 http://csc-ma.us/PROPAPP/newSearch.do;j sessionid=45251 ACED201120053EC57C 195... 11/23/2010 Q� �tt,lG 0? � ~'' 1t2`� Pis uw■ � 9_ coc.��c�cwKw . �• PUBLIC HEALTH DEPARTMENT fommunity Development Division --- ---_ �'E-127IFICA`IE-0(F-C09V1PLIANCYE-- As of.- November f: November 23, 2010 This is to cert that the individuaCsu6surface disposaCsystem received a SATIST•ACTORT INSTECTION of the: Construction of an On Site Sewage DisposaCSystem Oy: Peter Breen At: .Got 5. Map -090.A; (Parcef— 0074 210/090.A-0074-0000.0 it orth Andover, g1A 01845 The Issuance of this certiftate shaft not 6e construed as a guarantee that the system wiff function sa,t sfactoriCy. Sinn T SawYer, RW/9S 1Pu6Cic V aCth Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandoverarn 10/12/2022 00:27 FAX 2002/002 TOWN OF NORTH ANDOVER NORTH Office of CUMMUNITX DEVELOPMENT AND SERVICES x`'17 HEALTH DEPARTMENT ids OSGOOD STREET . "ORTH ,kNDOVER, MASSACHUSETTS 01815 9; 8,688,9540 — Phone Susan Y. Sawyer, IiEHS/RS 918.688.8476 — FAX Public Health Director E41A1L; healthde t n town fnorthandover.com WEBSITE: http;., �r�v�v,to�vnofnorihandnv'er Com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION C RFICA�N Thi undersigned hereby certify th-at tfie Sewage Disposal Syst8nstructed; ( } rep ired; - tVQ.R- by pe--[ 7--c rr �^-- H��fiM p 'PAR- N'r (Print Name) located at 60 Ste'"Q' l ( rte f (Installation Address) was installed in conformance with the North Andover Board of health approved plan, originally dated 11 17- 0-1 and last Revised on __ N�A _ ,with a design flow of 550 gallons per day, The materials used were in conformance with those specified oft 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: 3 le 10 Final inspection date: "5 S 1 O 10/1I/10 Installer: Engineer epresentativ�(Sf�mat�u, e) Ggn I-�oeiyw.�� 11 And - Pant Name Enginee /epresen e (Signature) es, And - Print Name (Signature) Dater :Ind - Print Name Fr,�•inecr�3 ��/ {Sign;�cu,rrj a Gni And - Print Name: Date; �lL'flJ. 5 North Andover Board of Assessors Public Access E �10R7h � ,A 1+4 ACHU Click Seal To Return — _ _SearchJor-Parcels Search for Sales Page 1 of 1 North Andover Board of Assessors MATCHING PARCELS Click on a column title to sort data by that column 8 items found, displaying all items.1 Fiscal Year Parcel ID St.No. I Street Owner Name 2010 210/090.A-0002-0000.0 16 OGUNQUIT ROAD LACEY, WILLIAM J, MARY H LACEY 2010 — 210/090.A-0055-0000.0 25 OGUNQUIT ROAD -- - — — DRAGOSITS, THOMAS, DRAGOSITS, DONNA SUE - - — - 2010 210/090.A-0077-0000.0 70 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0075-0000.0 85 OGUNQUIT ROAD BREEN PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0074-0000.0 99 OGUNQUIT ROAD BREEN, PETER R, KERRY M BREEN 2010 210/090.A-0076-0000.0 100 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210105.A-0001-0000.0 115L-4 OGUNQUIT ROAD BREEN, PETER R, C/O TOWN OF NORTH ANDOVER 2010 210/090.A-0073-0000.0 116 OGUNQUIT ROAD BREEN PETER R C/O TOWN OF NORTH ANDOVER 8 items found, displaying all items.1 http://csc-ma.us/PROPAPP/newSearch.do;j sessionid=45251 ACED201120053EC57C 195... 11/23/2010 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Monday, May 10, 2010 2:17 PM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley' Subject: Lot 5A-99 Ogunquit Road Hello, Please call Peter Breen to setup a Final Const. Inspection for 99 Ogunquit Lane. His number is: 978.265.7580. Thank you. O "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous Health Department Assistant TOWN OF NORTH ANDOVER Health Department 1600 Osgood Street Building 20; Suite 2-36 North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax pdellechiaie@townofnorthandover.com - E-mail http://www.townofnorthandover.com/Pages/index - Website Notes: If copied to BOHMembers - Reference Copy Only - no response requested at this time 1 NORTH q Q �tVEo X61 �rO F- 70 'Q_ [OCMIC M�WKK PUBLIC HEALTH DEPARTMENT Community Development Division February 11, 2010 Neve Morin Group, Inc. John Morin, PE 447 Old Boston Road Topsfield, MA 01983 Re: Lots 1, 5 and 6 Ogunquit Road Dear John, FILE COPY This is a response to your request for one year extensions to the approvals on the above mentioned lots, which are due to expire in March 2010. Two of these lots received a three-year approval in March of 2007. Please be advised that the current local and state regulations allows for a two year approval, with a single one year extension, for a total of three years. Although not stated, plans for lot 5 and 6 have already received the benefit of an additional year. Unfortunately, a second additional year cannot be approved by this office. Lot 1 may request the additional year, as it was approved in 2008. We will place your request on the agenda of the next Board of Health meeting scheduled for February 25, 2010. Please note that this office will allow for one year to fully complete the installations of the systems as long as the permits are pulled prior to expirations. If the owner chooses not to pull the permits, however, a new plan will be required to be submitted for a full review. Also note, that the North Andover Board of Health is poised to approve a new regulation at this coming, February 25th Board of Health meeting. This is not a revision; it is a complete rewrite of the local onsite waste water treatment regulations. In most cases we are now bringing our local regulation in line with the state Title V. This includes items such as deep holes no longer expiring. You may determine that this course of action may be advantageous to the owner. Continued to next page Pagel of 2 North Andover Health Department, i600 Osgood Street, Building 2o, Suite 2-36, North Andover, MA oi845 978.688.954o -Phone Either way, as it has been such a long period of time since the approval, please be reminded that the sites of the septic leaching areas must be in an undisturbed condition. If the areas appear disturbed, the Health Office will require confirmation of existing parent material still present. If you have any questions, please do not hesitate to contact me. We will place Mr. Breen on the February 25th meeting which is scheduled to begin at 7:00pm and will be held at the Town Hall, 120 Main Street. Sincer�;1y, Susan Sawyer, RSIS Public Health Director Cc: Peter Breen, Property owner 21Page North Andover Health Department, r600 Osgood Street, Building ao, Suite 2-36, North Andover, MA oi845 978•688.954o --Phone NORTH O��t►eo '6gti0 O ew i p cocHa xi wK. PUBLIC HEALTH DEPARTMENT (ommunity Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 99 Ogunquit Road (Lot 5) MAP: 90A LOT: 5 INSTALLER: Peter Breen DESIGNER: Isaac Rowe PLAN DATE: 1/12/07 BOH APPROVAL DATE ON PLAN: 3/18/07 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 5/11/10 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS Comments: SEPTIC TANK NA Contractor reports any changes to design plan NA Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered ® Building sewer in continuous grade, on compacted firm base NA Cleanouts per plan ® 1500 gallon tank has been installed H-10 loading mono construction ® Water tightness of tank has been achieved by Visual testing ® Inlet tee installed, centered under access port 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 NORTFf Q��tllC i6��O O M1 lift PUBLIC HEALTH DEPARTMENT (ommunity Development Division ® Outlet tee installed, centered under access port (gas baffle) ® 24" inch covers to within 6" of final grade installed over inlet & outlet access ports ® Hydraulic cement around inlet & outlet Comments: DISTRIBUTION -BOX ® Installed on stable stone base NA Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM (General) ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan NA 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan NA Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthoodover.com Inspection Form June 2008 Th 16� •`•0\ OG O ° #/gyp_ coc.ncwewK. , �• PUBLIC HEALTH DEPARTMENT (ommunity Development Division SYSTEM ELEVATIONS BM = 126.77 HR = 4.65 HI = 131.42 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthondover.com Inspection Form June 2008 ROD ELEVATION AS -BLT INVERT ELEV DESIGN INVERT ELEV Benchmark Building Sewer OUT 2.37 128.70 128.70 Septic Tank IN 2.56 128.51 128.50 Septic Tank OUT 2.78 128.29 128.25 Distribution Box IN 3.12 127.95 127.93 Distribution Box OUT 3.28 127.79 127.76 Lateral 1 TOP In/End 3.40/3.78 Lateral 1 INVERT 127.67/127.29 127.61/127.30 Lateral 2 TOP In/End 3.40/3.78 Lateral 2 INVERT 127.67/127.29 127.61/127.30 Lateral 3 TOP In/End 3.40/3.78 Lateral 3 INVERT 127.67/127.29 127.61/127.30 Bottom of Bed 126.29 126.30 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthondover.com Inspection Form June 2008 pORTH q O tt�eo OL O L Oq COCAieewKw PUBLIC HEALTH DEPARTMENT (ommunity Development Division CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- Waterline 10 10 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other) Foundation 10 (5) 20 (10) ® Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Inspection Form June 2008 Public Health Department Community Development Division March 19, 2007 Kerry & Peter Breen 770 Boxford Street North Andover, MA 01845 RE: Wastewater System Plan for 02unguit Road Lot 5, Map 90A, Lot 5 Dear Mr. & Mrs. Breen, The North Andover Board of Health has completed review of the onsite wastewater treatment and dispersal system design plans for the above referenced property submitted on your behalf by The Neve -Morin Group dated January 12, 2007 and received by this office on February 8, 2007. The design has been approved for use in the construction of a new onsite wastewater system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)) 2. It is the responsibility of the applicant and/or the applicant's designer, installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 1600 Osgood Street M HEALTH DEPARTMENT M _ Page 1 of 2 Building 20; Suite 2-36 E -Mail: healthdept@townofnorthandover.com North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 I The location of the soil absorption system is to be marked in the field by the designer prior to commencement of construction. 4. A plan or sketch is to be provided by the designer to this office indicating the locaiotn of elevation of two benchmarks to be used for construction prior to issuance of a Disposal System Construction Permit. Your effort to provide a properly functioning onsite wastewater treatment and dispersal system for your property is greatly appreciated. The Health Department may be reached at 978-688- 9540 with any questions you might have. Sincerel , usan Y. Sawyer, REHS/RS Public Health Director encl: List of licensed installers cc: The Neve -Morin Group file Plan Review Letter Approval Ogunquit Road Lot 5 Page 2 of 2 Public Health Department Community Development Division March 19, 2007 Kerry & Peter Breen 770 Boxford Street North Andover, MA 01845 RE: Wastewater System Plan for Ogunguit Road Lot 5, Map 90A, Lot 5 Dear Mr. & Mrs. Breen, The North Andover Board of Health has completed review of the onsite wastewater treatment and dispersal system design plans for the above referenced property submitted on your behalf by The Neve -Morin Group dated January 12, 2007 and received by this office on February 8, 2007. The design has been approved for use in the construction of a new onsite wastewater system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)) 2. It is the responsibility of the applicant and/or the applicant's designer, installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 1600 Osgood Street HEALTH DEPARTMENT Page 1 of 2 Building 20; Suite 2-36 E -Mail: healthdept@townofnorthandover.com North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 3. The location of the soil absorption system is to be marked in the field by the designer prior to commencement of construction. 4. A plan or sketch is to be provided by the designer to this office indicating the locaiotn of elevation of two benchmarks to be used for construction prior to issuance of a Disposal System Construction Permit. Your effort to provide a properly functioning onsite wastewater treatment and dispersal system for your property is greatly appreciated. The Health Department may be reached at 978-688- 9540 with any questions you might have. Sincerel , usan Y. Sawyer, REHS/RS Public Health Director encl: List of licensed installers cc: The Neve -Morin Group file Plan Review Letter Approval Ogunquit Road Lot 5 Page 2 of 2 Page 1 of 1 DelleChiaie, Pamela From: Sawyer, Susan Sent: Monday, September 19, 2005 2:00 PM To: DelleChiaie, Pamela Subject: RE: soil test dates The Ogunquit lots are repeat soils due to the expiration of the deep holes. We should make sure that we send Mill River copies of the old soil tests for reference. Let me know if you can't locate them in the files, they may be together in one file as they weren't acted upon. Thanks Susan -----Original Message ----- From: Lisa LeVasseur[mailto:Iisal@millriverconsulting.com] Sent: Monday, September 19, 2005 10:21 AM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: soil test dates Hi there, The following soil tests are scheduled: Lots 5, 6, & 9 Ogunquit September 20, 9:00 a.m. 6 Penni Lane, September 28, 9:00 a.m. Thanks! Lisa Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultin2.com 7/9/2008 NORTH OEtriRe ye'��/. Public Health Department Community Development Division March 19, 2007 Kerry & Peter Breen 770 Boxford Street North Andover, MA 01845 RE: Wastewater System Plan for Ogunguit Road Lot 5, Mai) 90A, Lot 5 Dear Mr. & Mrs. Breen, The North Andover Board of Health has completed review of the onsite wastewater treatment and dispersal system design plans for the above referenced property submitted on your behalf by The Neve -Morin Group dated January 12, 2007 and received by this office on February 8, 2007. The design has been approved for use in the construction of a new onsite wastewater system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)) 2. It is the responsibility of the applicant and/or the applicant's designer, installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 1600 Osgood Street HEALTH DEPARTMENT Page 1 of 2 Building 20; Suite 2-36 E -Mail: healthdept@townofnorthandover.com North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 M .! 3. The location of the soil absorption system is to be marked in the field by the designer prior to commencement of construction. 4. A plan or sketch is to be provided by the designer to this office indicating the locaiotn of elevation of two benchmarks to be used for construction prior to issuance of a Disposal System Construction Permit. Your effort to provide a properly functioning onsite wastewater treatment and dispersal system for your property is greatly appreciated. The Health Department may be reached at 978-688- 9540 with any questions you might have. Sincerel , usan Y. Sawyer, REHS/RS Public Health Director encl: List of licensed installers cc: The Neve -Morin Group file Plan Review Letter Approval Ogunquit Road Lot 5 Page 2 of 2 91 n '` � _o ao '� •i Nola 4 ul) o o{ ) I I r TRANSMISSION VERIFICATION REPORT TIME 03/19/2007 15:14 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 03119 15:13 FAX NO./NAME 819788873480 DURATION 00:01:27 PAGE(S) 05 RESULT OK MODE STANDARD ECM Orth Andover Health De-Dorlme 1 600 Osgood Street Building 20, Suite 2-36 North Andover, SAA 01845 978.688.9540 - Phone 978.688.8476 — Fax �eal�i�.dsptawnafnartlrandaver..eo�n, E�mgw� uuww.towaofnort anda�®,�.co� • Vlleloa��a Letter of Transmittal Mop of T0: DATE COMPANY: TRO* Pamela DolleChiaie, Health Department Assistant Ph 7 915—ell.- Fax• / � � �.- - _ "-" �� Wo rrre sending you: f7 Copy of Leer 0,014%Ns 17 lAt r ail in AeloW) These are transmitted as chefked below-, � ,�O�npmr�dasA► )0 L 7,AsANu W > L7far4gnr W ➢ aRftWMV4Wft=W > D%rnew ➢ L7&6*_ g*sf&ra&t North Andover Health Department 1600 Osgood Street Building 20, Suite 2-36 North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 — Fax healthdegt@townofnorthandover.com - E-mail www.townofnorthandaver.com - Website Letter of Transmittal Page / of v� We are sending you: O Copy of Letter O Plans O 0t r V !l in below) These are transmitted as checked below: ➢ a4 *yvva1xAbMd ➢ L7AsAVa*d ➢ Ow*" REMARKS: COPY TO: COPY TO: ➢ akr&%i%vnidxnyn ,t ➢ Orarawav SIGNED: ➢ OIPw6nr't iq*fw qPVNd ➢ L7&A7 ►t gmFzf6r&t. Dellethiaie, Health Department Assistant ON K 1�11_ We are sending you: O Copy of Letter O Plans O 0t r V !l in below) These are transmitted as checked below: ➢ a4 *yvva1xAbMd ➢ L7AsAVa*d ➢ Ow*" REMARKS: COPY TO: COPY TO: ➢ akr&%i%vnidxnyn ,t ➢ Orarawav SIGNED: ➢ OIPw6nr't iq*fw qPVNd ➢ L7&A7 ►t gmFzf6r&t. �f O LETTER OF TRANSMITTAL NORTF/ North Andover Health Departmentof tueo , 400 Osgood Street 6'� ooL North Andover, MA 01845 0 p 978.688.9540 - Phone __ _____ s, �C '" •" 978.688.8476 - Fax °+ C« me healthdet)t(a�townofnorthandover.com - E-mail �'1s "''T'o''��'� uS� www.townofnorthandover.com - Website Page of s�cN TO: Daniel Ottenheimer DATE: g 'i�j d.5-- COMPANY: FROM: Pamela f5elleChiaie, Health Dept. Assistant Mill River Consulting COPY TO: RE: Phone: 1.800.377.3044 or 978.282.0014 �L , Fax: 978.282.0012 I • • / � / � • / _�rls%/%l��LUrr W.p 0001_�Af�AOVIZWMSFAP These are transmitted as checked below: OFor Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY T . SIGNED: COPY TO: Sep 23 03 11:32a FORTH nNDOVER 971P':889542 r f BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978.6884540 APPLICATION FOR SOIL TESTS DATE: 10/11/04 MAP&PARCEL- Map 90A, Parcel 5 LOCATION OF SOIL TESTS: Lot 5 0 g u n q u i t Road OWNER: Peter & Kerry Breen TEL.NO.:978-687-7774 ADDRESS: 770 Boxford Street, North Andover ENGINEER:The Neve -Morin Group, Inc.TEL,NO.: 978-887-8586 CERTIFIED SOIL EVALUATOR: G r e g H o c h m u t h Intended use of land: Residential Subdivision n le Family Home Commercial Is This: X Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: p.2 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of3$ 60.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. 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. N.A. Conservation Commission Date Received: Check Amount: Check Date: �s f�C w� NAS RECEIVED AUG 2 4 2005 TOWN OF NORT�ANDOVER HEALTH DEP Y ^ V o Y `� D N• a N O a � • � Y • y `dSU IVld 33S Lu o d i ai in $ ❑m m $ y N r n . $ O p N • �o � W � ejb, J Q y .OY U m, < _ 8 Y 0) " d eT \ S o W � co A T Y W 8 N y R. e� .R O 1 4 " r y v� R ccn <e Y o W) y ' en o N ^r -y �1 o � � � '� , ' 1 � ,♦rte, at 10 1Sol dp- dO " .wwir 1` tart ' dog -rcu -rat � "w�"► -. � vxeo •, sr 1 f ' //♦ / VJ6♦. / SAL`*mss, �, 1 `♦ , ♦ � ♦ 11 I I ♦� / 1 1 1 1 1 ► �, 1 � •••.►on•• - '►'.ter ��'� �, r • � I Oo % . '�� i i fill �J" DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Tuesday, September 20, 2005 12:58 PM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: Soils for Ogunquit Road IMI Soils for Lots 5, 6, 9.tif Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com <http://www.millriverconsulting.com/> 5 DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Monday, September 19, 2005 10:21 AM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: soil test dates Hi there, The following soil tests are scheduled: Lots 5, 6, & 9 Ogunquit September 20, 9:00 a.m. 6 Penni Lane, September 28, 9:00 a.m. Thanks! Lisa Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com <http://www.millriverconsultin .cg om/> Page 1 of 1 DelleChiaie, Pamela From: Sawyer, Susan Sent: Monday, September 19, 2005 2:00 PM To: DelleChiaie, Pamela Subject: RE: soil test dates The Ogunquit lots are repeat soils due to the expiration of the deep holes. We should make sure that we send Mill River copies of the old soil tests for reference. Let me know if you can't locate them in the files, they may be together in one file as they weren't acted upon. Thanks Susan -----Original Message ----- From: Lisa LeVasseur[mai Ito: IisaI@mil Iriverconsulting.com] Sent: Monday, September 19, 2005 10:21 AM To: Sawyer, Susan; amcbrearty@miliriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: soil test dates Hi there, The following soil tests are scheduled: (:Lo�ts5, & 9 Ogunquit ptember 20, 9:00 a.m. 6 Penni Lane, September 28, 9:00 a.m. Thanks! Lisa Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 9/19/2005 Page 1 of 1 DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Tuesday, September 20, 2005 12:58 PM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsultin.g.com Subject:�11S-107-0-9- unquitRoad Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultina.com 9/20/2005 he Neve -Morin ATn Group, Inc. October 20, 2005 Ms. Susan Sawyer, R.S./R.E.H.S. Health Director Health Department 400 Osgood Street North Andover, MA 01845 Re: Lot 5, Ogunquit Road (Map 90A, Parcel 5) Lot 6, Ogunquit Road (Map 90A, Parcel 75) Lot 9, Ogunquit Road (Map 105A, Parcel 24) Owners: Peter & Kerry Breen Dear Ms. Sawyer: OCT 2 1 21.5 In accordance with 310 CMR 15.018 — Function of Soil Evaluators, please find enclosed copies of the certification forms for the soil testing which was conducted at the above -referenced properties on September 20, 2005. If you should have any questions regarding any of this information please do not hesitate to contact our office. Sincerely, THE NEVE-MORIN GROUP, INC. Isaac M. Rowe, R.S. Environmental Sanitarian IMR/km Enclosures cc: Peter Breen 684_Lots569 NABH.doc ENGINEERS • SURVEYORS * ENVIRONMENTAL CONSULTANTS • LAND USE PLANNERS 447 Old Boston Road (U.S. Route 1), Topsfield, MA 01983 978-887-8586 FAX 978-887-3480 Providing Professional Services Since 1978 www.nevemorin.com FORM 11 SOIL EVALUATOR FORM Pagel of 3 No. 684 Date: 9/20/05 Commonwealth of Massachusetts North Andover, Massachusetts Soil Suitabilitv Assessment for On-site Sewame Disposal Performed By: Isaac Rowe Date: 9/20/05 Witnessed By: Randy Burley (Mill River Consult) Date: 9/20/05 Location Address or Lots 5,6 & 9 Ogunquit Rd. Owner's Name Peter & Kerry Breen North Andover, MA 01845 Lot # Address and 770 Boxford Street North Andover, MA 01845 Telephone # 978-687-7774 New Construction Repair C� ` Office Review Published Soil Survey Available: No = Yes Year Published 1981 Publication Scale 1" = 1320' Drainage Class B Soil Limitations Surficial Geologic Report Available: No 0 Year Published Publication Scale Geologic Material (Map Unit) Landform Yes Flood Insurance Rate Map: Above 500 year flood boundary No Yes X Within 500 year flood boundary No X Yes Within 100 year flood boundary No X Yes Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range: Above Normal 0 Normal L —� Below Normal Other References Reviewed: Soil Map Unit CcC FORM 11— SOIL EVALUATOR FORM Page 2a of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road On -Site Review Deep Hole Number OP 05-1 Date 9/20/05 Time 10:00 am Weather Cloudy 75 Location (identify on site plan) See Plan Land Use Residential Slope (%) 8-15% Surface Stones Few 1' — 3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) Distances from: See Plan Open Water Body 1001+ feet Drainage Way feet Possible Wet Area 100'+ feet Property Line 10'+ feet Drinking Water Well 1001+ feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Groundwater: Standing Water in the Hole: NA Estimated Seasonal High Ground Water: 60" DEP APPROVED FORM — 12n195 Depth to Bedrock: NA DocumenQ Weeping from Pit Face: NA DocumenQ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stories, Bounders, Consistency, % Gravel) 0-12" A FSL 10YR3/2 12-36" Bw FSL 10YR5/8 36-60" Cl FS 2.5Y6/4 ESHWT @ 60" 60-108"+ C2 SL 2.5Y5/6 *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Groundwater: Standing Water in the Hole: NA Estimated Seasonal High Ground Water: 60" DEP APPROVED FORM — 12n195 Depth to Bedrock: NA DocumenQ Weeping from Pit Face: NA DocumenQ FORM 1 I — SOIL EVALUATOR FORM Page 2b of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road On -Site Review Deep Hole Number OP 05-2 Date 9/20/05 Time 10:00 am Weather Cloudy 75 Location (identify on site plan) Land Use Residential Slope (%) 8-15% Surface Stones Few 1'-3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) Distances from: See Plan Open Water Body 1001+ feet Possible Wet Area 1001+ feet Drinking Water Well 1001+ feet Drainage Way feet Property Line 10' + feet Other *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM — 12/7/95 DocumenQ DocumenQ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Bounders, Consistency, % Gravel) 0-12" A FSL 10YR3/2 12-30" Bw FSL 10YR5/8 30-120"+ C1 SL 2.5Y5/6 ESHWT 48" *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: NA Estimated Seasonal High Ground Water: 48" DEP APPROVED FORM — 12/7/95 DocumenQ DocumenQ FORM 11 — SOIL EVALUATOR FORM Page 2c of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road On -Site Review Deep Hole Number OP 05-3 Date 9/20/05 Time 10:00 am Weather Cloudy 75 Location (identify on site plan) See Plan Land Use Residential Slope (%) 8-15% Surface Stones Few 1'-3' Dia. Vegetation Woods Landform Drumlin Position on landscape (sketch on the back) See Plan Distances from: Open Water Body 1001+ feet Drainage Way Possible Wet Area 1001+ feet Property Line Drinking Water Well 100'+ feet Other feet 10' + feet *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial Till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: Estimated Seasonal High Ground Water: 36" DEP APPROVED FORM — 12/7/95 DocumenQ DocumenQ NA DocumenQ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Bounders, Consistency, % Gravel) 0-18" Fill & Ap 18-28" Bwb FSL 10YR4/6 28-102"+ Cl LS 2.5Y5/6 ESHWT 36" *MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) Glacial Till Depth to Bedrock: NA Depth to Groundwater: Standing Water in the Hole: NA Weeping from Pit Face: Estimated Seasonal High Ground Water: 36" DEP APPROVED FORM — 12/7/95 DocumenQ DocumenQ NA DocumenQ FORM 11 — SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road Determination for Seasonal High Water Table OP 05-1 Method Used: Depth observed standing in observation hole Depth weeping from side of observation hole X Depth to soil mottles Groundwater adjustment Index Well Number Adjustment factor Reading Date inches inches 60 inches feet Index Well Level Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in spring 20011 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. _ Signature Date 9 DEP APPROVED FORM - 12n195 Document6 FORM 11 — SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road Determination for Seasonal Hieh Water Table OP 05-2 Method Used: Depth observed standing in observation hole Depth weeping from side of observation hole X Depth to soil mottles Groundwater adjustment Index Well Number Adjustment factor Reading Date inches inches 48 inches feet Index Well Level Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in Spring 20011 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. Signature Date Z Os DEP APPROVED FORM — 12/7/95 Document6 FORM 11— SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Lots 5,6 & 9 Ogunquit Road Determination for Seasonal High Water Table OP 05-3 Method Used: Depth observed standing in observation hole Depth weeping from side of observation hole X Depth to soil mottles Groundwater adjustment Index Well Number Adjustment factor Reading Date inches inches 36 inches feet Index Well Level Adjusted ground water level Depth of Naturally Occurring; Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that in Spring 20011 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. ,1 Signaturefee-�—"'C�—"C Date DEP APPROVED FORM — 12n195 Document6 �J ltj NI!� 67 IQr�` - i _-- __._� � 11 � � � 1 o u 1 � 1 �_ 1 � � 1 � 1 � � � ,._._ _ �, � � � �, Town pf North Andover Health Department Date: Location: (Indicate Addr s, i ResiLdentia or Name orf business) Check #:Dg/ Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: �'Sep�Soil Testing /- ` $ 7 ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) G $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashVSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) 4 8 9 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer - LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax healthdept(a�townofnorthandover.com - E-mail www.townofnorthandover.com - Website Page of J pORTfy OE Kt��c , �qr 0? b ~', • ' Mb'6 OOH * 4 TO: Daniel Ottenheimer DATE: g a ®� COMPANY: FROM: Pamela 6elleChiaie, Health Dept. Assistant Mill River Consulting COPY TO: RE: Phone: 1.800.377.3044 or 978.282.0014 Fax: 978.282.0012 These are transmitted as checked below: OFor Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY TO: SIGNED: COPY TO: Sep 23 03 11:32a NORTH ANDOVER 9786889542 BOARD OF HEALTH ' NORTH ANDOVER, MASS. 01845 978-688.9540 DATE: 10/11/04 APPLICATION FOR SOIL TESTS MAP &PARCEL: Map 90A, Parcel 5 LOCATION OF SOIL TESTS: Lot 5 Ogunquit Road OWNER: Peter & Kerry Breen TEL.NO.:978-687-7774 ADDRESS: 770 Boxford Street, North Andover ENGINEER:The Neve -Morin Group, Inc-TEL.NO.: 978-887-8586 CERTIFIED SOIL EVALUATOR: G r e g H o c h m u t h Intended use of land: Residential Subdivision n le Family Home Commercial Is This: Repair testing Undeveloped lot testing X Upgrade for addition In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: p.2 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 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 $360.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. 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: Check Amount: Cheek Date: VSU iVld 33S \, °i0� ' 2 M +Br < N C,4 o �o \ N OD c M \ r IN S N W z o /• y ' � � uaaen N G • � � J . cr) —: O1 � � M co <. N . y Zo OD M a p (06 9G N < m , ' n 4A M 9 f 0 �tn m Y a w Z s a • •tea EM. -- ' �� ,,, � � VSU iVld 33S \, °i0� M +Br < N C,4 o �o \ N OD c M \ r IN S