HomeMy WebLinkAboutMiscellaneous - 1099 SALEM STREET 4/30/2018 (3) Health Department
1099 Salem Street Lot 2
North Andover, MA 01845
4
..a ► n ; Commonwealth of Massachusetts
Map-Block-Lot
106.A0049
BOARD OF HEALTH
Permit No
- North Andover BHP-2017-0517
v
P.I. FEE
F.I.
DISPOSAL WORKS CONSTRUCTION P @, ��,,
Permission is hereby granted RobertInnis
to(Construct)an Individual Sewage Disposal System.
at No 1099 SALEM STREET_=p -��o 0arce-1i /'o$? ,fi e _
J
as shown on the application for Disposal Works Construction Permit No. BHP-2017-051 ted July 7
Issued On: Jul-31-2017 ARD F HEALTH
----------------------------------------------------------------------------------
=ua Application for Septic Disposal System
TODAY'S DATE
Construction Permit — TOWN OF
$350.00-Full Repair
NORTH ANDOVER, MA 01845 $175.00-Component
Important: Application is hereby made for a permit to:
When filling outConstruct a new on-site sewage disposal system*
forms on the OZ
computer,use E] Repair or replace an existing on-site sewage disposal system*
only the tab key �
E]to move your Repair or replace an existing system component—What? 011
cursor-do not A n
use the return A. Facility Information
key. Qy„1
Address or Lot# Q 0
r�6
oc A -,NQr
City/Town
2.-*TYPE OF SEPTIC SYSTEM*:
➢ ❑ Pump Gravity(choose one)
***If pump system, attach copy of electrical permit to application***
➢ Conventional System (pipe and stone system)
➢ Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system.)
➢ ❑ Pressure Distribution S.A.S.(No D-Box)
--.--> ❑=PPessure Dosed-(D=Boz-Pres`ent)4S:A.S.----- --- .
➢ ❑ Does the system require an effluent filter? Yes No
If yes, does plan specify make and model of filter? YES =(no further info. needed)
NO=(installer must specify brand of filter before DWC issuance)
What is the Make? What is the Model.
2. Owner Information
NamLn5 12�07�r
Address(if different from above)
3 11 ,c.,,, M (OIC910
Ci( /Town II State Zip Code
�Rf�.l
Email address Telephone Number
3. Installer Information
c6 :'('\\$
Name Name of Company
4-)5
Address
City/Town State Zip Code .
Telephone Number(Cell Phone#if possible please)
4. Desiqner Information
L
Name \\ Name of Company
Address
City/Town State Zip Code
Telephone Number(Best#to Reach)
Application for Disposal System Construction Permit-Page 1 of 2
.1
•� '.a"'•r. Application for Septic Disposal Svstem
TODAY'S DATE
Construction Permit - TOWN OF
$350.00-Full Repair
NORTH ANDOVER, MA 01845 $175.00-Component
PAGE 2OF2
A. Facility Information continued....
5. Type of Building: tktesidential 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. I understand that until a final Certificate of Compliance has been issued by
this Board of Health, the installed system is not approved.
71.Z 2
Name Date T—rte
Appli n ed By: (Board of Health Representativ
3 �-
Name Date
Application Disapproved for the following reasons:
For Office Use Only:
1. Fee Attached? Yes No
2. Project Manager Obligation Form Attached. Yes_ No
3. Pump SsY tem? If so,Attach coy ofElectrical Permit Yes No
Applicant received copy of
"Electrical Inspection Notes for Septic Systems" Yes No
Handout?
4. Reviewed approval all a erwork received.P Yes � No
PP � P P —
Miss-1,99:
5. Foundation As-Built?(new construction only): Yes No
(Same scale as approved plan)
G. Floor Plans?(new construction only): Yes No
Application for Disposal System Construction Permit•Page 2 of 2
NORT ' 965
N 1
O• h0
l 3? .•.i• . ..'•. oL
T
Town of North Andover
HEALTH DEPARTMENT
$,CHUS!
CHECK#: DATE: 7
LOCATION: /G 9 4 0 8 _7�M S4
H/O NAME:
CONTRACTOR NAME: /30
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 Systems:
❑ Septic-Soil Testing $
�❑j Septic-Design Approval $
�] Septic Disposal Works Construction(DWC) $ 0® —
,❑` Septic Disposal Works Installers(DWI) $
❑ Title 5 Inspector $
❑ Title 5 Report $
❑ Other:(Indicate) $
He gent Initial
White-Applicant Yellow-Health Pink-Treasures
r
S
SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction for the septic system for the property at:
(Address of septic system) For plans by
R Y ngineer)
Relative to the application of O `{\�1 S
(Installer's name) And dated
✓� ngm date)
Dated
i I
o ay s ate With revisions dated
(Last revised date)
I understand the following obligations for management of this project:
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 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 (11� 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@northandoverma.gov) 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 septic 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: IQ's 1�? (Today's Date)
AAAS���J 44X4�
(Name—Print) (Name—Signed)
�i
Marchionda
& Associates, L.P.
I , s
Engineering and
Planning Consultants
October 24, 2017
Mr. Brian LaGrasse
Health Director
120 Main Street
North Andover,MA 01845
RE: 1099 Salem Street—Lot 2
Septic System—Field Revision
Dear Brian:
During review of the approved plans for the subject property, an error with the proposed grading of trench#1
was noticed. Trench#1 was inadvertently proposed higher than necessary and as such we have lowered .
Trench#1 by approximately 4 inches. The revised grading still meets the required separation to groundwater.
Additionally, we have raised the grade of the distribution box by 4 inches based on the as-built elevation of
septic tank outlet to maintain the proposed 1% slope to the distribution box. Attached,please find the revised
plan reflecting these changes(changes are shown in red text).
We apologize for any confusion this may have caused. Should you have any questions please do not hesitate
to contact us.
Sincerely,
Marchionda&Associates, L.P.
Craig Marchionda,PE
Project Engineer
Cc: Dave Innis
62 Montvale Avenue,Suite I Phone: 781-438-6121 www.marchionda.com
Stoneham, MA 02180-363 Fax: 781-438-9654
E-mail: mail@marchionda.com
mrERu¢o1Es ^�' --
_ _-- __. --_
- ___ �/ ,m/
',:; / _ - _ _-
sev+ne.0
----------
-
_-----------
.n¢..mrw®,..ern¢rew�ma.,,am. TYPICAL TRENCH DETAIL
emmelme¢n.n,ne.Ien...¢nnnane®na.e LOCUS MAP
a eam�.¢n.r,mn...,e,en m¢a.c. eE eox m
ameo vr¢nm a®mnem even.®r�ce�v. CM p11tlN 3'OP iNc41 tl+M[ wo LCIT2
tC1.
¢Ire au wa w,.m,w�eva,u¢msw,iv®rivmr.aunt b PC
6fi05
C047MCDON NOTES MEw/CAP
&.ACM
CROSS SECTION THROUGH TRENCHES
®wmvws®cs anvm c¢v,mva.mmnwnAn PfAf. E e.ls -__"� �-R' � _
m rR�Bo mw�avcimr"v�'ce�R®unm¢�anc Wmn '- -----n---
VALVE BOX OVER INSPECTION WELL DETAIL
.nnm.ml..ea.mm.
.� ..
aeE.w¢m.,n.newn ;I �. ,• T-
------------
.nlw¢an,emr�nwm wu¢.aa.mecmev¢u.m IL _ jI 1 :.���, n ------ •`.:: t3
LEGEmPw®¢¢NnbromwD
88
`
--------"'_'mm -_�I> - ' s -` �-R'.,yD,,"., .. ,eme r,�.,'Ln.�¢c°nx.a,/lx's�.k•an,a."E"oa'�;"^`y�O
i_°12,1Z
b�o
ES
a
¢Inmw,¢°mx¢.ee.uer arp wmn¢r v¢nb mumxc �- l 6Em1W y; - �, Jml y�k 4'',4 WE1"'I� i` }' 3 LT
.eammtneaaPevnn n,mwam .m LEACHING TRENCH SUMMARY
mnrname.m� 1610 tee- i m ¢ek.a ,d. n¢«am.m.em..r j .d�v_-t ., •,,�``�. be.�� - .�.. r 1 ,`,
1e3.e M- 1500 GALLON SEPTIC TANK
ww.n.rar.®nmrn¢.w®.m '°mow 16593 w..- DESIGN CALCULATIONS
w m 1
Lu
N O LL Lu x�
SOIL TEST DATA r m, uar,mowxacwl¢Anae ^N. ,((� /" sw,xAmw ma,mann x a 4 s Z n 2 m O
rp v�/were ay� w / ki '' N y yO CS 6 C) Z
n Ineule enx6nm w.n.ru reser mmz. `-/ •• f '\ W Q O Z d Q
Cdb.W 3L n.¢,a,.—u..onm m•1N_v. / ,F;-^' ss,mc rnx uro sAs W
mall r Ivm1 g(¢1Mdte0VeUlEnRAtq! , w mw 'Em O Z Y O
¢eun nes.ac ,u m
e¢wm
r,t6' IoutYt66.s61Ao- m.et�nen.rw. -.6�ca an _ EX. HIT. CONC. UI'IV_ It
Z
l
wn conrranorCIL a.
Al
�a;t p
RIZOME t'.
ALSCALMarchionda
j�tac a r_ —•r 3 � ,v PLLA� 20 10 HOo zo -2 60IM&A-1, s.L.P.
d B
J_xnmY+e.d° VERTICAL SCALE:iZ' PoenBriml alCmaWmrb
,l 16 r9IIlIXYt 7w9E0. �remw tly
l oul-165.9] - 62 Montvale Avenue
- cLL _.__ tp♦ Ta S
4 )mrsrre� pF Sttoneh—eh
am,MA 02160
7EL: 7E 438-6121
wp 1 r—L 9 FA%: ] 436-9654
Emal:leng1glneeringQmarchiondo.com
® � I y ep„�,� VfeEsite: www.marchionde.com
Wam
,x —w ,m —m ,r I _ ¢nmrauva .,rnvw ane v\\mvrlmison,mwV¢\sr¢wx-¢V m9emnga
eOPROFILE TRENCH#2 6 OUTLET CONCRETE DISTRIBUTION BOX
10/25/2047 Town of North Andover Mail-Fwd:[North Andover MA] 1099 Salem Street-Lot 2 Septic System(Sent by Craig Marchionda,c.marchionda@...
��®,�-
w ,
NOR
Massachu Us _ Toni Wolfenden <twolfenden@northandoverma.gov>
Fwd: [North Andover MA] 1099 Salem Street - Lot 2 Septic System (Sent by Craig
Marchionda, c.marchionda@marchionda.com)
2 messages
Brian LaGrasse<blagrasse@northandoverma.gov> Tue, Oct 24, 2017 at 5:02 PM
To: Toni Wolfe nden<twolfenden@northandoverma.gov>, Isaac Rowe <irowe@millriverconsulting.com>
---------- Forwarded message----------
From: Contact form at North Andover MA<vtsd mailer@vt-s.net>
Date: Tue, Oct 24, 2017 at 4:57 PM
Subject: [North Andover MA] 1099 Salem Street- Lot 2 Septic System (Sent by Craig Marchionda,
c.marchionda@marchionda.com)
To: blagrasse@northandoverma.gov
Hello blagrasse,
Craig Marchionda (c.marchionda@marchionda.com)has sent you a message via
your contact form (https://www.northandoverma.gov/user/56/contact)at North
Andover MA.
If you don't want to receive such e-mails, you can change your settings at
https://www.northandoverma.gov/user/56/edit.
Message:
Good Afternoon Brian,
Upon reviewing our plans for the subject property an error was noticed and
we have made revisions. Attached please find a memo summarizing the
revisions as well as a revised plan. We apologize for any confusion this may
have caused. Please feel free to contact us with any questions you may have.
Thank you,
Craig Marchionda
Brian J. LaGrasse, CEHT
Director of Public Health
Town of North Andover
120 Main Street
North Andover, MA 01845
I
Phone 978.688.9540
Fax 978.688.8476
Email blagrasse@northandoverma.gov
Web www.northandoverma.gov
https://mail.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=Kkobh6whZGg.en.&view=pt&search=inbox&th=15f537ab5664ca29&siml=15f50319fd60a... 1/3
i
10/25/2017 Town of North Andover Mail-Fwd:[North Andover MA] 1099 Salem Street-Lot 2 Septic System(Sent by Craig Marchionda,c.marchi*o da@...
.. 1
� SwKTLT:uy�s • ,j
memo to bo h_10242017_-_red u ce d.pdf
1621K
Isaac Rowe<irowe@millriverconsulting.com> Wed, Oct 25, 2017 at 8:21 AM
To: Brian LaGrasse <blagrasse@northandoverma.gov>, Toni Wolfenden <tolfenden@northandoverma.gov>
Cc: Isaac Rowe <irowe@millriverconsulting.com>
Brian,
I am comfortable with that because they were more than conservative on their initial ESHWT under trench 1.
Thanks,
Isaac Rowe
Project Manager
pw �n" AN N1VZiV$A4Y
�LL RIVER CONSULTING
CAV,36Ac.S0l'id()114'Cion C-inl l;kiAI-9-11130)f
6 Sargent Street
Gloucester, MA 01930-2719
Phone:978-282-0014 ext.804
www.millriverconsulting.com
From: Brian LaGrasse [ma i Ito:blag rasse@northandoverma.gov]
Sent: Tuesday, October 24, 2017 5:02 PM
To: Toni Wolfenden; Isaac Rowe
Subject: Fwd: [North Andover MA] 1099 Salem Street- Lot 2 Septic System (Sent by Craig Marchionda,
c.marchionda@marchionda.com)
[Quoted text hidden]
[Quoted text hidden]
https://mail.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver-Kkobh6whZGg.en.&view=pt&search=inbox&th=15f537ab5664ca29&siml=15f5O319fd60a... 2/3
I
10/25/2:: 7 Town of North Andover Mail-Fwd:[North Andover MA] 1099 Salem Street-Lot 2 Septic System(Sent by Craig Marchionda,c.marchionda@...
i.Y.
1
All email messages and attached content sent from and to this email account are public records unless qualified as an
exemption under the Massachusetts Public Records Law.
Visit us online at www.northandoverma.gov.
https://mai l.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver-Kkobh6whZGg.en.&view=pt&search=inbox&th=l 5f537ab5664ca29&siml=15f50319fd60a... 3/3
(rte_ D
I
North Andover Health Department
Community and Economic Development Division PA
G®
July 26, 2017
Kindred Homes, Inc.
P. O. Box 531
North Andover, MA 01845
Re: Subsurface Sewage Disposal System Plan for 1099 Salem Street—Lot 2
(Map 106A,Parcel 49)
To Whom It May Concern:
The proposed wastewater system design plan for the above site dated May 17, 2017 with a final
revision date of July 17, 2017 and received on July 18, 2017 has been approved.
The design has been approved for use in the construction of a new on-site septic system for a 4-
bedroom house with a maximum of 9 total rooms,utilizing a gravity system. This design plan
approval is valid until July 26, 2020.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover.
This approval is also subject to the following conditions:
1. Please include risers on the septic tank to bring the inlet cover, center clean out cover
and outlet cover to within 6" of final grade.
2. Prior to the issuance of the Disposal Works Construction Permit,the applicant must
submit a foundation as-built at the same scale as the approved plan.
3. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms
or a total of 9 rooms.
Page 1 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
1099 Salem Street—Lot 2 July 26, 2017
w
4. . '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)).
5. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system 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.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincere
B an J. L /Grasse, CEHT
Director of Public Health
Encl. Installers list
cc: Marchionda Associates, L. P., 62 Montvale Ave, Suite 1, Stoneham, MA 02180
File
Page 2 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
North Andover Health Department
Community and Economic Development Division
July 26, 2017
Kindred Homes, Inc.
P. 0. Box 531
North Andover, MA 01845
Re: Subsurface Sewage Disposal System Plan for 1099 Salem Street—Lot 2
(Map 106A, Parcel 49)
To Whom It May Concern:
The proposed wastewater system design plan for the above site dated May 17, 2017 with a final
revision date of July 17, 2017 and received on July 18, 2017 has been approved.
The design has been approved for use in the construction of a new on-site septic system for a 4-
bedroom house with a maximum of 9 total rooms,utilizing a gravity system. This design plan
approval is valid until July 26, 2020.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover.
This approval is also subject to the following conditions:
1. Please include risers on the septic tank to bring the inlet cover, center clean out cover
and outlet cover to within 6" of final grade.
2. Prior to the issuance of the Disposal Works Construction Permit,the applicant must
submit a foundation as-built at the same scale as the approved plan.
3. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms
or a total of 9 rooms.
Page 1 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
1099 Salem Street—Lot 2 July 26, 2017
4. 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)).
5. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system 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.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincere
B /an J. L /Grasse, CEHT
Director of Public Health
Encl. Installers list
cc: Marchionda Associates, L. P., 62 Montvale Ave, Suite 1, Stoneham, MA 02180
File
Page 2 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
North Andover Health Department
Community and Economic Development Division
July 26, 2017
Kindred Homes, Inc.
P. O. Box 531
North Andover, MA 01845
Y 1 e
Re: Subsurface SewageP Disposal System Plan for 1099 Salem Street—Lot 2
(Map 106A, Parcel 49)
To Whom It May Concern:
The proposed wastewater system design plan for the above site dated May 17, 2017 with a final
revision date of July 17, 2017 and received on July 18, 2017 has been approved.
The design has been approved for use in the construction of a new on-site septic system for a 4-
bedroom house with a maximum of 9 total rooms,utilizing a gravity system. This design plan
approval is valid until July 26, 2020.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a-Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover.
This approval is also subject to the following conditions:
1. Please include risers on the septic tank to bring the inlet cover, center clean out cover
and outlet cover to within 6" of final grade.
2. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit a foundation as-built at the same scale as the approved plan.
3. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms
or a total of 9 rooms.
i
Page 1 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
1099 Salem Street—Lot 2 July 26, 2017
4. 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)).
5. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system 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.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincere
Bran J. L Grasse, CEHT
Director of Public Health
Encl. Installers list
cc: Marchionda Associates, L. P., 62 Montvale Ave, Suite 1, Stoneham, MA 02180
File
Page 2 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
Marchionda
& Associates, L.P.
Engineering and
Planning Consultants
July 17, 2017 TOWN OF NORTH ANDOVER
NPATM D TMENT
Mr. Brian LaGrasse
Health Director
120 Main Street
North Andover, MA 01845
RE: 1099 Salem Street—Lots 1 &2__/
Septic System Reviews
Dear Brian:
Thank you for taking the time to review our septic system design revisions for 1099 Salem Street, Lots 1 &2
so promptly. Below please find your review comments (received via email from Mill River Consulting on
July 14, 2017) followed by our responses in italics. Our revised design plans are included as well.
Lot 1:
No outstanding review comments.
Lot 2:
1. It appears your reserve trench is above and the primary is adjacent to TP-13 and P-13. It was my
understanding we were going to stay away from this test pit because we abandoned the perc test(see
my field notes attached).
We have slightly revised the location of TP-13 and P-13 on the site plans to more accurately reflect
their actual locations. Additionally, we have split one of our reserve trenches into two shorter reserve
trenches (providing the same total length) to provide more separation from TP-13 and P-13. We do
feel that the result of the percolation test performed in P-13 was an anomaly based on the overall
consistency of the other nearby percolation tests.
2. Your cover letter and plan do not seem to address items #9-12 if my review letter.
We apologize for missing these review comments initially. Please see our responses below, with
numbering consistent with your review letter;
9. The finished side slope of the leaching facility is greater than 3:1 (3 10 CMR 15.255).
We have revised the grading in this area to achieve a 3:1 slope between the proposed
impervious barrier and retaining wall.
62 Montvale Avenue,Suite I Phone: 781-438-6121 www.marchionda.com
Stoneham, MA 02180-363 Fax: 781-438-9654
E-mail: mail@marchionda.com
10. Provide finish grade spot elevations to confirm the breakout elevation of trench#1 (167.3-
167.6) is met (3 10 CMR 15.255).
Two finish grade spot elevations have been added to the plan to confirm the breakout elevation
of trench I is met.
11. Provide finish grade spot elevations to confirm the minimum cover material is met above
the septic tank(3 10 CMR 15.228(1)).
Two finish grade spot elevations have been added to the plan to confirm the minimum cover
over the septic tank is met.
12. Although not a reason for disapproval, you may wish to consider the following: It appears
trench#2 is designed on a higher existing grade elevation (162.5) than the proposed location of
approximately 161.8.
We appreciate you bringing this to our attention and have decided to revise the design of
trench #2 based on an existing elevation of 161.8.
The existing grade of trench #2 has been changed from 162.5+/- to 161.8+/--. The ESHWT for trench
#2 has been revised to 158.3 based on 42" below the existing grade of 161.8. The separation between
the ESHWT and the bottom of trench #2 is 4 feet. Similarly,for trench #1 the ESHWT for was stepped
due to the difference in existing elevations at the two trench locations and is at elevation 160.0 (42"
below existing grade of 163.5). The separation between the ESHWT and the bottom of trench #1 is 4
feet.
We hope our responses adequately address your review comments. Should you have any additional questions
please do not hesitate to contact us.
Sincerely,
Marchionda &Associates, L.P.
L
Craig Marchionda, PE
Project Engineer
Cc: Kindred Homes
Arco Excavators, Inc.
v
Marchionda
&Associates, L.P. RECEIVED
11012 12017
Engineering and
Planning Consultants TOWN OF NORTH ANDOVER
June 21,2017 HEALTH DEPARTMENT
Mr. Brian LaGrasse
Health Director
120 Main Street
North Andover,MA 01845
RE: 1099 Salem Street—Lots 1 &r 2
Septic System Reviews
Dear Brian:
We submitted septic system plans for the subject lots in late May. Since submitting the plans we have noticed
a drafting oversight on our plans,which may potentially cause confusion during the construction and
inspection of the systems. We wanted to bring this to your attention now and we will clarify this when
submitting revised plans addressing any comments you may have upon the completion of your review.
On each of the two lots there is a dashed line shown 10 feet from the edge of the trenches and it is labeled
"prop. septic system". This line is not necessary beyond the limits of the impervious barrier. We understand
this line may be mistakenly interpreted as the limit of excavation for the systems. The limit of excavation will
be 5' (minimum) beyond the trenches as indicated in construction note#1 on our plans. Where the
impervious barrier is proposed,the excavation will need to extend greater than 5 feet to facilitate the
installation of the barrier.
We have attached a sketch identifying the drafting oversight for your reference. The same sketch applies to
both lots. We hope this helps address any possible confusion regarding the limit of excavation.
Please do not hesitate to call if there are questions or if any additional information is required.
Sincerely,
Marchionda&Associates,L.P.
Craig Marchionda,PE
Project Engineer
Cc: Kindred Homes
Arco Excavators, Inc.
62 Montvale Avenue,Suite.1 Phone: 781-438-6121 www.marchionda.com
Stoneham, MA 02180-363 Fax: 781-438-9654
E-mail: mail@marchionda.com
�x..w,Im,M.. � �_ _"=- '�fsr / .¢ =" ,/• tel/ j �•." "; - �� ..
GEWR4 MOM
,,�x mww.mw...,ror�w.m eau. ,.�`� l { f �' o:a �--� -a` � ��-p"-�.i' ^^ •-��� •:'�,• 1�_ _
.^A 170.161 SO.FT.'-
¢a.�wAm� FT � � ^¢a:, � .- --rte`' - .e^' 4.09 ACRES /' •�� _.,,+''L�`b �--�_
TYPICAL TRENCH DETAIL
x,a l•�=,• / na i /'� � "'` `_'; rl"19•r .-ni i �'•`
rw^w�wr.¢mn�w..v¢r.,warx.r�un.¢ LOCUS MAP '*'691.N'°m` U t '
oamxuu• .AunF -CHANGES TO LOT2 ruEMr G I dr ,,--__
swuenm mm rmooavm mwa Vi�VE�—mFPl19,
¢ ° •a rr4s,aux d "
.b P.V L. REMOVC PROP _ - 8 5 r r.
COIISiFx110N NOTES i' P
' v LL PE./cw t ..__ EPTC SY6TEM' �sem ° \^•' .J-•_I ,
-sal.b r.ec CROSS SECTION THROUGH TRENCHES
®®.�m¢scd� wramm.wmvmu¢w,rvaw �_PIpWa1 TKNU1 _ '. ASHEO LINE ,� a - i� ��
A �
If--rp-,-,__-_-= ar
_ a r snot,m:w A
.¢.M ww l®w mo.r¢e°.n owwx mo mu
�w�r�www xx¢°onern.womammrwm•
VALVE BOX COVER I _t xn II
INSPECTION WELL DETAIL 1 1 I '� .. i -'a.
rmu rao mn 1
'____
...Mr.mr.FmM.w.m wuwr:¢,xw w°.a Fn,w¢P,m wma LEGEND IL
aAMv:EW -JI E,o>n E.'. nni .m
--a,:
rww�®:mrrwxxesa�rawnawumiwow®vem.N 'IEACHMGTREHCH SUMMARY
rxmew �em.¢wnss wsxb x wi°��sOawaIDMM.r�nawx�� I /'� '\,. I
¢^E xnw FrF°®Fnr^xroom MmOmx
meum .¢¢rcmu rir Pm un mw ;
¢w¢xmawm mMw.s,mr m..¢^wm r:um wmwmw ne,°uwmm mn rw mm w.wmmw.[rw anm.n..w>�o `so t 'y
n,m w^wwrx®c mrx^ur°wawwrxnw R¢wurr H..
1500 GALLON SEPTIC TANK-
----------- :v - - --------
-- ----------- -DESIGN CALCULATIONS
'
W
SOIL TEST DATA ' - ml:°:w..va us r,. - "� '�` ---
a.°°"` Benchmark w 4 Z 0
AIv wrn runea.AuaanrtArmx Y. PK Nail r �✓n-'`, _ \ '� / vwi os a W 6-
U
-
P R wwr..r r El'e.1 3979 �� .,y � ``/ y\ O F a:a
Elev 159.66.NAVD 86
#SA 'r?,1 / \ O Z Y a
•u® L ia:xnr , _.__._._ 4TFTIMI�^UObtlVMRPt ���. Z
wi°in
w. ..r
#5At�
NIES
mr
#2A Marchionda
F NTAL
N HORIZOsCALE: 'y10
—L r 1- 20 10 0 20 1 40 e0z 1 a z 4 aM&A-oclata%L.P.
Enpname�oce
am,R
� dwu' VERTICAL SCALE:/'=2'
/\ I 62 Montvale A—
R°J s tneham,MA 02180
TEL: (781 438-6121
FAX; 781)438-9654
e9hloda.<om
Wb,ite: w—maarchi-ftcm
OA2 ESA7�1
:wmn¢O1POanms°vw¢x�rmk __•_n.cawr V^°1cTnI-w1m®OnNO.Aa Axr-Ev axrmrRO
PROFILE TRENCH#2 6 OUTLET CONCRETE DISTRIBUTION BOXY__ of/zs/w�
k ry^gsy SHEET 3 OF t
i
. 0
0
North Andover Health Department
Community and Economic Development Division
June 20, 2017
Craig Marchionda, P.E.
Marchionda&Associates,L.P.
62 Montvale Avenue, Suite 1
Stoneham,MA 02180
Re: 1099 Salem Street—Lot 2 (Map 106A,Lot49)
Dear Mr. Marchionda,
The proposed wastewater system design plan for the above site dated May 17, 2017 and received
on May 30, 2017 has been reviewed. Unfortunately, the plan cannot be approved until the
following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North
Andover regulation that is not met by this design follows each item where applicable.
1. Indicate the location of all deep observation test holes and percolation tests that were
performed on site. The abandoned test holes and percolation tests should be depicted to
confirm the proposed leaching facility is within an area of suitable soil.
2. Indicate the location of the existing or proposed water service line (3 10 CMR
15.220(4)(m)).
3. The reserve leach trenches should be graphically depicted on the design plan to confirm
compliance with setback requirements. It appears the western reserve leach trench would
be about 19 feet from the cellar wall(3 10 CMR 15.211).
4. Indicate the location and elevation of the foundation drain(NA 3.2).
5. Indicate the specifications of the inlet and outlet tees for the septic tank on the design
plan(3 10 CMR 15.227).
6. 6 inches of stone is required below the septic tank(3 10 CMR 15.221(2) & 15.228(l)).
7. Indicate if the septic tank is H-10 or H-20 loading.
8. The distribution box appears to have insufficient cover material as shown on the site plan
and profile views. 9 inches of cover material is recommended.
Page 1 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
9. The finished side slope of the leaching facility is greater than 3:1 (310 CMR 15.255).
10. Provide finish grade spot elevations to confirm the breakout elevation of trench#1
(167.3-167.6) is met(3 10 CMR 15.255).
11. Provide finish grade spot elevations to confirm the minimum cover material is met above
the septic tank(3 10 CMR 15.228(1).
Although not a reason for disapproval, you may wish to consider the following:
12. It appears trench#2 is designed on a higher existing grade elevation(162.5) than the
proposed location of approximately 161.8.
Please feel free to contact the office or Mill River Consulting at 978-282-0014 with any
questions you may have. We look forward to working with you to obtain a wastewater treatment
and dispersal system which will be in compliance with all regulations and assure protection of
public health and the environment of North Andover.
Sincer ly,
ria,. LaGrasse, CEHT
Director of Public Health
cc: Kindred Homes, Inc.
File
i
Page 2 of 2
North Andover Health Department, Town Hall, 120 Main Street,
North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542
r-
NORTH ANDOVER
131 MAIN ST
NORTH ANDOVER
MA
01845-9998
2439270845
05/30/2017 (800)275-8717 11:56 AM
ProductSale Final
Description Oty Price
Prepaid Mail 1
(Weight:0 lbs. 4.60 oz.)
(Destiration:GI-OUCESTER, MA 01930)
(Acceptance Date:05/30/2017 11:56
:52)
(Label #:9114901496450497549090)
Total -------------$0.00
BRIGHTEN SOMEONE'S MAILBOX. Greeting
cards available for purchase at select
Post Offices.
Yf�YtY(YfYfIY�ICY:YiY(7r Yl7C�K'K����71'1C 7�K:CYC Yl YC YCYCYC YC Yf YC YC Y(
Order stamps at usps.com/shop or call
1-800-Stamp24. Go to
usps.com/clicknship to print shipping
labels with postage. For other,
---11 ,-Pnn-Aqv-IISPS.
USPS TRACKING# 9114 9014 9645 0497 5490 90
&CUSTOMER For Tracking or inquiries 90 to USPS.corn
9
RECEIPT LABEL(ROLL) or ca111-800.222-1811.
evcvrvcwvrrvrvcvcv�r�rsrxxxn,.-„............. . _
Get your mail when and where you want
it with a secure Post Office Box. Sign
up for a box online at _
usps.com/poboxes.
Y(Y(Yt YC YC YC Y(Yi�YCKYf�)C fC�X��iC YCKY(7r Yt Y(�YCY(Y(1C YC YM Yc 1C YC YC YC
All sales final on stamps and postage
Refunds for guaranteed services only
Thank you for your business
NOW HIRING. Please visit
www.usps.com/careers to apply.
HELP US SERVE YOU BETTER
TELL US ABOUT YOUR RECENT
POSTAL EXPERIENCE
Go to:
https://Postalexperience.com/Pos
840-5018-0132-001-00017-631.61--02
or scan this code with
Your mobile device:
or call 1-800-410-7420.
YOUR OPINION COUNTS
Bill 111: 840-50180132-1-1763161-2
Clerk: 26
TOWN OF NORTH ANDOVER
Community&Economic Development
HEALTH DEPARTMENT
120 Main Street
NORTH ANDOVER,MASSACHUSETTS 01845
978.688.9540—Phone
978.688.9542—FAX
E-MAIL:healthdept@northandoverma.gov
WEBSITE:hqp://www.northandoverma.gov
SEPTIC PLAN SUBMITTAL
FORM RECEIVE®
MAY 2 6 2017
Date of Submission:05/25/2017 TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Site Location: 1099 Salem Street(Lot 2)
Engineer:Marchionda&Associates, L.P.
New Plans? Yes X $275/Plan Check# (includes 1St submission and one re-
review only)
Revised Plans?Yes $125/Plan Check#
Site Evaluation Forms Included? Yes X No
Local Upgrade Form Included? Yes No X
Telephone#:(781)438-6121 Fax#:(781)438-9654
E-mail:c.marchionda@marchionda.com
Homeowner
Name: Kindred Homes, Inc.
OFFICE USE ONLY
When the ission is complete (including check):
➢ Date stamp plans and letter
➢ Complete and attach Receipt
➢ it Copy File; Forward to Consultant
➢ Enter on Log Sheet and Database
Page 1 of 14
Commonwealth of Massachusetts
City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
r�
q:Y
A. Facility Information
Dave Kindred
Owner Name
1099 Salem Street 106.A/49
Street Address Map/Lot#
North Andover MA 01845
City State Zip Code
B. Site Information
1. (Check one) ® New Construction ❑ Upgrade ❑ Repair
2. Soil Survey Available? ® Yes ❑ No If yes: NRCS 307D
Source Soil Map Unit
Paxton fine sandy loam Possible high groundwater table
Soil Name Soil Limitations
Coarse loamy lodgement till derived from gneiss, granite and/or
schist Landform
3. Surficial Geological Report Available? ® Yes ❑ No If yes: 2006 1:50,000 C.Deposit
Year Published/Source Publication Scale s/TIII
4. Flood Rate Insurance Map
Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No
If Yes,continue to#5.
5. Within a velocity zone? ❑ Yes ® No
MassGIS Wetland Data Layer: MassDEP Wetlands 12K
6. Within a Mapped Wetland Area? El Yes ® No Wetland Type
7. Current Water Resource Conditions (USGS): 12/2016 Range: ❑ Above Normal ® Normal ❑ Below Normal
Month/Year
8. Other references reviewed:
t5form11 -TP14-15•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 2 of 14
Commonwealth of Massachusetts
City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area)
Deep Observation Hole Number: TP-14 01/05/17
Date Time Weather
1. Location
Ground Elevation at Surface of Hole: 161.0 Latitude/Longitude: /
feet
Description of Location: Northeast area of lot, in woods
2. Land Use Woodland 12
(e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%)
Wooded
Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS)
3. Distances from: Open Water Body Drainage Way Wetlands 155
feet feet feet
Property Line 30 Drinking Water Well Other
feet feet feet
4. Parent Material: Unsuitable Materials Present: ❑ Yes ® No
If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock
5. Groundwater Observed: ❑ Yes ® No If yes:
Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: 42 157.5
inches elevation
t5form11 -TP 14-15•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -1 Page 3 of 14
Commonwealth of Massachusetts
City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (continued)
Deep Observation Hole Number: TP-14
Redoximorphic Features Coarse Fragments Soil
Soil Horizon/Soil Matrix:Color- Soil Texture �a by Volume
Depth(in.) Layer Moist Munsell USDA Soil Structure Consistence Other
y ( ( Cobbles Moist
Depth Color Percent Gravel &Stones
0-15 Ap 10YR2/1 Loam 0 0 Weak Friable
15-25 Bw 10YR4/6 F LS 0 <5 Structureless V. Friable
25-60 C1 10YR5/8 42 7.5YR4/6 2 F Sand 10 <5 Structureless Loose
60-120 C2 2.5Y5/6 F LS 15 15 Structureless Friable Firm in
place
Additional Notes:
Small roots to 52"
t5form11 -TP 14-15•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 4 of 1 4
Commonwealth of Massachusetts
Ail City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (continued)
Deep Observation Hole Number: TP-15 01/05/17
Date Time Weather
1. Location
Ground Elevation at Surface of Hole: 163.3 Latitude/Longitude: /
feet
2. Land Use Woodland 12
(e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%)
Wooded
Vegetation Landform Position on Landscape(SU,SH,BS, FS,
3. Distances from: Open Water Body Drainage Way Wetlands 130
feet feet feet
Property Line 55 Drinking Water Well Other
feet feet feet
4. Parent Material: Unsuitable Materials Present: ❑ Yes ® No
If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock
5. Groundwater Observed: ❑ Yes ® No If yes:
Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: 46 159.5
inches elevation
t5form11 -TP 14-15-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 5 of 4
�;. Commonwealth of Massachusetts
City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (continued)
Deep Observation Hole Number: TP-15
Redoximorphic Features Coarse Fragments
Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil
Depth(in.) Munsell USDA Soil Structure Consistence Other
Layer Moist
y (Munsell)
Depth Color Percent (USDA)
Gravel Cobbles (Moist)
&Stones
0-9 Ap 10YR2/1 SL <5 0 Weak V. Friable
9-24 B 10YR5/8 F LS 10 <5 Moderate V. Friable
24-120 C 10YR5/2 46 7.5YR5/8 2 F-M LS -15 5 Structureless Friable V. Firm in
place
Additional Notes:
Small roots to —70"
t5form11 -TP 14-15•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 6 0f 4
Commonwealth of Massachusetts
City/Town of North Andover
t
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
1
C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area)
Deep Observation Hole Number: TP-17 01/05/17
Date Time Weather
1. Location
Ground Elevation at Surface of Hole: 160.6 Latitude/Longitude: /
feet
Description of Location: Northeast area of lot, in woods
2. Land Use Woodland 12
(e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones, boulders,etc.) Slope(%)
Wooded
Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS)
3. Distances from: Open Water Body Drainage Way Wetlands 170
feet feet feet
Property Line 30 Drinking Water Well Other
feet feet feet
4. Parent Material: Unsuitable Materials Present: ❑ Yes ® No
If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock
5. Groundwater Observed: ❑ Yes ® No If yes:
Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: 42 157.1
inches elevation
t5form11 -TP 17•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 7 of 14
Commonwealth of Massachusetts
City/Town of North Andover
1 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (continued)
Deep Observation Hole Number: TP-17
Redoximorphic Features Coarse FragmentsSoil
o
Soil Horizon/Soil Matrix: Color- Soil Texture �o by Volume
Depth(in.) Layer Moist(Munsell) (USDA) Cobbles Soil Structure Consistence Other
Depth Color Percent Gravel (Moist)
&Stones
0-10 Ap 10YR2/1 LS 0 0 Structureless Loose
10-17 B 10YR3/6 Loam <5 0 Weak Loose
17-120 C 10YR6/8 42 2 LS 5 <5 Structureless Friable
Additional Notes:
Roots to —45"
t5form11 -TP 17-rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 8 of 14
Commonwealth of Massachusetts
.= City/Town of North Andover
J
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
D. Determination of High Groundwater Elevation
1. Method Used: Obs. Hole#TP-14 Obs. Hole#TP-15
❑ Depth observed standing water in observation hole
inches inches
❑ Depth weeping from side of observation hole
inches inches
® Depth to soil redoximorphic features (mottles) 42 46
inches inches
❑ Depth to adjusted seasonal high groundwater(Sh)
(USGS methodology) inches inches
Index Well Number Reading Date
Sh = Sc—[Sr X (OWc—OWmax)/OWr]
Obs. Hole# Sc Sr OWc OWmax OWr Sh
Obs. Hole# Sc Sr OWc OWmax OWr Sh
E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. 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 ❑ No
b. If yes, at what depth was it observed? Upper boundary: 15 Lower boundary: 120
inches inches
c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary:
inches inches
t5form11 -TP14-15•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 9 Of 4
Commonwealth of Massachusetts
City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
D. Determination of High Groundwater Elevation
1. Method Used: Obs. Hole#TP-17 Obs. Hole#
❑ Depth observed standing water in observation hole
inches inches
❑ Depth weeping from side of observation hole
inches inches
® Depth to soil redoximorphic features (mottles) 42
inches inches
❑ Depth to adjusted seasonal high groundwater(Sh)
(USGS methodology) inches inches
Index Well Number Reading Date
Sh = Sc—[Sr X (OWc—OWmaxyowr]
Obs. Hole# Sc Sr OWc OWmax OWr Sh
Obs. Hole# Sc Sr OWc OWmax OWr Sh
E. Depth of Pervious Material
1. Depth of Naturally Occurring Pervious Material
a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil
absorption system?
El Yes ❑ No
b. If yes, at what depth was it observed? Upper boundary: 10 Lower boundary: 120
inches inches
c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary:
inches inches
• t5form11 -TP17•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal Page 10 of 4
Commonwealth of Massachusetts
City/Town of North Andover
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
F. Board of Health Witness
Isaac Rowe (Mill River Consulting) North Andover
Name of Board of Health Witness Board of Health
G. Soil Evaluator Certification
1 certify that I am currently approved by the Department of Environmental Protection'pursuant to 310 CMR 15.017 to conduct soil
evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form,
are accurate and in accordance with 310 CMR 15.100 through 15.107.
Lam .
05/25/17
Signature of Soil Evaluator Date
Craig Marchionda /SE13892 01/01/2019
Typed or Printed Name of Soil Evaluator/License# Expiration Date of License
Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and
to the designer and the property owner with Percolation Test Form 12.
• t5form11 -TP 17•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal I Page 11 4
Commonwealth of Massachusetts
City/Town of North Andover
W Percolation Test
Form 12
M
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
Important:When
filling out forms A. Site Information
on the computer,
use only the tab Dave Kindred
key to move your Owner Name
cursor-do not 1099 Salem Street(Map 106.A, Lot 49)
use the return Street Address or Lot#
key.
North Andover MA 01845
r� City/Town State Zip Code
(978)265-7641
Contact Person(if different from Owner) Telephone Number
'eke" B. Test Results
01/05/17 10:58 01/05/17 14:28
Date Time Date Time
Observation Hole# P-15 P-17
Depth of Perc 36"top, 54"bottom 35"top, 54" bottom
Start Pre-Soak 11:00 14:40
End Pre-Soak 11:15 14:56
Time at 12" 11:15 14:56
Time at 9" 11:36 15:18
Time at 6" 12:06 16:07
Time (9"-6") 30 min 49 min
Rate (Min./Inch) 10 17
Test Passed: ® Test Passed:
Test Failed: ❑ Test Failed: ❑
Craig Marchionda, SE13892
Test Performed By:
Isaac Rowe, Mill River Consulting
Board of Health Witness
Comments:
t5form12.doc•08/15
Perc page 12 of 14'
0* H 7883
M T
Town of North Andover
HEALTH DEPARTMENT
SACHUSf
CHECK#:R.0/9 DATE: 3 .2 6 20I
LOCATION: 9 50J4 I?,.)
H/O NAME:
CONTRACTOR NAME:
Type of Permit or License: (Check box)
❑ Animal $
❑ Body Art Establishment $
❑ Body Art Practitioner $
i
❑ 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 Systems:
❑ Septic-Soil Testing $
Septic-Design Approval $
❑ Septic Disposal Works Construction(DWC) $
❑ Septic Disposal Works Installers(DWI) $
❑ Title 5 Inspector $
❑ Title 5 Report $
❑ Other. (Indicate) $
H lt� ent Initials
White-Applicant Yellow-Health Pink-Treasurer