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Miscellaneous - 121 RALEIGH TAVERN LANE 4/30/2018 (3)
-12-1-RALEIGH TAVERN LANE 210/107.A-0113-0000.0 �5 All) North Andover Board of Assessors Public Access Page 1 of 1 s A NORTH North Andover Board of Assessors I 9SSACHUS laproperty Record Card - Click Seal To Retum Parcel ID:210/107.A-0113-0000.0 FY:2013 Community :North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlar e Search for Parcels Search for Sales p g, Summary !x Residence - .Y Detached Structure Condo 121 RALEIGH TAVERN LANE - Commercial - Location: 121 RALEIGH TAVERN LANE GLENNON,DAMIEN Owner Name: GLENNON,MEGAN Owner Address: 121 RALEIGH TAVERN LANE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 7-7 Land Area: 1.01 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 2172 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 479,600 447,800 Building Value: 244,300 222,100 Land Value: 235,300 225,700 Market and Value:. 235,300 Chapter Land Value: LATESTSALE Sale Price: 524,500 Sale Date: 04/21/2005 Arms Length Sale Code: Y-YES-VALID Grantor: HARRISON,MICHELE Cert Doc: Book: 9469 Page: 194 I I _ i - I http://csc-ma.us/PROPAPP/display.do?linkld=2258526&town=NandoverPubAcc 12/12/2013. t'ED' R�R9TED V North Andover Health Department (ommunity and Economic Development Division November 27, 2017 Megan Glennon 121 Raleigh Tavern Lane North Andover, MA 01845 Re: Wastewater Treatment Service System Contract Dear Homeowner: Please note The Health Department has received a letter by Wastewater Treatment Services Inc. notifying the town that you have discontinued the maintenance contract for your alternative septic system. The maintenance contract is required by the Health Department and was conditional upon approval and installation of your alternative septic system. According to the Department of Environmental Protection,throughout its life, the system shall be under a maintenance agreement with no less than a one year contract. Please send a copy of a new contract with a maintenance company to the North Andover Health Department on or before December 31, 2017. Some information regarding regular maintenance of your septic system is attached. Please call the Health Department at 978.688.9540 if you have any questions, or e-mail your questions to: healthdept@northandoverma. og_v. Thank you for taking the time to consider the benefit that routine maintenance has on your septic system and the environment. Sincrt , Brian LaGrasse, CEHT Director of Public Health 120 Main Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov 44 Commercial Street Raynham, MA RECEOVE® 02767 13 2017 Tel: (508) 880-0233 T00 OF NORTH ANDOVER Fax: (508) 880-7232 VeAjt I DEPARTMENT October 9, 2017 ; COPY Ms. Megan Glennon 121 Raleigh Tavern Lane North Andover, MA 01845 Re: Serial Number: 24747 Location: 121 Raleigh Tavern Lane,North Andover MA Dear Ms. Glennon: We understand you do not wish to continue your Operations and Maintenance contract with our company. Please be advised the Massachusetts Department of Environmental t be in lace for the life of the alternative septic contract' n requires a maintenance c p Protectio q system. Also,we are required to inform both the state and local agency of your decision. If you have any questions or need additional information please call our office at -- - (508) 880-0233. Sinn/�c��erely, sem- �v Wastewater Treatment Services Copy to: Massachusetts DEP North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 i RECEIVED cif DEC ' L tUlo 8'NORTH ANDOVER HEALTH DEPARTMENT 44 Commercial Street Raynham,MA 02767 Tel: (508)880-0233 Fax: (508)880-7232 November 8, 2016 North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Attention: Health Agent Reference: FAST®Wastewater Treatment System- Serial Number: 24747 Attached please find the Field Inspection& Service Report with field test results for services performed on 10/13/16 at the property of Megan Glennon located at 121 Raleigh Tavern Lane,North Andover, MA. Please call if you have any questions or require additional information. Sincerely, eV,� �� �� Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Megan Glennon Massachusetts DEP 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsite(a)biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAS7'System 26017 INSTALLATION AUTHORIZED.SERVICE PROVIDER Installation Address 121 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MA 01845 Owner Name:Megan Glennon Mail Address: 121 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MA 01845 Raynham,MA 02767 Phone:978-975-3101 Fax: e-mail: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 24747 5/24/2005 EQUIPMENT YES NO.- MAINTENANCE PERFORMED AND COMMENTS: Electrical Panel(s) Visual Alarm Operating x Audio Alarm Operating x (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone 20" Aerobic Treatment Zone 20" - ,,; EFFLUENT=(ophonal)' LIMIT, .- RESULT Estimated Daily Flow 440 gpd pH(Standard Units) 5 Color Turbid Temperature 62 Odor Turbid Comments:System needs to be pumped including pump chamber. TECIINICIAN SERVICE DATE John Medeiros 10/13/16 d Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 26017 A. Installation Megan Glennon Owner 121 Raleigh Tavern Lane Facility Street Address North Andover 01845 City Zip Mailing address of owner, if different: 121 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip 978-975-3101 Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number John Medeiros 17549 Certified Operator Name Certification Number C. Facility/System Information 24747 Bio-Microbics, Inc. MicroFAST.5 DEP ID Manufacturer ID Model Number 5/24/2005 5/24/2005 Installation Date Start of Operation I Approval Type: [] General [] Provisional [] Piloting [x] Remedial [] General Denite Seasonal Residence—used less than 6 mo./year: []Yes [x] No D. Operating Information 10/13/16 Inspection Date Previous Inspection Date 20" Pumping Recommended [x]Yes [] No Sludge Depth(to be checked yearly) 1 i Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 ILI DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 26017 E. Field Testing Field Inspection: Color: [] gray [] brown [] clear [x] turbid [] Other(specify): Odor: [] musty [] earthy [] moldy []offensive [x]turbid Effluent Solids: [x] no []some pH 5 SU DO 7.6 mg/L Turbidity 8.24 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: [] Influent [] Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: 440 gpd Parameters sampled: Influent. [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent. [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter, Checked Splash Recycle, Pump(s) Inspected Notes and Comments: System needs to be pumped including pump chamber. 2 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 26017 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. 10/13/16 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31 th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 3 f10 f2�ik� 4' # s North Andover Health Department (ommunity Development Division November 5, 2013 COP"( Ms. Megan Glennon 1, 121 Raleigh Tavern Lane North Andover, MA 01845 Re: Septic System maintenance contract Dear Homeowner, In a routine check of our files,the Health Department has noticed that we do not have a record of your most recent contract or recent inspection documents in regards to your alternative subsurface system at 121 Raleigh Tavern Lane. The last communication that can be located is from 2012 (see attached). Please confirm the status of your contract with Wastewater Treatment Services or assist us by updating our records with any new contact information you may have on your new inspection company. A response to this letter is requested within ten(10) days of receipt. We appreciate your cooperation in this matter and your continued protection of the environment. Thank you. Sin rel , Susan Y. S er, S/RS Public Health D' ector j Encl.: Waste Water Treatment Services letter- April 25, 2012 Cc: File i i i 1600 Osgood Street,unit 2035,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townofnorthandover.com Megan Glennon 121 Raleigh Tavern Lane North Andover, MA 01845 Time Line for violation to Title V-Non-compliance to inspection of alternative subsurface system at 121 Raleigh Tavern Lane,North Andover Letter sent November 5,2013 requesting response within 10 days.No response Phone call and message left December 12, 2013. Requested call back or the issue would be brought before the Board of Health next Thursday. 44 Commercial Street RECrl �® Raynham, MA 02767 AUG 2 0 2014 Tel: (508)880-0233 TOWN OF NORTH ANDOVER Fax: (508)880-7232 HEATH DEPARTMENT July 24, 2014 North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Attention: Health Agent Reference: FAST' Wastewater Treatment System- Serial Number: 24747 Attached please find the Field Inspection & Service Report with field test results for services performed on 6-19-14 at the property of Megan Glennon located at 121 Raleigh Tavern Lane,North Andover, MA. Please call if you have any questions or require additional information. / Sincerely, G�/^2v�ue2�� d���i�r��J�2aticev Wastewater Treatment Services, Inc. Service Department Enclosures Copy to: Megan Glennon Massachusetts DEP S i.+ te"3 8450 Cole Parkway, Shawnee, KS 66227, Phone 913-422-0707, Fax 913-422-0808 e-mail:onsiteCcr�biomicrobics.com, www.biomicrobics.com, 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST°System 21698 INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: 121 Raleigh Tavern Lane Name:Wastewater Treatment Services,Inc. North Andover,MA 01845 Owner Name:Megan Glennon Mail Address: 121 Raleigh Tavern Lane Mail Address: 44 Commercial Street North Andover,MA 01845 Raynham,MA 02767 Phone:978-975-3101 Fax: e-mail.: Phone:(508)880-0233 Fax:(508)880-7232 e-mail: INSTALLATION INFORMATION Model No. Serial No. Date of Installation Date of last pump out MicroFAST.5 24747 5/24/2005 EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS Electrical Panel(s) Visual Alarm Operating x Audio Alarm Operating x (if present) Blower(s) Air Inlet Filter Clean x Blower Hood Vents Clear x Excessive Noise x Excessive Vibration x Treatment unit(s) Unusual Odor x Pumpout Required x Primary Settling Zone Aerobic Treatment Zone EFFLUENT(optional) LIMIT RESULT. Estimated Daily Flow 440 gpd pH(Standard Units) 7 Color Clear Temperature 65 Odor Earthy Comments: TECHNICIAN SERVICE DATE David Zavelle 6-19-14 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems 21698 A. Installation Megan Glennon Owner 121 Raleigh Tavern Lane Facility Street Address North Andover 01845 City Zip Mailing address of owner, if different: 121 Raleigh Tavern Lane Street Address/PO Box: North Andover MA 01845 City State Zip 978-975-3101 Telephone Number B. Authorized Service Provider Wastewater Treatment Services, Inc. O&M Firm 44 Commercial Street Street Address Raynham MA 02767 City State Zip 508-880-0233 Telephone Number David Zavelle 12920 Certified Operator Name Certification Number C. Facility/System Information 24747 Bio-Microbics, Inc. MicroFAST .5 DEP ID Manufacturer ID Model Number 5/24/2005 5/24/2005 Installation Date Start of Operation Approval Type: [] General [] Provisional [] Piloting [x] Remedial (] General Denite Seasonal Residence—used less than 6 mo./year: [ )Yes [x] No D. Operating Information 6-19-14 Inspection Date Previous Inspection Date Pumping Recommended []Yes [x] No Sludge Depth(to be checked yearly) 1 Massachusetts Department of Environmental Protection LlBureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 21698 E. Field Testing Field Inspection: Color: [] gray (] brown [x] clear [] turbid [) Other(specify): Odor: [] musty [x] earthy [] moldy [] offensive []turbid Effluent Solids: [x] no [] some pH 7 SU DO 5.29 mg/L Turbidity 8.02 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: [] Influent [ ] Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: 440 gpd Parameters sampled: Influent: [] pH [] BOD [] CBOD []TSS []TKN [] Nitrate [] Nitrite (] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform Effluent: [] pH [] BOD [] CBOD ( ]TSS []TKN [] Nitrate [] Nitrite [] Phosphorus [] Spec. Cond. []Ammonia []Alkalinity [] Oil Grease []VOC [] Fecal Coliform G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Cleaned Filter, Checked Splash Recycle Notes and Comments: I 2 Massachusetts Department of Environmental Protection LlBureau of Resource Protection -Title 5 . DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems 21698 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. 6-19-14 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use— by January 31st of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use— b March 31 th of each year for the previous 12 months Y Y General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 i i 3 Mas. avul,ev, �rea� cfervrc�s% �izG ti 44 Commercial Street Raynham, MA 02767 September 26, 2006 _ ._. ,- 0VED Tel.: (508) 880-0233 REPE Faz:.(608) 880-7232 OCT - 3 2006 Megan Glennon TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 121 Raleigh Tavern Lane North Andover, MA 01845 Reference: Dividing Wall Cover Not To Grade 121 Raleigh Tavern Lane North Andover—Serial # 24747 Dear Ms. Glennon: Wastewater Treatment Services was at your site for service and testing of your FAST Treatment System. As of January 1, 2006, the Massachusetts Department of Environmental Protection changed its requirements on all alternative septic systems for service and testing in single family homes. The main concern is that some permits previously did not require testing and.the distribution boxes and other covers were not brought to grade. This has all changed with the new guidelines from the State. Access to all covers; the distribution box,pump chamber, observation and UV (if applicable) is now required so it is essential that access is given for service and field testing in order to meet these State requirements. It is the owner's responsibility to have these covers brought to grade. Additional visits required because of no access to test will be billed at our hourly rate. Please have covers brought to finish grade so we can complete the requirements of your permit. Your help is needed to resolve this issue. If you have any questions, please call. I Sincerely, Wastewater Treatment Services, Inc. Service Department Cc: North Andover Board of Health i i 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 RECEIVED March 13, 2009 MAR 17 2009 WN OF Ms. Megan Glennon TO HEALTH pE TARTMENTER 121 Raleigh Tavern Lane North Andover, MA 01845 Re: Serial Number: 24747 Location: 121 Raleigh Tavern Lane, North Andover, MA Dear Ms. Glennon: We understand you do not wish to continue your maintenance contract with our company. Please be advised the Massachusetts Department of Environmental Protection requires a maintenance contract be in place for the life of the alternative septic system. Also, we are required to inform both the state and local agency of your decision. If you have any questions or need additional information please call our office at (508) 880-0233. Sincerely, Donna L. Callahan Copy to: Massachusetts DEP North Andover Board of Health 1600 Osgood Street J North Andover, MA 01845 f, lPasteeoatev- 91- tInewt c f ervica; Ylzcl 44 Commercial Street Raynham, MA 02767 RECEIVED Tel: (508) 880-0233 Fax: (508) 880-7232 OCT 0 2 2009 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT September 25, 2009 Ms. Megan Glennon 1.21 Raleigh Tavern Lane North Andover, MA 01845 Re: Serial Number: 24747 Location: 121 Raleigh Tavern Lane, North Andover, MA Dear Ms. Glennon: We understand you do not wish to continue your maintenance contract with our company. Please be advised the Massachusetts Department of Environmental Protection requires a maintenance contract be in place for the life of the alternative septic system. Also, we are required to inform both the state and local agency of your decision. If you have any questions or need additional information please call our office at (508) 880-0233. Sincerely, a� Donna L. Callahan Copy to: Massachusetts DEP North Andover Board of Health"'� 1600 Osgood Street North Andover, MA 01845 44 Commercial Street Raynham, MA. 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 RECEV April 25, 2012 OR ' 4 TOWN OF NORTH ANDOVER Ms. Megan Glennon HEALTH DE ARTMENT 121 Raleigh Tavern Lane North Andover, MA 01845 Re: Serial Number: 24747 Location: 121 Raleigh Tavern Lane, North Andover MA Dear Ms. Glennon: We understand you do not wish to continue your maintenance contract with our company. Please be advised the Massachusetts Department of Environmental Protection requires a maintenance contract be in place for the life of the alternative septic-system. Also, we are required to inform both the state and local agency of your decision. If you have any questions or need additional information please call our office at (508) 880-0233. Sincerely, Donna Fabiano Copy to: Massachusetts DEP North Andover Board of Health 1600 Osgood Street North Andover, MA 01845 Town of North Andover Office of the Health Department ' p Community Development and Services Division 400 OSGOOD STREET w <.<a a:.. • North Andover,Massachusetts 01845C104 978.688.9540-Phone Susan Y. Sawyer,REHS/RS 978.688.8476-Fax Public Health Director Cypq ' FICA OF COqVI�'GIAXC'E As of: 9Viay 13, 2005 gWis is to cert that the individualsu6surface disposal system repaired' — Fuf(System by ,john Soucy at 121 Raleigh Tavern .Gane North Andover, AVIA 01845 has been installed in accordance with the provisions of 0itfe v of.the State Sanitary Code and with the North Andover Board of l feafth regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. .� `S an T Sawyer Pu6fic Yfealth(Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( )constructed; K)repaired; by 500G�I Sewer SerYice located at )d ( Ra t ee a k 'czyer n Lau- was installed in conformance with the North Andover Board of Health approved plan, System Design Permit.# ,plan dated , with a design flow of gallons day.. The materials used were in conformance with those g per Y specified on the approved d 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: q laylLO,5- 7, 5P Engineer Representative Final inspection date: SIV Engineer Representative Installer: AA, © Lic.#: Date: �.� OF Engineer: �a BElt9 -C. Date: v CIVIL b0.45999 A�'o .. AS-BUILT CHECKLIST r, LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES &LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, -SNI IN SERE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES &PERC TESTS �✓- ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D-BOX _1 ORIGINAL STAMP& SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW LOCATION& ELEVATIONS OF BENCHMARK USED y L" TOWN OF NORTH ANDOVER f NORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'"SS,CHU t� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 121 Raleigh Tavern Lane MAP:107A LOT: 113 INSTALLER: John Soucy DESIGNER: Ben Osgood Jr. PLAN DATE: 1/6/05 BOH APPROVAL DATE ON PLAN: 1/7/05 DATE OF BED BOTTOM INSPECTION: 4/20/05 DATE OF FINAL CONSTRUCTION INSPECTION: 4/27/05 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE ADVANCED TREATMENT X FAST COMPONENT SUMMARY FROM PLAN GALLON TANK = 1500 LOADING OF SEPTIC TANK = H-10 GALLON PUMP CHAMBER = 1000 LOADING OF PUMP CHAMBER = H-10 TYPE OF SAS = Infiltrator DIMENSIONS AND DETAILS OF SAS: 32.83 X 32.25 SITE CONDITIONS ❑x Existing septic tank properly abandoned ❑x Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Sewer from house has 2-bends to tank. Page 1 of 4 r s� TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER,MASSAC14USETTS 01845 �'"ss,CH„5 Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged 0 1500 gallon tank has been installed (H-10) (2 piece) ❑ Water tightness of tank has been achieved (Visual) 0 Inlet tee installed, under access port ❑ Outlet tee (gas baffle) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present D Hydraulic cement around inlet & outlet (note) Comments: Could not see hydraulic cement around inlet to S.T. FAST unit installed — no outlet tee. PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1000 gallon Pump Chamber installed (H-1) (monolithic) 0 Inlet tee installed,under access port 0 Pump(s) installed on stable base 0 Alarm float working 0 Pump On/Off float working 0 Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs 0 Hydraulic cement around inlet & outlet Comments: Page 2 of 4 TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET *0 NORTH ANDOVER,MASSACHUSETTS 01845 "Ss;;CM„5 t`g Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to 6 in into C soil layer, as provided on plan ►� Size of SAS excavated asp er Ian p Title 5 sand installed p on ifs specified Ian p D Gravelless disposal systems: type, number and location as per plan 0 Elevations of laterals installed as on approved plan D 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Retaining wall to be checked at Final Grade Inspection—need Top of Wall Elevations. PRESSURE DISTRIBUTION 0 4 inch manifold D laterals installed with end sweeps size: 1.5" material: PVC Squirt test 3 ft in height D Equal distribution to all laterals D orifice size 1/4 inch as per plan Comments: CONTROL PANEL Alarm & Pump are on separate circuits D Alarm sounds when float is tripped Location of control panel: Basement ❑ Rated for exterior if placed outside Comments: Page 3 of 4 TOWN OF NORTH ANDOVER t�1oRT11 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'"ss,�CHU Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SYSTEM ELEVATIONS Benchmark:100.0 Rod at Benchmark: 2.12 Height of Instrument: 102.12 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 97.39 Septic Tank IN 96.00 96.88 , Septic Tank OUT 95.75 96.36 Pump Chamber IN 95.70 96.27 Pump Chamber OUT 95.45 95.67 Top of Chamber HIGH 98.17 98.23/ 98.20 Top of Chamber LOW 98.17 98.20/98.18 Lateral Invert HIGH 197.90 97.91 Lateral Invert LOW 197.90 97.85 Chamber elevations are based on top of chambers at start and end of each row. Highest and lowest elevations are provided. Page 4 of 4 I i „p Commonwealth of Massachusetts Map-Block-Lot Q4 .�t 107.A-0113- 3 Board of Health Permit No x 07 P-2005 B North Andover BHP-2005-0079 BH -- 0 9 P.I. FEE F.I. $250.00 ----------------------- Disposal Works Construction Permit Permission is hereby granted John-S WY----------------------------------------- ------------ to(Repair)an Individual Sewage Disposal System. at No 121 RALEIGH TAVERN LANE --------------------------------------------------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP-2005-007 Dated April 11,-2005 --------------------- ----------- --- ---------------------- Issued On:Apr-11-2005 &ealth ............................................................................................................................................................................... I rt r P TOWN OF NORTH ANDOVER t,►ORTF1 Office of COMMUNITY DEVELOPMENT AND SERVICES a°•';`" "�"�° HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845 4"D•'';�" SSwCHU 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com-e-mail www.townoftiorthandover.com-website APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: LOCATION: g c"Z4-VI L11 LICENSED INSTALLER NAME: 6 LA L PLEASE PRINT SIGNATURE:,Z Z406,6,ZTELEPHONE# �' -S76) t7' -7f 7- CHECK --CHECK ONE: FULL SYSTEM REPAIR: ($250) COMPONENT REPAIR(indicate what parts): ($125) * NEW CONSTRUCTION: * If NEW CONSTRUCTION, please attach the Foundation As-Built Plan. $250.00 or$125 Fee Attached? Yes No Project Manager Obligation From Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes No Approval of Health Agent Date:1 S12- e5- INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at la J c V 16elative to the application of dated C��,� for plans by IV, Y-�% and dated with revisions dated��— — 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 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 manger, 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 necgssary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work(other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others utWicensed 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. Under 'g ed Licensed S c nstaller �C Date: Dis sal Works Consruction Pej4it# COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION METROPOLITAN BOSTON- NORTHEAST REGIONAL OFFICE MITT ROMNEY ELLEN ROY HERZFELDER Governor Secretary KERRY HEALEY RECEIVED ROBERT W. GOLLEDGE,Jr. Lieutenant Governor Commissioner FJAN 2 t 2005 TOWN OF NCRTH ANDOVER January 19, 2005 HEALTH DEPARTMENT Michelle Harrison 121 Raleigh Tavern Lane North Andover, MA 01345 RE: STATEMENT OF ADMINISTRATIVE DEFICIENCY AND CHANGE OF PERMIT CATEGORY Application for BRPWP59b: DEP Approval of Variance Granted by the Local BOH 121 Raleigh Tavern Lane, North Andover(17-Ipswich) DEP Transmittal No.W058877 Dear Ms. Harrison: The Metropolitan Boston-Northeast Regional Office of the Department of Environmental Protection has received and reviewed your application for approval of Title 5 variances. An engineer of the Department has completed an administrative review of the plans and accompanying data, and it is the opinion of the Department that the requested variances to Title 5 cannot be approved as submitted for the following reasons: • The Department noted that Benjamin C. Osgood, Jr. had signed for the applicant, Michelle Harrison. The Department requires the signature of the applicant or a signed letter by the applicant allowing Benjamin C. Osgood, Jr. to act as her agent. • The written concurrence of the North Andover Board of Health for the compaction of the soil is required by the Title 5 Alternative to Percolation Testing for System Upgrades, BRP/DWM/PeP- P00-4, dated September 8, 2000. • The application was submitted for this project requesting additional variances such as the reduction in the area.of the soil absorption system (SAS) and a reduction in the separation of the groundwater from the bottom of the SAS. The 25 percent reduction in the area of the SAS and the separation of the estimated high groundwater from the bottom of the SAS from four(4)feet to two(2)feet result in this application's classification as a BRPWP64c. A copy of the BRPWP64c application and two copies of the Supplemental Transmittal Form (STF), one for the application and one for the payment, are being sent along with a copy of this letter to your consultant, Benjamin Osgood, Jr., New England Engineering Services, Inc. You must either sign the BRPWP64c application or submit a letter, signed by you, stating that Mr. Osgood or a representative of New England Engineering Services, Inc. has been authorized to sign documents on your behalf. This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. One Winter Street,Boston,MA 02108•Phone(617)654-6500•Fax(617)556-1049•TDD#(800)298-2207 DEP on the World Wide Web: hftp://www.state.ma.us/dep 10 Printed on Recycled Paper In accordance with 310.CMR 4.00, you have one hundred eighty(180)days from the postmarked date of this letter in which to address the listed deficiencies. Within the one hundred eighty(180)daytime frame, the applicant is advised to allow for the appropriate Board of Health action on the revised submittal since the Department of Environmental Protection's subsequent action may be its final action and, therefore, any further filing in this matter would be considered a NEW application. If the applicant cannot accommodate the schedule of the Board of Health within the one hundred eighty(180)day period, or for any other reason requires additional time, the applicant may, by written agreement with this Department, extend this schedule. in accordance with 310 CMR 4.04(2)(f). The applicant is also advised that when the Department receives the new information, it will initiate a second administrative review. Should the application be deemed to be administratively complete, the Department has sixty-(60) days to conduct a technical review of the application. Please note that the fee for a BRPWP64c application is now$430. Your consultant may have submitted a$230 fee for the Title 5 variance application. As such, an additional$200 is due. Please complete the enclosed Supplemental Transmittal Form (for payment), enclose payment for$200 and send to: DEP, P.O. Box 4062, Boston, MA 02211. All checks should be made payable to the Commonwealth of Massachusetts and should reference the original, as noted above, Transmittal Number of the application. If you have any questions regarding this matter, please contact George A. Kretas at(617)654-6602. Very truly yours, Madelyn Morris Deputy Regional Director Bureau of Resource Protection mm/gak Enclosures(STF for new application, BRPWP64c application, and STF for payment) cc: • Susan Y. Sawyer, R.S., Public Health Director, Health Department, 400 Osgood Street, North Andover, MA 01845 • Benjamin'C. Osgood, Jr., New England Engineering Services, Inc., 60 Beechwood Drive, North Andover, MA 01845 • Claire Golden, BRP-NERD, Boston MAY-8-2005 18:48 FROM:SKYWORKS 7813763320 TO:919786851099 P:6/10 COMIMOIN EA,TH OF MASSACHUSETTS --~ -:: EXECUTIVE OFFICE OF B+NwRONNIENTAL.AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION METROPOLITAN BOSTON--NORTHEAST REGIONAL OFFICE Nu'rr ROY Governor A ELLEN ROY IERZFELDEB ICERR ELM-Ey R Secretary Lieutenant Governor � ® � 2 05 ROBERT W.GOLT EDGE,Jr. Commissioner VER 1b' � - E February 2,2005 Michelle Harrison tr m ti 121 P.aleigh Tavem !ane iTt North Andover, MA 01845 t5� � RE:APPROVAL OF INSTALLATION OF AN ALTERNATE SYSTEM FOR REMEDIAL use mac (BRPWP64c),WITH VARIANCE 121 Raleigh Tavern Lane(174pswich) DEP Transmittal No.W05s$77 �� w T. rr: b 0 Dear Ms. Harrison: The Metropolitan Boston-Northeast Regional Office of the Department of Environmental Protection has received and reviewed your appiication.f6r approval of the installation of an aftemate system for o remedial use with a variance pursuant to 310 CMR 15.000 with the above transmittal number. This application is for an upgrade of an existing failing system. No increase in design flow is proposed. -� N The application contained written notification,dated January 6,2005 that the North Andover Board —� of Health had approved the proposed system where use of a Bid-Microbus, Inc.,MicroFast 0.5 Wastewater Treatment System is proposed. As part of the approval of the MicroFast treatment system for remedial use, the designer may select one of three design criteria that may be waived.The criteria that may be waived are the size of the soil absorption system(SAS),the depth of naturally occurring pervious material,and the depth to groundwater. The Department has noted that the North Andover Board of Health tied approved the reduction in the separation of the groundwater from the bottom of the SAS'from four(4)feet to two(2)fleet and the reduction in area of the SAS by 25 percent result in this application's classification as a BRPWP64c,as noted on the application. Accompanying the application were plans consisting of two(2)sheets titled as follows: Title: Proposed Subsurface Sewage Disposal System Location: 121 Raleigh Tavern Lane Municipality:North Andover Applicant Michelle Harrison Designer..Benjamin C.-Osgood,Jr., RE:Na.45891 Date(Last Revision): November 30,2004(January 6,2005) 7118 Information is available in alwmte format by calling our ADA Coordinator at(617)574.687E One Winter Street,Boston,MA 02108.Phone(617)6346500.Fax(61T)558.1 04).MO It(Bop)296-2207 DEP on the Watid VAcid web: htlp:/haww.state.ma.uslpep 40 Printed an Recycled Papez' MAY-8-2005 18:47 FROM:SKYWORKS 7813763320 TO:919786851099 P:5/10 f� ESad= north Court,-- R_ai5�.� Gi �oad5 381 ;Qfmor: 5treet Lawrence, "aaaach¢se�t3 GIw4t; v?./'0=l05; • 1c RECIFIV D MAY 0 9 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT L TOWN OF NORTH ANDOVER <aORTN Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT Is 6100 400 OSGOOD STREET "`r' ' NORTH ANDOVER,MASSACHUSETTS 01845 'SSACHUst 978.688.9540-Phone Susan Y.Sawyer,RENS/RS 978.688.9542-FAX Public Health Director I May 2,2005 Michelle Harrison 121 Raleigh Tavern Lane North Andover,MA 01845 RE: Subsurface Sewage Disposal System Plan for 121 Raleigh Tavern Lane,Map 107A, Lot 113 Dear Ms.Harrison The North Andover Board of Health has completed review of the septic system design plans and the installation of the septic system for the above referenced property. As you are aware,the septic system at this property includes a treatment unit which is allowed to be used in Massachusetts under an approval letter issued by the Massachusetts Department of Environmental Protection. This letter has certain requirements which were likely presented to you by the septic system designer,however we are repeating them here again to assure clarity. The approval letter issued by the Massachusetts Department of Environmental Protection(DEP)for the treatment unit which is part of this onsite wastewater system requires: a) "Operation and Maintenance Agreement: Throughout its life,the Owner of the System shall have the System properly operated and maintained in accordance with Company's and designer's . operation and maintenance requirements and this Approval and be under an operation and maintenance agreement(O&M).No O&M agreement shall be for less than one year." A signed agreement must be returned to this office prior to the issuance of the Certificate of Compliance. Additionally, the agreement must indicate that effluent from the septic system needs to be monitored quarterly. At a minimum, the following parameters shall be monitored: pH, BOD5, and TSS. All monitoring and operation and maintenance data shall be submitted to the local approving authority and the DEP by January 31 st of each year for the previous calendar year. After one year of monitoring and reporting and at the written request of the owner,the DEP may reduce the monitoring and reporting requirements. b) "The owner of the System shall record in the appropriate registry of deeds a notice that discloses the existence of this Remedial Use approved alternative system. A copy of the book and page number of the recording must be provided to the local approving authority,and the Department of Environmental Protection prior to the issuance of the Certificate of Compliance." C) The owner of the System shall provide a copy of the DEP Approval letter, prior to the signing of a purchase and sale agreement for the facility served by the System or any portion thereof,to the proposed new owner. )`A Certificate of Compliance has been endorsed by the designer and installer. Items a)and b)referenced above need to be completed before our office can endorse the Certificate and issue it to you. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely, Susan Y. Sawyer, REHS/R Public Health Director cc: New England Engineering Services file • R TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 40 400 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845 'ss�caus�< Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.6889542-FAX January 6,2005 Michelle Harrison 121 Raleigh Tavern Lane North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 121 Raleigh Tavern Lane,Map 107A,Lot 113 Dear Ms.Harrison: The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated November 30, 2004,final revision date January 6, 2005. The design has been approved for use m the construction of an upgrade onsite septic 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. The design plan needs to be updated to provide distances from the septic tank and soil absorption system to the dwelling and property line pursuant to North Andover Regulations section 8.03. 2. The wetlands delineation shown on the plan must be confirmed by the North Andover Conservation Commission. 3. 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)). 4. 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. 5. As the new leaching field is in the approximate location of the existing leaching field,any fill, pipes,old leach stone or other unsuitable material under the new leaching field shall be removed and the replaced with sand meeting the specifications of Title 5 fill material. 6. Prior to issuance of a septic installers permit to construct the system,a draft of a mainwnance agreement must be submitted to the Health Department. Prior to the final issuance of a Certificate of Compliance a signed maintenance agreement that conforms to the DEP approval of a FAST pretreatment system must be submitted to the Health Department. 7. Prior to the issuance of a septic installers permit to construct,the Health Department must receive proof of approval of variances from Title V,by the Department of Environmental Protection. In addition,the following items were brought before the Board of Health at a meeting on December 9, 2004: Title 5 Variances: "A Motion was made by Ms. Barczak and seconded by Dr. Trowbridge to I. "Allow for the use of a laboratory textural analysis (sieve analysis)as outlined by DEP Policy#BRP/DWM/PeP-Poo-4 in lieu of a percolation test to determine the loading rate of the soil." 2. Allow the reduction in required leach field size by 25%from 1,333 sq. ft. required to 1000 sq. ft. Local Bylaw Variances "A Motion was made by Ms. Barczak and seconded by Dr. Trowbridge to allow for:" 1. Reduction in offset distance between a leach bed and a wetland from 100 feet to 20 feet. 2. Reduction in offset distance between a septic tank and a wetland from 75 feet to 38 feet. 3. Reduction in offset distance between a pump chamber and a wetland from 75 feet to 51 feet. Local Upgrade Approval "A Motion was made by Ms. Barczak and seconded by Dr. Trowbridge to allow for:" 1. Reduction in offset distance between a leach bed and.a wetland from 50 feet required by Title 5, Section 15.211 (1)to 20 feet. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. 7Y. Sawyer, REHS/RS Public Health Director encl: List of licensed septic system installers cc: New England Engineering Services file NEW ENGLAND ENGINEERING SERVICES INC December 1, 2004 Susan Sawyer North Andover Board of Health 27 Charles Street RECEIVED North Andover, MA 01845 DEC 0 1 2004 Re: 121 Raleigh Tavern Lane, North Andover TOWN u'P,'01RTH ANDOVER Septic System Design HEALTH DEPARTMENT Dear Susan, The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. 2. (2) Copies of the Form 11 Soil Evaluator Sheets. 3. (2) Copies of Soil Sieve Analysis Report. 4. (2) Copies of the Sewage Pump Calculations. 5. (2) Copies of the Variance Request Letter. 6. (2) Copies of the Public Notice and Return Receipts. 7. (2) Copies of the Form 9A—Request for Local Upgrade Approval 8. (2) Copies of the Form 9B —Local Upgrade Approval 9. (2) Copies of the Infiltrator Approval Form. 10. (2) Copies of the MicroFast System Approval Form 11. (2) Copies of a Fast System Maintenance Agreement (Draft Copy) 12. (1) Check for payment of the Town approval fee. If you have any comments or questions please do not hesitate to contact this office. Sincerely, Steven E. Pouliot Project Manager I 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 s r9 B �.. B m Ln REM Ln IMMM � USE I m �7(EndorsementRa4ulred) Postage $ 0.37 UNIT ID: 0630 `� Postage $ 0.37 UNIT ID: 0630 rq � rtifies Fee 0 Certified Fee O Postmark 0 Fee Postmark 0edept Fee Here (Endorsements Required) 1.75 M 1.75 Here C3 Restricted Deivery Fee Clerk: KK5NFG o Restricted nt Requlivery r� t� (Endorsement Required) O (F-ndorsemertRequired) Clea: KY.St�G 4.42 11/30/04 '� �- a 4.42 11/30/04 r-1 Tit o. .�__' d` - "l 927BOH rn LDavid OH o E3 Vincent Mc Entee C3izio ._..__..._... M1Tav;MTA Lane 60 Raleigh Tavern Lanever, 01845 North Andover, MA 01845 �- . • ru B ` �- Ln M ,. • Ln M up ra ma r9 Rl L USE C Certified Fee Postage $ 0.37 UNIT ID: 0630 a Postage $ 0.37 WIT ID: 0630 2.30 C3 Return Rer9ept Fee Postmark 3 Certified Fee (Endorsement Required) 1.75 Here C3 Return Red Postmark O Restricted Derrvery Fee (End R 1. D (Endorsement Required) Clerk: Kowa a (E astrid`�d m rRe"�quir� Clerk: KY.SMfG C3 rout Postage&Fees $ 4.42 o 11/30104 Toni Postage&pms 44 4.42 11/30/44 o 927BOH m C3 o $ 927BOH r, Richard Mulley _ _._. C ork - r, 's Arist Frangules b;,, 13 5 Raleigh Tavern Laneo """"'---. z 371 Raleigh Tavern Lane North Andover,MA 01845 North Andover,MA 01845 - CD B j Ln AM C3 B ' ' 0 MI---- ul m I M1711"11,90 &I W "7 11 Postage $ 0.37. WIT ID: 0630 r-4 Certified Fee M C Postmark '� Postage $ 0.37 MIT ID: M. C3 Return Redept Fee (Endorsement Required) 1.75 Here C3 Certified Fee 30 O RestridedD.eBveryFee Clerk: KK5MFG o ReturnRedeltFee �• Postmark r R (EndorsementRequired) O (Endorsement Required) 1.75 Here O t� Total Postage&Fees 4.k2 11/30/04 o R�'c Dethrery Fee Clerk: KKSNFG � (Endorsement Required) ` O M 927BOH 4.42 11/30/04 GBF/JGF Realty Tnist m , 927BOH 136 Raleigh Tavern Lane --------=�-- C3 North Andover, MA 01845 17- Cheryl Cronin MEN 357 Raleigh Tavern Lane T\Tnr+T, o„A,,.,o.- X4n 01Qnc i. Commonwealth of Massachusetts City/Town of Form 9A _ Application for Local Upgrade Approval 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 your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 5.404(1), is not feasible. 310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer, use Michelle Harrison only the tab key Name to move your 121 Raleigh Tavern Lane cursor-do not Street Address use the return key. North Andover MA 01845 City/Town State Zip Code rah 2. Owner Name and Address (if different from above): same erom Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Installation of new residential subsurface sewage disposal system. 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other(describe below): Current residential sewage disposal system is in failure. 121 RALEIGH TAVERN LN-FORM 9a•rev. 5/02 Application for Local Upgrade Approval* Page 1 of 4 a r I Commonwealth of Massachusetts City/Town of .. W W Form 9A - Application for Local Upgrade Approval 1M 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 your local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): Leach field 7. Design Flow per 310 CMR 15.203: Design flow of existing system: Unknown gpd Design flow of proposed upgraded system 440 gpd Design flow of facility: n/a gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): ® Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: 3. Local Upgrade Approval is requested for(check all that apply): ® Reduction in setback(s)—describe reductions: Request reduction in offset distance from a wetland to a leach bed from 50 feet required by Title 5 Section 15.211 (1) to 20 feet. ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft. Percolation rate min./inch Depth to groundwater ft 121 RALEIGH TAVERN LN-FORM 9a•rev. 5/02 Application for Local Upgrade Approval• Page 2 of 4 Commonwealth of Massachusetts City/Town of W Form 9A - Application for Local Upgrade Approval c� �M 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 your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(i)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Andrew McBrearty 9/21/04 Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: No other location available on the lot for the system size required. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: A 1500 gallon Micro Fast Septic tank is included in the design. 121 RALEIGH TAVERN LN-FORM 9a•rev. 5/02 Application for Local Upgrade Approval• Page 3 of 4 r Ao Commonwealth of Massachusetts City/Town of Form 9A - Application for Local Upgrade Approval 'GSM 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 your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible: Town sewer is not in the area of the property. 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit ❑ Complete plans and specifications ❑ Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." 12/01/04 Facility Owner's Signature Date Benjamin C. Osgood, Jr., P.E. (Agent for owner) New England Engineering 12/01/04 Name of Preparer Date 60 Beechwood Drive North Andover Preparer's address City/Town MA 978-686-1768 State/ZIP Code Telephone 121 RALEIGH TAVERN LN-FORM 9a•rev.5/02 Application for Local Upgrade Approval* Page 4 of 4 Commonwealth of Massachusetts City/Town of y Local Upgrade Approval Form 913 ly,M DEP has provided this form for use by local Boards of Hea'Ith if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information Important: When filling out 1. Facility Name and Address forms on the computer,use Michelle Harrison -- ---- only the tab key Name to move your 121 Raleigh Tavern Lane cursor-do not Street Address use the return MA 01845 key. North Andover --- ---- City/Town State Zip Code r� 2. Owner Name and Address (if different from above): ------- eam Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 9P4 Bamin C. Osgood, Jr. PE ❑ RS 5. System Designer: Name 60 Beechwood Drive North Andover MA, 018_45 Address City/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for: Reduction in setback(s)—specify: ❑ Reduction in SAS area of up to 25%: sas size,sq.ft. °i°reduction Form 913-121 Raleigh Tavern Lane•rev.5/02 Local Upgrade Approval* Page 1 of 2 ,r Commonwealth of Massachusetts City/Town of Local Upgrade Approval Form 9B ' M B. Approval (continued) ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft — Percolation rate min. /inch Depth to groundwater ft _ ❑ Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: Approving Authority Print 4ia ture Date Form 9B-121 Raleigh Tavern Lane•rev.5/02 Local Upgrade Approval* Page 2 of 2 TOWN OF NORTH ANDOVER NORTp Office of COMMUNITY DEVELOPMENT AND SERVICES ° °p HEALTH DEPARTMENT 400 OSGOOD STREET '° ••syr• ��' NORTH ANDOVER,MASSACHUSETTS 01845 'sS�ceus� 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.9542—FAX Public Health Director E-MAIL:healthdeptg ownofnorthandover.com WEBSITE:http://www.townofnorthandover.com January 7,2005 Michelle Harrison Phone:978.794.9526 121 Raleigh Tavern Lane North Andover,MA 01845 L% Dear Michelle, The enclosed DEP Form 9b must be submitted to the appropriate Regional Office of the Department of Environmental Protection at One Winter Street,Boston MA by the property owner. Please call us if you have any further questions. Sincerely, Susan Y. Sawyer Public Health Director Xc: File SYS/pfd Town of North Andover HEALTH DEPARTMENT 27 Charles Street North Andover,MA 01845 978.688.9540 healthdep! ownofnorthandover.com SEPTIC PLAN SUBMITTAL FORM i DATE OF SUBMISSION: 2 I SITE LOCATION: l 2A t-P L-eAC,-tf i,4ver-►-k L.4+'J E ENGINEER: C_ Osc,-�o� NEW PLANS: YES $225.00/Plan Check#: (Includes 1 EW and one Re-Review Only) REVISED PLANS: YES $75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone#: 97 b 8 to- 1-7& Fax#: q7 S - &8 5— Iy4 9 E-mail:- Nr.-EGr,-UkL A-OL- Gyv'A HOMEOWNER NAME: OFFICE USE ONLY When the submission is complete Including check): 1. Date stamp plans and letter. 2. Complete and attach Receipt 3. Copy File; Forward to Consultant 4. Enter on Log Sheet and Database NEW ENGLAND ENGINEERING SERVICES INC December 1, 2004 Susan Sawyer North Andover Board of Health 400 Osgood Street RECELVED North Andover, MA 01845 DEC 0 1 2004 Re: 121 Raleigh Tavern Lane, North Andover ER Septic System repair design TOHEALTI-I DEPARTMENT Dear Susan: Please accept this letter as a request to be included on the December 90 2004 Board of p q , Health agenda to consider variances and local upgrade approvals required for the above referenced septic system repair design. The specific variances and local upgrade approvals are as follows. LOCAL UPGRADE APPROVALS 1. Reduction in the offset distance between a leach bed and a wetland from 50 feet required by Title 5 section 15.211(1)to 20 feet. LOCAL VARIANCES REQUIRED 1. Reduction in offset distance between a leach bed and a wetland from 100 feet to 20 feet. 2. Reduction in offset distance between a septic tank and a wetland from 75 feet to 38 feet. 3. Reduction in offset distance between a pump chamber and a wetland from 75 feet to 51 feet. TITLE 5 VARIANCES REQUIRED 1. Allow the use of a laboratory textural analysis(sieve analysis) as outlined by DEP policy#BRP/DWM/PeP-P00-4 in lieu of a percolation test to determine the loading rate of the soil. 2. Allow the reduction in required leach field size by 25% from 1333 sq. ft. required to 1000 sq. ft. 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 i r' Pursuant to our conversation the abutter notification has already been sent. A copy of the notice and the certified mail receipts are attached herewith. If you have any questions, or need additional information, please do not hesitate to contact this office. Sincerely, Benjamin C. Osgood, Jr., P.E. President PUBLIC NOTICE PUBLIC HEARING Public notice is hereby being given to the abutters of 121 Raleigh Tavern Lane,North Andover,MA regarding the request of Michelle Harrison for approval of Variances to the requirements of Title 5,the state law governing the installation of septic systems. The following Variance is being requested: TITLE 5 VARIANCES 1. Allow the use laboratory textural analysis(sieve analysis) as outlined by DEP Policy#BRP/DWM/PeP-P00-4 in lieu of a percolation test to determine the loading rate of the soil. 2. Allow the reduction in required leach field size by 25%from 1,333 sq. ft. required to 1000 sq. ft. LOCAL BYLAW VARIANCES 1. Reduction in offset distance between a leach bed and a wetland from 100 feet to 20 feet. 2. Reduction in offset distance between a septic tank and a wetland from 75 feet to 38 feet. 3. Reduction in offset distance between a pump chamber and a wetland from 75 feet to 51 feet. j LOCAL UPGRADE APPROVAL 1. Reduction in offset distance between a leach bed and a wetland from 50 feet required by Title 5, Section 15.211 (1)to 20 feet. The North Andover Board of Health will hold a public hearing regarding this request in Thursday, December 9,2004 at 7:00 PM at the Department of Community Development building conference room located at 400 Osgood Street,North Andover, MA. If you have questions regarding this hearing,you may contact the North Andover Board of Health at(978) 688-9540, or contact New England Engineering Services, Inc. at(978) I 686-1768. i Soil and Plant Nutrient Testing Lab West Experiment Station 10/14/04 University of Massachusetts Amherst,MA 01003 413.545.2311 http://www.umass.edu/plsoils/soiltest TEXTURAL ANALYSIS RESULTS Customer Name: New England Engineering 60 Beechwood Drive N. Andover, MA 01845 Sample ID: 60058-1 Customer Designation: TP1 USDA SIZE FRACTIONS PERCENT OF WHOLE SAMPLE PASSING Main Fractions Size (mm) Percent Size (mm) Sieve # Sand 0.05-2.0 66.0 Silt 0.002-0.05 28.5 Clay < 0.002 5.5 Total < 2.0 100.0 2.00 #10 84.5 Sand Fractions Size (mm) Percent 1.00 #18 79.0 Very Coarse 1.0-2.0 6.5 0.50 #35 70.7 Coarse 0.5-1.0 9.7 0.25 #60 59.1 Medium 0.25-0.5 13.7 Fine 0.10-0.25 19.8 0.10 #140 42.4 Very Fine 0.05-0.10 16.2 0.05 #270 28.7 66.0 0.02 20 um 16.9 0.005 5 um 8.0 Silt Fractions Size (mm) Percent 0.002 2 um 4.7 Coarse 0.02-0.05 14.0 Medium 0.005-0.02 10.5 Fine 0.002-0.005 4.0 28.5 USDA Textural Class = sandy loam COMMENTS: Gravel Content = 15.5% Soil and Plant Nutrient Testing Lab West Experiment Station 10/14/04 University of Massachusetts Amherst,MA 01003 413.545.2311 http://www.umass.edu/plsoils/soiltest TEXTURAL ANALYSIS RESULTS Customer Name: New England Engineering 60 Beechwood Drive N. Andover, MA 01845 Sample ID: 60058-1 Customer Designation: TP2 USDA SIZE FRACTIONS PERCENT OF WHOLE SAMPLE PASSING Main Fractions Size (mm) Percent Size (mm) Sieve # Sand 0.05-2.0 61.0 Silt 0.002-0.05 33.3 Clay < 0.002 5.7 Total < 2.0 100.0 2.00 #10 93.8 Sand Fractions Size (mm) Percent 1.00 #18 89.8 0.50 #35 82.2 Very Coarse 1.0-2.0 4.3 Coarse 0.5-1.0 8.1 0.25 #60 71.1 Medium 0.25-0.5 11.8 Fine 0.10-0.25 20.3 0.10 #140 52.1 Very Fine 0.05-0.10 16.5 0.05 #270 36.6 61.0 0.02 20 um 21.3 0.005 5 um 9.9 Silt Fractions Size (mm) Percent 0.002 2 um 5.4 Coarse 0.02-0.05 16.3 Medium. 0.005-0.02' 12.2 Fine 0.002-0.005 4.8 33 .3 USDA Textural Class= fine sandy loam COMMENTS: Gravel Content = 6.2% t NEW ENGLAND ENGINEERING SERVICES INC � � PRE SURE DISTf1BUTION:DESIGN''SPREADSHEET 'r 121 Raleigh Tavern Lane=North Andover MA f Fill in the shaded areas,revise as needed IF ERROR----PRESS ESCAPE DESIGN FLOW(in gallons/day)? Elevation of the PUMP OFF SWITCH,in feet? 92.45? Elevation of the upper LATERAL,in feet? 97.92] DELIVERY PIPE distance,from pump to manifold,in feet? 21 DELIVERY PIPE diameter,in inches(if not 2"--use 2"min)? 31 Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) 31 IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)? :yes ,YES How many orifices in the MANIFOLD? 0 MANIFOLD ORIFICE diameter,in inches(if not 5/16") 0� 0.3125 MANIFOLD DIAMETER(if not 2"--use 2"min)? -j 4' 4 TOTAL LENGTH OF MANIFOLD 30" Does MANIFOLD drain to FIELD after dose(yes or no)? no How many LATERALS? 10 Pumping chamber weep hole size(usually.25") 0.1875'USE 0 I FORCE MAIN DOES NOT DRAIN PROGRAM WILL CALCULATE UP TO 26 LATERALS AND UP TO 50 ORIFICES PER LATERAL Your HIGHEST elevation lateral MUST be LATERAL 1: (first orifice from lateral 1/2 of orifice spacing) Lateral 1: Lateral 2: Lateral 3: Lateral 4: Lateral 5: Length of each LATERAL,in feet? 31.25 31.25 31.25 31.25 31.25. Diameter of each LATERAL,in inches(1.5"min)? € 1.5 1.5 1.5 1.5 1.5 Elevation of each LATERAL,in feet? 97.92 97.92 97.92 97.92 97.92. Number of ORIFICES per lateral 8 8 8 8 8 Distance from Manifold to closest Orifice,in feet 2 2 2 2 2. III ORIFICE SPACING,in feet 4 4 4 4 4. Diameter of ORIFICES,in inches?(D) 0.25 0.25 0.25 0.25 0.251 Square feet of leachfield per laterals(can ignore) : 248 248 248 248 248: Maximum number of orifices in any one lateral 8 Minimum lateral diameter 0 Lateral Lateral Lateral Lateral 1 Hole Lateral 2 Hole Hole Spacing Hale Spacing Hole Spacing Spacing Error Spacing Error Error Error Error FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(Dd"2.63)))"1.85) PRESSURE CALCULATIONS(using orifice dischage equation Q=11.79 D"2 hd^.5 Lateralt: Lateral 2: Lateral 3: Lateral 4: Lateral 5: LATERAL DISCHAGE(first approximation) 10.21 10.21 10.21 10.21 10.21 MANIFOLD ORIFICE DISCHARGE 0.00 TOTAL SYSTEM DISCHAGE(first approximation) 102.10 TOTAL DISCHARGE PER LATERAL 10.23 10.23 10.23 10.23 10.23 DISCHARGE PER SQUARE FOOT OF LEACHFIELD 0.04125133 0.04125133 0.0412513 0.0412513 0.0412513 ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.28 1.28 1.28 1.28 1.28 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.28 1.28 1.28 1.28 1.28 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 0.5% 0.5% 0.5% 0.5% 0.5% MAXIMUM DISCHARGE LATERAL 10.23 MINIMUM DISCHARGE LATERAL 10.23 MAXIMUM DISCHARGE PER SQUARE FOOT 0.04 MINIMUM DISCHARGE PER SQUARE FOOT 0.04 •DIFFERENCE DISCHARGE for SYSTEM by orifice 0.5%as percent of maximum orifice in system %DIFFERENCE DISCHARGE for SYSTEM by laterals 0.0%as percent of maximum lateral in system %DIFFERENCE DISCHARGE for SYSTEM by square feet 0.0%as percent of maximum square foot in system WEEP HOLE DISCHARGE(usually a 1/4"weep hole) 1.07 weep hole= 0.1875 inch VOID VOLUME IN DELIVERY PIPE 7.71 VOID VOLUME IN MANIFOLD 19.58 VOID VOLUME IN EACH LATERAL 2.87 2.87 2.87 2.87 2.87 TOTAL LATERAL VOID VOLUME 28.69 MINIMUM DOSE VOLUME(based on void volume) 143.43 to 286.85 MIN ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole.usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting he. TOTAL HEAD LOSS IN EACH LATERAL 0.15 0.15 0.15 0.15 0.15 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM 0.15 MANIFOLD HEADLOSS(center-fed unless manifold design) 0.05 DELIVERY PIPE HEADLOSS 0.51 wl delivery 3 inch diameter FITTING LOSS(headloss'.15) 0.45 add extra head if fittings are more than absolute n DISTAL PRESSURE HEAD 3.00 STATIC HEAD(OFF-SWITCH TO HIGH LATERAUMANI FOLD) 5.47 HEADLOSS PUMP TO WEEPHOLE(assume 3'run) 0.07 PUMP MUST BE ABLE TO PASS SOLIDS AT 103.37 G.P.M 9.71 FEET OF HEAD or After OTIS(network losses=1.3'distal head) 103.37 G.P.M. 12.99 FEET OF HEAD 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 NEW ENGLAND ENGINEERING SERVICES INC �:;�PRESSIJRE•DISTRdBUTION�DESIGN�SPREA�DSHEET �, °: 121 Raleigh Tavern Lane;North Andover MA�F.�. � :_ " November 30,2004 Fill in the shaded areas,revise as needed DESIGN FLOW(in gallons/day)? Elevation of the PUMP OFF SWITCH,in feet? Elevation of the upper LATERAL,in feet? DELIVERY PIPE distance,from pump to manifold,in feet? DELIVERY PIPE diameter,in inches(if not 2"--use 2"min)? Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)? How many orifices in the MANIFOLD? MANIFOLD ORIFICE diameter,in inches(if not 5/16") MANIFOLD DIAMETER(if not 2"--use 2"min)? TOTAL LENGTH OF MANIFOLD Does MANIFOLD drain to FIELD after dose(yes or no)? How many LATERALS? Pumping chamber weep hole size(usually.25") PROGRAM WILL CALCULATE UP TO 26 LATERALS AND UP TO 50 ORIFICES PER LATERAL Your HIGHEST elevation lateral MUST be LATERAL 1: (first orifice from lateral 1/2 of orifice spacing) Lateral 6 Lateral 7: Lateral 8:Lateral 9: Lateral 10: Length of each LATERAL,in feet? � 31.25 31.25 31.25 31.25 '31.25: Diameter of each LATERAL,in inches(1.5"min)? 1.5 1.5 1.5 1.5 1.5 Elevation of each LATERAL,in feet? f 97.92 97.92 97.92 97.92 97.92. Number of ORIFICES per lateral € 8 8 8 8 8' Distance from Manifold to closest Orifice,in feet ? 2 2 2 2 2: ORIFICE SPACING,in feet 4 4 4 4 4 Diameter of ORIFICES,in inches?(D) } 0.25 0.25 0.25 0.25 0.25 Square feet of leachfield per laterals(can ignore) ` 248 248. 248 248 248 Maximum number of orifices in any one lateral Minimum lateral diameter Lateral Lateral Lateral Lateral Lateral Hole Hole Hole Hole Hole Spacing Spacing spacing Spacing Spacing Error Error Error Error Error FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(Dd12.63)))"1.85) PRESSURE CALCULATIONS(using orifice dischage equation Q=11.79 13^2 hd^.5 Lateral 6::: Lateral7: Lateral8: Lateral 9. Lateral 10: LATERAL DISCHAGE(first approximation) 10.21 10.21 10.21 10.21 1021 MANIFOLD ORIFICE DISCHARGE TOTAL SYSTEM DISCHAGE(first approximation) TOTAL DISCHARGE PER LATERAL 10.23 10.23 10.23 10.23 10.23 - DISCHARGE PER SQUARE FOOT OF LEACHFIELD 0.0412513 0.0412513 0.041251 0.0412513 0.0412513 ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.28 1.28 1.28 1.28 1.28 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.28 1.28 1,28 1.28 1.28 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 0.5% 0.5% 0.5% 0.5% 0.5% . MAXIMUM DISCHARGE LATERAL MINIMUM DISCHARGE LATERAL MAXIMUM DISCHARGE PER SQUARE FOOT MINIMUM DISCHARGE PER SQUARE FOOT %DIFFERENCE DISCHARGE for SYSTEM by orifice %DIFFERENCE DISCHARGE for SYSTEM by laterals •DIFFERENCE DISCHARGE for SYSTEM by square feel WEEP HOLE DISCHARGE(usually a 1/4"weep hole) VOID VOLUME IN DELIVERY PIPE VOID VOLUME IN MANIFOLD VOID VOLUME IN EACH LATERAL 2.87 2.87 2.87 2.87 2.87 TOTAL LATERAL VOID VOLUME MINIMUM DOSE MUST INCLUDE MANIFOLD BECAUSE MANIFOLD DRAINS TO FIELD MINIMUM DOSE VOLUME(based on void volume) ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole,usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting TOTAL HEAD LOSS IN EACH LATERAL 0.15 0.15 0.15 0.15 0.15 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM MANIFOLD HEADLOSS(center-fed unless manifold design) DELIVERY PIPE HEADLOSS FITTING LOSS(headloss'.15) DISTAL PRESSURE HEAD STATIC HEAD(OFF-SWITCH TO HIGH LATERAUMAN I FOLD) HEADLOSS PUMP TO WEEPHOLE(assume T run) GPM=all laterals plus manifold orifices plus weep hole head is sum of static head and headloss shown head is static head,delivery losses and network losses 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 I BK 9469 PG 194 Deed I/We,Michele V.Harrison,of 121 Raleigh Tavern Lane,North Andover,Massachusetts 01845 in consideration of Five Hundred Twenty-Four Thousand,Five Hundred and 00/100 Dollars($524,500.00)Dollars grant to Damien T.Glennon and Megan A.Glennon,husband and wife as tenants by the entirety of 85 Dascomb Road,Andover,Massachusetts 01810 with QUITCLAIM COVENANTS A certain parcel of land,together with the buildings thereon,situated in North Andover,Essex County,MA and shown as Lot 26 on plan entitled"Definitive Plan,Raleigh Tavern Estates,North Andover,Massachusetts,dated May 15, 1968"which plan Is recorded with North District of Essex Registry of Deeds as Plan#5913,and to which plan reference Is hereby made for a more particular description of said premises. Being more particularly bounded and described as follows: Northwesterly by Raleigh Tavern Lane,168 feet; Northeasterly by Lot#25,as shown on said plan,263 feet; Southeasterly by lot#35 and#36,as shown on said plan,168 feet;and Southwesterly by lot#27,as shown on said Plan,263 feet. Containing 44,184 square feet. rn G� C'S _ fl -�iC Orr For reference to title see deed of Richard J. Harrison,recorded with the Essex Registry of Deeds at Book 3705>rge 262. •- _,,, 7- - t� v Executed as a seal ent this 21st day of April,2005. �% _ ao c Michele V.Harrison w 0 at D .,.. 0 p � C 0 j tV 4o Commonwealth of Massachusetts Essex,Siff z On this 21st day of April,2005,before me,the undersigned notary public, personally appeared Michele V.Harrison,proved to me through satisfactory evidence of identification,which were a to be the person whose name is signed on the preceding or attached do n and aclmowledged to me that he/she/they 0 signed it voluntarily for its stated purpose. d HMichael o and Notary Public mMy Commission Expires: March 21,2008 a, a ~ n U MCHAEL E.LOMBM MM Notary Public tu+ 07 M r Commomrea8h of Massschuselts M 0)g WCmr ssonExpkeshbr21,2008 (4 In µ X�M _ � � o I 01986.2005 Standard Solutions,Inc.781.324-0550 DeedNoEx I30ARD '� . i:" .. . . OF DEAL 1 r NORTH ANDOVER, MASS. 01845 ED V 1 978-688-9540 �E C E APPLICATION FOR SOIL TESTS AUG 2 4 2004 DATE: d ` RTH ANDOVER MAP&PARCEL: O I wN OF NpEPARTMENT LOCATION OF SOIL TESTS: OWNER: TEL.NO.:— ADDRESS: I(A\J Q Yn �--O• N kY d ryulf r ENGINEER: L.NO.:_ GI�I i CERTIFIED SOIL EVALUATOR: I b rew:w t Ni C. o S CM0>) !Q,/iel&W-0 C. %,�NOO-elD Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing X Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 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 p ades.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 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 �'—"IKP N.A.Conservation Commission Approval: — �a �� q u�„tf145 of- tl1� -a64 d ar-e,� . Date Received: Check Amount: Check ate: RECEIVED I SEP - 7 2004 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT i o=�`y� •�u �7 0 1°?' /� `� 6� vos s�'• - c°.°gam 400 losy ;�r L�z�-� '•c. �ti���• '� J �o X0.0.66 .� �"p „ z�-------- ����w�� c� 6- o �E DoT 4,..;..IOh J%l • �••o'L .4 •yah/ .I a c/EY/ ...� �6L Q�,�1 1 rd's soo' �' o•� ; 92 0 00 a r oo S'/ z'T ti 0 0 pIr -w— co Cal LF 1oT � �y� oo . � /'�/ �, ~'�.'�`�'''� o��es � C :rs966 ice' �► g N Q � ,fir r � SZ 10�► �y � �ti �e �`:�� �-�'1` s•s�-2 �'�f`` •• L o � �+ •�� o? o-, '•JIB-.,, �ti '?'� w o • • 1 1 G >'�'.:::�;T � .c, ..or �� .00:oC•1 �r oZFSd P �1 �.Q V , m Q��, tob. � •'�+ /� ,,/''..pori� B/ 1°� "; v f o �Z �®T rc� wy o •a �� � � ,� •�o�'"' lc•csF �zz sa'tsr :, ` \ H ; ��� ; �1 yy 'L' 'oma ..,• \�► `'�mar o o� ,,. Q� ''� _ •:•bbr � �° • -0.49 s ` o,,,_ � ,i• s'�•.. •G" � per,-a � N � �7se I? :eroZS B�' .tr►�►.�wl�wl� 1��i� ,` _ '• g•� ,00°-off•!' `fj4 e N o"Z � �/ 1�T �`'`e�2.,1 o T /• 1 d4 0� � ��N s� .. �r�- � 1 s.p� ..� 7 t '�o' � g by � ., �-• w '• as .��. _ �►► �. a+orreNN+,[ 0�, Y J J!1 S � z ��'r � 1 ?��► .rw r�,(..a�„����dl .�sfyp .tarrNrsl " /z 10' l���yl�t�id3 t'Ar p1 tiooi t � ass 1 r , I ' t TOWN OF NORTH ANDOVER ct NORTh Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET '". • �'' NORTH ANDOVER,MASSACHUSETTS 01845 Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX January 21, 2005 Department of Environmental Protection Northeast Regional Office 1 Winter Street Boston,MA 02108 RE: in-situ state of Soils Address: 121 Raleigh Tavern Lane, North Andover, MA Soil Testing conducted on (date): 9/21/2004 North Andover Board of Health Representative: Andrew McBrearty In accordance with Title 5 Alternative to Percolation Testing Policy for System Upgrades,the soils in the area of the proposed SAS were determined to be Uncompacted. Sincerely, Susan Y. Sawyer,REHS/R Public Health Director i i AN1/17/2004 22:16 17813340115 TANGARDR PAGE 01 FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 No. Z Date:/P/ Commonwealth of Massachusetts /Vo• Massachusetts Soil Suitability Assessment foron-sw Sewagre Disposal Performed By: .... ./ - .. .... 11!..,., :. Date: ..... ... ..... � ...--^ Witnessed By: ..... ............... .. . L,4=mn Aftdt Of/2/ 6Y. ow •s Haft. [At I Addmu,and ? A10 New construction ❑ Repair Office Review } I, Published Soil Survey Available: No ❑ Yes 0 Year published ................... Publication Scale Soil Map Unit UD,/ Drainage Class�X��f�d�� Soil Limitations � '��GGtf�r �r Surfreial Geologic Report Available: No ® Yes ❑ Year Published ` k... . Publication Scale �..._.m. Geologic Material (Map Unit) 77,................................. ................................. Landform _............................ Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No El Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) :..................................... .................... Wetlands Conservancy program Map(map unit) ...........................................•.......... Current Water Resource Conditions (USGS): MonthA`:/I� Range :Above Normal EnNormal ❑Belvv Normal ❑ Other References Reviewed: — I j DEP APPROVED FORM-12/07/95 I 41/17/2004 22:16 17813340115 TANGARDR PAGE 02 FORM II - SOIL EVALUATOR FOIitii Page 2 of 3 Location Address or Lot No, �2/ �G,�(�� .��iC/ �,(/� /�r•����'G�� On-site ,Review Deep Hole Number l Date:. // .m Time: /.'?Q Weather Location (Identify on site plan) 77 -.. ...:... ... :...:..:. :.. Land Use ,� ' / 6! /T. l SIOpe M) Surface Stones k. Vegetation Landform5r e%VV Position on landscape r Distances from: Open Water Sody:006 feet Drainage way 7Q feet Possible Wet Area W:1- feet Property Line feet Drinking Water Well 7./ feet Other DEEP OBSERVATION'HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil 0"er Surface(inches) (USDA) (Munsell) Mottling (Structure.Stones,Boulders, Consistency, % Grave)) 71 //19!4 evil / 1AIa� Parent Material(geologic) C�- `yam Gam— OepthtoSedrock: Depth to Groundwater: $lending Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: . 2 (:�74fLle- if--- � ZZy DEP APPROVED 170101-1 WOW 411/17/2004 22:16 17813340115 TANGARDR PAGE 03 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 44- 6414w.. On-site Review e Deep Hole Number Z . Date:. .Z//� Time: Weather Location (identify on site plan) Land Use . . Slope (96) Surface Stones Vegetation Landform �.T �'�i'!`J>. J?!ol'�.9�/•*t Position on landscape 1" po Distances from: Z.5-0 Open Water Body feet Drainage way feet Possible Wet Area d feet Property Line ... feet Drinking Water Well 1370 feet Other :...... .:.�" :......::: DEEP ORSERVATION'HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(inches) (USDA) iMunsell) Mottling 1Strucnue,Stones,Boulders, Consistency, % Gravell Lot elo y",/,V Parent Material(geologic) �� _ �`�GG DepthtoDedrock: Depth to Groundwater: Standing Water in the Hole; -- Weeping from Pit Face: Estimated Seasonal High Ground Water /� DEP APPROVED FORAI•t2/07/95 s1/17/2004 22:16 17813340115 TANGARDR PAGE 04 FORM 11 - S0I1, LVALUA,TOR FORM Page 3 of 3 Location Address or Lot No. Lei Determination eoo-Seasonalgh Water Fable Method Used: ❑ Depth observed standing in observation hole......... inches ❑ Depth weeping from side of observation hole inches d Depth to soil mottles . . ".. inches l� ❑ Ground water adjustment ................... feet -4&Z 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 I areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? r Certification I certify that on ;�Cdate) 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, Sign atur C` ate /o DEP AFPROVx b FORM-12/07195