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Miscellaneous - 1292 OSGOOD STREET 4/30/2018
1292 OSGOOD STREET ,t �Y`1 � � 210/034.0-0043-0000.0 Vit, ,`, � _ - -- `� � �� I r I � ' � : North Andover Board of Assessors Public Access Page 1 of 1 MATCHING PARCELS Fiscal parcel ID Address Owner Name Year 2006 210/034.0-0.049-0000.0 OSGOOD STREET FORGETTA DEVELOPMENT LLC 2006 210J035.0-0009-0000.0 1210 OSGOOD FORGETTA FAMILY STREET TRUST FORGETTA REALTY 2006 210/034.0-0043-0000.0 1292 OSGOOD TRUST STREET FORGETTA, DANIEL A & JOANNE E 2006 210/034.0-0013-0000.0 1284 OSGOOD FORGETTA, ARTHUR H STREET 2006 210/034.0-0053-0000.0 1284 OSGOOD FORGETTA, ARTHUR H STREET 2006 210/016.0-0058-0000.0 3 TRINITY COURT FORGETTA, ARTHUR H CARMELITA FORGETTA e http://csc-ma.us/NandoverPubAcc/j sp/SaveSearch.j sp 3/14/2006 ' I North Andover Board of Assessors Public Access 1 Parcel ID: 210/034.0-0043-0000.0 Community: North Andover SKETCH PHOTO Click on Photo to Enlar e No F A . 1 Ava'110aftblerr K 1292 OSGOOD STREET t 1 J Location: 1292 OSGOOD STREET Owner Name: FORGETTA REALTY TRUST FORGETTA,DANIEL A& JOANNE E { Owner Address: 1292 OSGOOD STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 31 - 1 Land Area: 1 acres Use Code: 031 - MULTIUSE-COM Total Finished Area: 4620 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 730,500 717,800 Building Value: 392,000 379,300 Land Value: 338,500 338,500 Market Land Value: 338,500 Chapter Land Value: LATESTSALE Sale Price: 1 Sale Date: 08/22/2002 Arms Length Sale Code: A-NO-FAMILY Grantor: Cert Doc: Book: 07029 Page: 0275 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=802944 3/14/2006 i ay � A • t / c2� i Lot & Street C�'o , ^ Map/Parcel 7z,,63 �3 CONSTRUCTION APPROVAL Has plan review fee been paid�S NO Permit# Plan Approval: Date: Approved by:�— Designer: Zk_�Olan Date: Conditions: f Water Supply: _.Town._ Well Well Permit: Driller: Well Tests: Chemical Date Approved Bacteria I Date Approved Bacteria II Date Approved Plumbing Sign-Off: Wiring Sign-off- Comments:— Form "U" Approval: pprovaI to IssCYe: ` ES NO Date Issued By: Conditions: Final Approval: All Permits Paid? NO Well Construction Approval? YES NO Septic System Construction Approval? NO Certification? NO Other? YES NO Any Variance Needed? YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: • SEPTIC SYSTEM INSTALLATION CONDITIONS: Is the installer licensed? NO Type of Construction: REPAIR New Construction: Certified Plot Plan Review S NO Floor Plan Review <Y ES NO Conditions of Approval from Form U YES NO Issuance of DWC permit: NO DWC Permit Paid? S NQ DWC Permit � Installer: 1 rK Begin Inspection: YES NO Excavation Inspection: Needed: Passed: By: XJ v Construction Inspection: Needed: Built Plan Satisfactory: YES: Approval of Backfill: Date: By: Final Grading Approval: Date: By: , I A Final Construction Approval: Date: 01 By: Certificate of Compliance: Approval: Date: LETTER OF TRANSMITTAL !! North Andover Health Department 14ORTH 400 Osgood Street ?0�14 $6.q�'O 3 e.. 6 North Andover,MA 01845 O� 978.688.9540 - Phone 978.688.8476 -Fax "o ,•"• 9A c«.acwwc« � healthdent(&townofnorthandover com -E-mail 044-*E0 www.townofnorthandover.com - Website Page I of �.. % CHUs�� TO: DATE: WILLIAM (BILL) DUFRESNE, �/� /C/- PROJECT MANAGER / COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant MERRIMACK ENGINEERING SERVICES RE: ��� Phone:978.475.3555 2 . Fax: 978.475.1448 We are sending you: OPlan Review Letter OAPPROVED ONOT APPROVED OSystem Construction Follow-Up OOther These are transmitted as checked below: OFor your File OAs Required OAs Requested OFor Your Use REMARKS: , COPY TO: Fax# Homeowner or Mailed COPY TO: Fax# File or Mailed COPY TO: Fax# or Mailed' TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 12/04/01 This is to certify that the individual subsurface disposal system constructed (X) or repaired ( ) by Tim Quinlan at 1292 Osgood Street has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector !NO:/V2 my 2 0 2001 „ TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System 0 constructed; ( )repaired; by u/Al c.Aiy r &A A 91& ,es located at OR& 05G - D S}rce+- was installed in conformance with the North Ai0over Board of Health approved plan, System Design Permit #LX9, dated with an approved design flow of?lO gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000,Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: 10-01--01 Engine epresentative Final inspection date: l0 ')g-01 Engineer R resentative Installer: -71m Qcu1yL4&) Lic.#: 14S-1 Date: 1r3[-&)t0( Design Engineer: I 142r 4W410 Date: /"o/PIDp n-A A4, ^•'!Y Gu' a _;` \ No. 706 MERRIMACK ENGINEERING SERVICES, INC, PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET•ANDOVER,MASSACHUSETTS 01810•TEL(978)475-3555,373-5721 •FAX(978)475-1448•E-MAIL:merreng@aol.com April 20, 2006 Ms. Susan Sawyer t Public Health Director APIR 2 0 2006 400 Osgood Street j North Andover,MA 01845 ' %wtJR Re: 1292 Osgood St Dear Ms. Sawyer: We have received your review letter dated April 19,2006 regarding the above referenced site. With regard to item#1,we have revised the plan to reflect the location of T-3 &T-4. We respectfully request the North Andover Board of Health approve the use of these test pit results as they are more than 2 years old, and are consistent with recently conducted test pit#5. With respect to item#2 of your letter, we ask that you approve the design as re-submitted, with the condition that a non hazardous industrial waste holding tank permit is filed for and obtained and that no request for a construction permit will be made by our client until this, and all other necessary permits are obtained. Lastly, with regards to item#3 of your letter, since the existing system is only a few years old, and since construction of the existing system required substantial sand fill, we feel it is unnecessary to remove existingsuitable sand fill only to be replaced with similar sand fill. Also since both the North Andover Board of Health and the design engineer conduct excavation inspections during the normal course of a system installation, we could collectively agree upon the extent of the sand removal during this inspection as the extent of spoiled soils is typically very evident on systems this new. We appreciate your consideration of this matter and look forward to discussing these issues, and others related to this design at your earliest available meeting agenda. Very truly yours, MERRIMACK ENGINEERING SERVICES William Dufrense Project Manager tl I MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS LAND SURVEYORS PLANNERS 66 PARK STREET•ANDOVER,MA 01810• (978)475-3555,373-5721 •FAX(978)475-1448 •E-MAIL info@merrimackengineering.com May 23, 2006 Ms. Susan Sawyer: Public Health Director 1600 Osgood Street Building 20, Suite 2-36 MAY 2 3 2006 North Andover, MA 01845 TO r4,,., 1� Re: 1296 Osgood Street/Beauty Salon Dear Ms. Sawyer: We are working with Wendy Forgetta regarding the above referenced project. Pursuant to 310 CMR 18.00,permits are not required for installation of an industrial waste holding tank. The current procedure requires the applicant to install a holding tank consistent with the new regulations and then submit a Compliance Certification Form (DEPO1) certifying compliance with DEP regulations. Attached is a copy of this application which will be submitted to DEP upon completion and installation of the holding tank. We hope this information will be helpful in your evaluation of the pending septic approvals. Very truly yours, MERRIMACK ENGINEERING SERVICES William Dufresne Project Manager ti c , Massachusetts Department of Environmental Protection Industrial Wastewater Holding Tank DEP Assigned Facility ID or Compliance Certification Form (DEP01 ) Facility Name Important: A. Facility Information When filling out forms on the computer,use Mandolin Hair Salon 7231 only the tab key a. Facility Name b.Facility SIC Code c.DEP Assigned Facility ID to move your 1296 Osgood Street -2 nd Floor cursor-do not d.FacilitySite Address Street No.,Street Name,Street Suffix e. St,Ave,etc. e.SecondaryUnit e. Building-C,7th Floor use the return ( 9 ) ( 9 g ) key. North Andover MA 01845 f.City g.State h.Zip Code r� 1296 Osgood Street 2nd I.Facility Mailing Address(If different from the facility site address above) j.Secondary Unit North Andover MA 01845 amen k.City I.State m.Zip Code 978-697-5380 58-2678675 n.Phone Number o.Fax Number p.Federal Employer Identification Number(FEIN or EIN) A-I. Certification Information Wendy Forgetta Owner 978-697-5380 a.Contact Person First Name b.Contact Person Last Name c.Title d.Telephone Number Wendy Forgetta Owner 978-697-5380 e.Owner First Name f.Owner Last Name g.Title h.Telephone Number i.General business description B. Industrial Wastewater and Holding Tank Information Answer all questions, unless you are directed to skip a question. Do not answer questions that you are directed to skip. 1. Major sources of industrial wastewater a. ❑ Process wastewater (Check all that apply) b. ❑ Equipment cleaning wastewater c. ❑ Spent concentrated solution d. ❑ Floor spills or floor drainage e. E Other(s) (Please describe below) Hair Treatment Describe major sources 2. Major pollutants in the industrial wastewater a. ❑ BOD/COD (Check all that.apply) b. ❑ Oil &Grease c. ❑ Low/High pH d. ❑ Cyanide e. ❑ Cadmium f. ❑ Chromium -_�.,C g. ❑ Copper h. ❑ Lead i. ❑ Nickel MAY 3j• ❑ Silver k. ❑ Zinc o"'i {i I. E Other(s)(Please describe below) Hair Color& Perm Products Describe major pollutants Odep01.doc 12/02 Page 1 of 6 Massachusetts Department of Environmental Protection Industrial Wastewater Holding Tank DEP Assigned Facility ID or Compliance Certification Form (DEP01 ) Facility Name B. Industrial Wastewater and Holding Tank Information (Cont.) 3. Holding Tank ID (If any): 4. Holding Tank Installation Date: (MM/DD/YYYY) 5. Tank Type (Check one box only): a. ❑ Above-ground b. ® In-ground 6. Tank Construction Material a. ❑ Steel (Check appropriate box(es)or specify): b. ® Concrete c. ® Fiberglass d. ❑ Plastic e. ❑ Other(s) (Please describe below) Fiberglass Primary/Concrete Containment Describe construction material 7. Tank Capacity a. ® Less than 3,000 gallons (Check one box only): b. ❑ 3,000 gallons or more B-I. Compliance Information Section-1 General 101 Do you discharge industrial wastewater to ❑ yes—you must cease discharging and a septic system, leaching field, or complete a Return to Compliance Plan cesspool? ® no 102 Do you discharge industrial wastewater to ❑ yes—you must cease discharging and a storm drain or to the ground without a complete a Return to Compliance Plan surface water or groundwater discharge " permit? ® no 103 Is the discharge of your industrial ❑ yes— I have checked with DEP and I am wastewater to a municipal sewer system aware of the restrictions that may apply to feasible? my facility (if your answer is yes to this question, you need to check with DEP for restrictions ® no that may apply to your facility before completing this certification) Odep0l.doc 12/02 - Page 2 of 6 Massachusetts Department of Environmental Protection Ll Industrial Wastewater Holding Tank DEP Assigned Facility ID or Compliance Certification Form (DEP01 ) Facility Name B-I. Compliance Information (Cont.) 104 Is your facility located in the Zone I or ❑ yes— I have checked with DEP and I am Zone A of a drinking water supply area? aware of the restrictions that may apply to (if your answer is yes to this question, you my facility need to check with DEP for restrictions that may apply to your facility before ® no completing this certification) 105 Is this certification for an above-ground ❑ yes holding tank? ® no -skip to question 301 Section-2 Above-Ground Holding Tank 201 Is this above-ground holding tank ❑ yes constructed or lined with material compatible with your industrial ❑ no -submit a Return to Compliance Plan wastewater? 202 Is this above-ground holding tank ❑ yes remotely filled or automatically filled? ❑ no-skip to question 203 202a Have you provided an appropriate ❑ yes audio and light alarm system for this above-ground holding tank? ❑ no-submit a Return to Compliance Plan 203 Have you provided appropriate spill ❑ yes containment for this above-ground holding tank? ❑ no-submit a Return to Compliance Plan 204 Have you provided "Non-Hazardous ❑ yes Industrial Wastewater' labels for this above-ground holding tank? ❑ no-submit a Return to Compliance Plan 205 Was this above-ground holding tank both ❑ yes installed after November 15, 2002 and fabricated on site? ❑ no -skip to question 401 ■depOl.doc 12/02 Page 3 of 6 Massachusetts Department of Environmental Protection Industrial Wastewater Holding Tank Ll Compliance Certification Form DEP01 DEP Assigned Facility lDor 1"' ( ) Facility Name B-I. Compliance Information (Cont.) 205a Was this above-ground holding ❑ yes —skip to question 401 tank constructed in accordance with engineering plans that were ❑ no—submit a Return to Compliance Plan stamped and signed by a and skip to question 401 Massachusetts Registered Professional Engineer? Section-3 In-Ground Holding Tank 301 Is this in-ground holding tank constructed ® yes or lined with material compatible with your industrial wastewater? ❑ no -submit a Return to Compliance Plan 302 Is the capacity of this in-ground holding ® yes tank greater than 500% of the average daily flow? ❑ no -submit a Return to Compliance Plan 303 Have you provided an appropriate audio ® yes and light alarm system for this in-ground holding tank? ❑ no-submit a Return to Compliance Plan 304 Have you provided"Non-Hazardous ® yes Industrial Wastewater' labels or signs for this in-ground holding tank? ❑ no-submit a Return to Compliance Plan 305 Was this in-ground holding tank installed ❑ yes before November 15, 2002? ® no-skip to question 306 305a Was this in-ground holding tank ❑ yes -skip to question 401 constructed in accordance with engineering plans that were ❑ no stamped and signed by a Massachusetts Registered Professional Engineer? OdepOl.doc 12/02 Page 4 of 6 ' Massachusetts Department of Environmental Protection Industrial Wastewater Holding Tank DEP Assigned Facility ID or Compliance Certification Form (DEP01 ) Facility Name B-I. Compliance Information (Cont.) 305b Will you (or did you)obtain an ❑ yes -skip to question 401 integrity assessment by November 15, 2003, which will be ❑ no -submit a Return to Compliance Plan prepared by a Massachusetts and skip to question 401 Registered Professional Engineer, for this in-ground holding tank? 306 Was this in-ground holding tank ® yes constructed in accordance with engineering plans that were stamped and ❑ no- submit a Return to Compliance Plan signed by a Massachusetts Registered Professional Engineer? 307 Have you provided an appropriate ® yes secondary containment for this in-ground holding tank? ❑ no - submit a Return to Compliance Plan Section-4 Record Keeping 401 Do you maintain all holding tank ® yes construction and installation records (including all applicable permits)at the ❑ no - submit a Return to Compliance Plan facility? 402 Do you keep and maintain the appropriate ® yes operating records, including wastewater shipment,..ultimate destination, and hauler ❑ no-submit a Return.to Compliance Plan information at the facility? I MdepOl.doc 12/02 Page 5 of 6 J a Massachusetts Department of Environmental Protection Industrial Wastewater Holding Tank IL DEP Assigned Facility ID or Compliance Certification Form (DEP01 ) Facility Name C. Certification Statement (Note: Complete all required Return to Compliance Plan forms before signing this statement) "I,Wendy Forgetta , attest under the pains and penalties of perjury: (Name of responsible official) (i) that I have personally examined and am familiar with the information contained in this submittal, including any and all documents accompanying this certification statement; (ii) that, based on my inquiry of those individuals responsible for obtaining the information, the information contained in this submittal is to the best of my knowledge, true, accurate, and complete; (iii) that systems to maintain compliance are in place at the facility and will be maintained even if processes or operating procedures are changed; and (iv) that I am fully authorized to make this attestation on behalf of this facility. am aware that there are significant penalties including, but not limited to, possible fines and imprisonment for willfully submitting false, inaccurate, or incomplete information." AA Signature Date(MM/DD/YYYY) Wendy Forgetta Owner Printed Name Title Source of Signatory Authority(Check appropriate box): 1. If a Corporation: a. ❑ President b. ❑ Secretary c. ❑ Treasurer d. ❑ Vice President(if authorized by corporate vote) e. ❑ Representative of the above(if authorized by corporate vote and if responsible for overall operation of the facility) 2. If a Partnership: - ❑ General Partner 3. If a Sole Proprietorship: ® Proprietor 4. If an Institution: ❑ Principal Executive Officer 5. If a Municipality or a Public Agency: a. ❑ Principal Executive Officer b. ❑ Ranking Elected Official (Empowered to enter into contracts on behalf of the municipality or public agency) Mdepo1.doc 12/02- Page 6 of 6 ■ i AS-BUILT CHECKLIST �l LOT NUMBER STREET NAME _ ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS ` LOCATIONS & DIMENSIONS OF SYSTEM INCLUDING RESERVE TIES TO LOT LINES &DWELLING, WELLS a. FROM SEPTIC TANK / b. FROM LEACH AREA V LOCATIONS OF DEEP HOLES & PERI 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 ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. NORTH ARROW LOCATION &ELEVATIONS OF BENCHMARK USED 3c� Y ��•,�.r :i •i Town of North Andover $ORrN Office of the Building Department 3? t: OCommunity Development and Services Division William J.Scott, Division Director `°• -- °� 27 Charles Street North Andover,Massachusetts 01845 I D.Robert Nicetta Telephone(978)688-9545 Building Commissioner Fax(978)688-9542 MEMORANDUM To:Heidi Cmll`in,Town Planner From:Robert Nicetta,Building Commissioner Date:November 16,2000 Re:Florist Stop Facility O1292 Osgood Street Daniel and Joanne Forgetta presently reside in a single family dwelling at 1292 Osgood Street The location was recently changed by Town Meeting to a Business-1(B-1)District The North Andover Zoning By-law Section 4.126,Paragraph 1 allows retail establishment and Paragraph 9 allows residential use including one and two family dwellings.The by-law does not specify only one(1)structure on the lot,nm does it not allow th6 proposed retail and the existing single family structures to co-exist As such,I am of the opinion tlrt both are allowed in the B-1 District if you require further in formation please call my office. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATTON 688-9530 HEALTH 688-9540 PLANNING 688-9535 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program BRP WM 05 Treatment Facility Rating Worksheet Chemical Precipitation (reaction vessel) Clarification .......... 5 ChromeReduction .......................................................... 5 Cyanide Destruction ........................................................ 5 Detention Basins,Swales, Infiltration Trenches .................. 2 Disinfection .................................................................... 5 Equalization ................................................................... 2 Evaporation Single ....................................................................... 2 Multiple ..................................................................... 5 Filtration/Sludge Dewatering Cartridge ................................................................... 3 Centrifuge .................................................................. 8 FilterPress ..........................:...................................... 8 Membrane .................................................................. 5 Vacuum Filter............................................................. 10 Flocculation/Mixing/Coagulation ....................................... 5 Flotation ........................................................................ 5 Neutralization/pH Adjust Single ....................... ............................................... 3 Multiple ..................................................................... 5 Oil/Water Separation GravityFed ................................................................ 2 Baffled ...................................................................... 5 Settling With Manual Sludge Removal ........................................ 3 With Mechanical Sludge Removal ................................... 5 Sludge Blending/Thickening ............................................. 5 Sludge Drying (mechanical dryers) .................................... 5 Note: This worksheet is used to determine permit application fees only, not certification grades for wastewater treatment. wm05ins•rev.05/03 BRP WM 05 Treatment Facility Rating Worksheet•Page 2 of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program BRP WM 05 Treatment Facility Rating Worksheet This worksheet is used to guide the applicant in choosing the correct fees category, pursuant to 310 CMR 4.00. The systems described here are the only method of determining categories for Type I and Type II facilities. Rating system for proposed discharges "Unit Operations" is defined as processes used to treat any surface water discharge. They are listed in bold-faced type on the next page. The rating system is based on the number of specific unit operations in a proposed wastewater treatment facility and the total number of points assigned to each unit operation. Type II Facility-This is defined as any facility that has three or more unit operations as listed in bold-faced type on the next page, OR has a rating of greater than 20 points. This would be category BRP WM 05. Type 1 Facility-This is defined as any facility that has less than three unit operations listed in bold-faced type on the next page, AND has a rating of less than or equal to 20 points. This would be category BRP WM 06. Example: Unit Operation Points Equalization 2 Sludge Blending/Thickening 5 Chrome Reduction 3 Flotation 5 4 Unit Operations 15 Points Since this facility has four unit operations, it is considered a Type II facility, even though it has a rating of less than 20 points. Unit Operations in Industrial Wastewater Treatment Systems Refer to 257 CMR 2.00 for any other unit operations not listed here. Unit Operation Points Absorption/Adsorption Carbon ...................................................................... 5 IonExchange ............................................................. 5 Biological Wastewater Treatment Activated Sludge ......................................................... 6 Contact Beds(anaerobic) .............................................. 5 RBC ......................................................................... 5 SandFilters ................................................................ 4 Trickling Filters ............................................................ 4 wm05ins•rev.05/03 BRP WM 05 Treatment Facility Rating Worksheet•Page 1 of 2 LIMassachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program Surface Water Discharge (NPDES) • Non-Industrial Wastewaters BRP WM 05 Permit Fact Sheet • Submit fee and a copy of the DEP Transmittal Form to: Department of Environmental Protection, P. O. Box 4062, Boston, MA 02211. 10. What are the state regulations that apply to these permits?Where can I get copies? These regulations include, but are not limited to: • Surface Water Discharge Regulations, 314 CMR 3.00. • Surface Water Quality Standards, 314 CMR 4.00. • Wastewater Treatment Plant Operators, 257 CMR 2.00. • Timely Action Schedule and Fee Provisions, 310 CMR 4.00. These may be purchased at: State Bookstore(in State House) State Bookstore Room 116 436 Dwight Street Boston, MA 02133 Springfield, MA 01103 617-727-2834 413-784-1376 wm05ins•rev.5/03 BRP WM 05 Permit Fact Sheet•Page 4 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program Surface Water Discharge (NPDES) • Non-Industrial Wastewaters BRP WM 05 Permit Fact Sheet be deficient, applicants are given the opportunity to correct the discrepancy and the Department then conducts a supplemental technical review. Because NPDES permits are issued jointly by the state and federal governments, DEP cannot begin its technical review until EPA issues a draft permit. 7. What are annual compliance fees? Annual compliance fees are assessed on facilities holding DEP permits. Assessments begin in the state fiscal year following the year the permit is issued. There are 3 categories of compliance fees for surface water discharges: $6,240: • Surface Water Discharges of 150,000 gallons per day or greater; or • Discharges requiring more than secondary treatment; or • Discharges from a categorical industry with pretreatment standards at 40 CFR 400.00 et seq.; or • Discharges from marine or oil pipeline oil terminal; or • Discharges of non-contact cooling water in excess of 1 million gallons per day. $1,060: All other Surface Water Discharges excluding 310 CMR 4.10(6)(tt) permits effective 11/30/94. The following entities are exempt from Annual Compliance Fees: • Massachusetts state agencies • Massachusetts cities, towns, counties, districts • Municipal housing authorities, and federally recognized Indian tribe housing authorities. $100: Discharge of non-process water not subject to anti-degradation provisions of 314 CMR 4.00, excluding 310 CMR 4.10(6)(tt) permits, effective 11/30/94. 8. How long is the notice of intent in effect? Federal and state regulations each stipulate that NPDES permits be issued for a period, "not to exceed 5 years". Permits may be issued for less than 5 years. 9. How can I avoid the most common mistakes made in submitting an application? • Use appropriate state and federal forms. The state forms are included in the Forms Section to this application package. • Answer all application questions. Follow the accompanying instructions carefully when answering. • Submit complete and thorough engineering reports, plans and specifications. Make sure they are stamped and signed by a Massachusetts Registered Professional Engineer. • Make sure the application is signed and dated in ink by a legally responsible official. • Submit a copy of the DEP Transmittal Form and the completed application forms to the DEP Office of Watershed Management. wm05ins•rev.5/03 BRP WM 05 Permit Fact Sheet•Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program Surface Water Discharge (NPDES) • Non-Industrial Wastewaters BRP WM 05 Permit and Plan Approval for Type II Discharge (Non-Industrial) Instructions and Supporting Materials Table of Contents • introduction • permit fact sheet • treatment facility rating worksheet • DEP addresses and phone numbers Introduction DEP Permit Applications, as well as Instructions&Support Materials, are available for download from the DEP Web site at mass.gov/dep in two file formats: Microsoft WordTM and Adobe Acrobat PDFTM. Either format allows documents to be printed. Instructions &Support Materials files in Microsoft WordTM format contain a series of documents that provide guidance on how to prepare a permit application. Although we recommend that you print out the entire package, you may choose to print specific documents by selecting the appropriate page numbers for printing. Permit Applications in Microsoft WordTM format must be downloaded separately. Users with Microsoft WordTM 97 or later may complete these forms electronically. Permitting packages in Adobe Acrobat PDFTM format combine Permit Applications and Instructions&Support Materials in a single document. Adobe Acrobat PDFTM files may only be viewed and printed without alteration. Permit Applications in this format may not be completed electronically. wm05ins•rev.9/02 Introduction•Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program Ll Surface Water Discharge (NPDES) • Non-Industrial Wastewaters BRP WM 05 Permit Fact Sheet 1. What is the purpose of NPDES Permits? These permits protect public health and the environment by controlling pollutant discharges to surface waters and ensuring that the water quality criteria and receiving water use prescribed in the Massachusetts Surface Water Quality Standards(314 CMR 4.00)are met. 2. Who must apply? In general, NPDES permits must be applied for and obtained by: • Any agency or political subdivision of the Commonwealth • Any federal agency • Any public or private: -corporation -authority. -individual -partnership -association, or -other entity proposing to discharge non-industrial wastewater from a point source to surface waters. Any facility without remediation discharges and outside the SIC Codes listed below must apply. 1000- 1399 Metal Mining, Coal Mining, Oil and Gas Exploration 1474- 1499 Chemical/Fertilizer Mining, Nonmetallic 2000-3999 Manufacturing 4231 Maintenance Facilities for Motor Freight Transport 4581 Airports, Flying Fields and Airport Terminal Services 4911 -4939 Electric and Gas Production 7216 Drycleaning 7217 Carpet and Upholstery Cleaning 7218 Industrial Laundries 7384 Photofinishing Laboratories 7532 -7539 Automotive Repair and Paint Shops 7549 Automotive Services 7819 Motion Picture Developing/Printing/Film Processing 8062-8069 Hospitals 8071 Medical Laboratories 8072 Dental Laboratories Any facility whose SIC Codes is listed above proposing to discharge industrial wastewater from a point source to surface waters must apply for NPDES permits listed under BWP IW 16, 18, 26, 27, 35, 36, or 37. Form BRP WM 05 is designed to collect general information that applies to Type II discharges to surface waters. In addition, public wastewater treatment facilities must fill out Form BRP WM 2A, "Application for Permit to Discharge Municipal Wastewater,"and all other facilities must fill out Federal Form 2C, 2D, 2E, or 2F, whichever is appropriate. Forms 2C, 2D, 2E and 2F may be obtained by calling the EPA at 617-565- 3529. wm05ins•rev.5/03 BRP WM 05 Permit Fact Sheet•Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection • Watershed Permitting Program Surface Water Discharge (NPDES) • Non-Industrial Wastewaters BRP WM 05 Permit Fact Sheet 3. What other requirements should be considered? • In addition to filing the appropriate application forms with the Massachusetts DEP, an applicant must contact the U.S. EPA to obtain and file the appropriate federal NPDES permit application forms. It is not necessary to submit engineering designs or final plans to EPA for approval. • Application for operator certification and facility rating in accordance with 257 CMR 2.00 is required for operation of treatment works. • Permits of this type may require MEPA review. Please carefully examine the MEPA Regulations (301 CMR 11.00)to determine if your project exceeds the MEPA review thresholds. For more information contact the MEPA Unit of the Executive Office of Environmental Affairs at 617-727-5830. DEP cannot begin technical review of the permit application until the MEPA process has been completed, unless otherwise agreed to in writing. Copies of MEPA filings (with reference to any applicable Transmittal numbers)should be sent to the appropriate program offices in Boston and the DEP MEPA Coordinator in the region where the facility is located. Addresses for DEP Regional Office are contained on the"Addresses and Phone Numbers" page of this application package. 4. What is the application fee? BRP WM 05 Type II Discharge $ 5,525 5. What is the Primary Permit Location? Completed permit applications should be submitted to: Department of Environmental Protection Division of Watershed Management 627 Main Street,2nd Floor Worcester, MA 01608 6. What are the timelines? DEP offers a money-back guarantee for completing permit reviews on time. If the Department fails to complete its permit review within prescribed timelines, it will refund the permit application fee and will continue working on the application. The timeline (in days) for this NPDES permit is: Administrative Supplemental Review Permit Category and Technical Technical Review of Public Review (if needed) Comments BRP WM 05 230 200 90 The timelines established for each category consist of an Ad min istrative/Technical Review period and, if a public comment period is required, additional time to review comments received. If an application is found to wm05ins•rev.5/03 BRP WM 05 Permit Fact Sheet•Page 2 of 4 North Andover Board of Assessors Public Access Page 1 of 1 t MATCHING PARCELS Fiscal Parcel ID Address Owner Name Year 2005 210/034.0-0049-0000.0 OSGOOD STREET FORGETTA DEVELOPMENT LLC 2005 210/035.0-0009-0000.0 1210 OSGOOD FORGETTA FAMILY TRUST STREET 1292 OSGOOD FORGETTA REALTY TRUST 2005 210/034.0-0043- 00.0 STREET FORGETTA,DANIEL A& JOANNE E 2005 210/034.0-0013-0000.0 1284 GOOD FORGETTA,ARTHUR H STREET 2005 210/034.0-0.053-0000.0 1284 OSGOOD FORGETTA,ARTHUR H STREET 2005 210/016.0-0058-0000.0 3 TRINITY COURT FORGETTA,ARTHUR H _ _ - _ CARMELITA FORGETTA Page: 1 of 1 1 http://csc-ma.us/NandoverPubAcc/jsp/SaveSearch.jsp 11/28/2005 North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/034.0-0049-0000.0 Community: North Andover SKETCH PHOTO Bch "aura Available AvaMll Location: OSGOOD STREET Owner Name: FORGETTA DEVELOPMENT LLC Owner Address: 1049 TURNPIKE STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 34 - 4 Land Area: 13.79 acres Use Code: 440 -IND-DEV-LAND Total Finished Area: ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 685,900 685,900 Building Value: 0 0 Land Value: 685,900 685,900 Market Land Value: 685,900 Chapter Land Value: LATEST SALE Sale Price: 2,800,000 Sale Date: 11/20/2001 Arms Length Sale Code: B-NO- Grantor: FORGETTA FAMILY INTRACORP TRUS Cert Doc: Book: 06489 Page: 0241 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=461734 11/28/2005 North Andover Board of Assessors Public Access Page 1 of 1 ' Parcel ID: 210/035.0-0009-0000.0 Community: North Andover SKETCH PHOTO No SkEatch No Picture Rable Location: 1210 OSGOOD STREET Owner Name: FORGETTA FAMILY TRUST Owner Address: 1210 OSGOOD STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 - 5 Land Area: 9.5 acres Use Code: 017-RES-CH61A Total Finished Area: 3457 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 399,000 324,000 Building Value: 222,300 186,000 Land Value: 176,700 138,000 Market Land Value: 323,500 Chapter Land Value: 176,686 LATEST SALE Sale Price: 1 Sale Date: 05/02/1985 Arms Length Sale Code: A-NO-FAMILY Grantor: FORGETTA PASQUALINA Cert Doc: Book: 01965 Page: 0133 http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&Linkld=461747 11/28/2005 North Andover Board of Assessors Public Access Page 1 of 1 ' Parcel ID: 210/034.0-0043-0000.0 Community: North Andover SKETCH PHOTO Click on Photo to Enlarge No Skcftt%^Ah �H 4" Avapllabl= n i 1292 OSGOOD STREET .JA "J < ``. . Location: 1292 OSGOOD STREET Owner Name: FORGETTA REALTY TRUST FORGETTA, DANIEL A & JOANNE E Owner Address: 1292 OSGOOD STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 31 - 1 Land Area: 1.85 acres Use Code: 031 -MULTIUSE-COM Total Finished Area: 4620 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 717,800 717,800 Building Value: 379,300 379,300 Land Value. 338,500 338,500 Market Land Value: 338,500 Chapter Land Value: LATEST SALE Sale Price: 1 Sale Date: 08/22/2002 Arms Length Sale Code: A-NO-FAMILY Grantor: Cert Doc: Book: 07029 Page: 0275 http://csc-ma.us/NandoverPubAcc/J*sp/Home.jsp?Page=3&Linkld=461729 11/28/2005 North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/034.0-0013-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge No Picture v I'1 I Location: 1284 OSGOOD STREET Owner Name: FORGETTA,ARTHUR H Owner Address: 3 TRINITY COURT City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 - 5 Land Area: 0.57 acres Use Code: 104 -TWO-FAM-RES Total Finished Area: 2832 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 375,900 380,800 Building Value: 222,800 227,700 Land Value: 153,100 153,100 Market Land Value: 153,100 Chapter Land Value: LATEST SALE Sale Price: I Sale Date: 06/25/1989 Arms Length Sale Code: A-NO-FAMILY Grantor: FORGETTA PASQUALINA Cert Doc: Book: 2954 Page: 0250 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=461709 11/28/2005 North Andover Board of Assessors Public Access Page 1 of 1 3 Parcel ID: 210/034.0-0053-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge EN F-- No rictus Available ......................................... Location: 1284 OSGOOD STREET Owner Name: FORGETTA,ARTHUR H Owner Address: 3 TRINITY COURT City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 -5 Land Area: 1.38 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 2270 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 485,600 243,200 Building Value: 315,200 0 Land Value: 170,400 243,200 Market Land Value: 170,400 Chapter Land Value: LATESTSALE Sale Price: 1 Sale Date: 06/25/1989 Arms Length Sale Code: A-NO-FAMILY Grantor: FORGETTA PASQUALINA Cert Doc: Book: 2954 Page: 0250 http://csc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=3&Linkld=46173 8 11/28/2005 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, April 12, 2006 12:26 PM To: 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; Marianne Peters(E-mail); 'McBrearty Andrew(E-mail)' Subject: FW: Forgetta- 1292 OSGOOD STREET Hi guys, Can you let me know the plan status on this? Submitted 3/13/06. Thanks! -----Original Message----- From: Sawyer,Susan Sent: Wednesday,April 12,2006 12:14 PM To: DelleChiaie, Pamela Subject: Forgetta Wendy from Forgetta's called this AM to ck on the septic plan status. Please call her back 978 697-5380 thx S Susan Sawyer, R.S. Public Health Director office 978 688-9540 fax 978 688-8476 1 TOWN OF NORTH ANDOVER Ot NORTH 4 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET M NORTH ANDOVER, MASSACHUSETTS 01845 'ss�cNuget Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdeptLtownofnorthandover.com www.townofnorthandover.com April 26,2006 Merrimack Engineering Services,Inc. Attn: William Dufresne,Project Manager 66 Park Street Andover,MA 01845 Re: 1292 Osgood Street Dear Mr.Dufresne, The Health Department has reviewed your letter in response to the Board of Health comments made on April 19, 2006.Your request to utilize the test pits has been placed on the next meeting agenda for the Board of Health meeting scheduled on Thursday,May 25,2006. As this is a routine item,Health Department personnel do not have an issue with presenting the request without presence of the owner or engineer.However,you are welcome to be present if you choose. With that variance,the plan will be approved the next business day.The time available before the meeting should be sufficient to begin to address the outstanding issue of the holding tank.Please submit information regarding the status of the tank permit prior to May 25"'so that the board members can be provided with all information on this project. TZhanky S an Sawyer,REHS/R Public Health Director Cc: Owner: TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET 'c°. • ''4' NORTH ANDOVER, MASSACHUSETTS 01845 �sS�ceuS�t Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthde tt a)townofnoilhandover.com www.townofnorthandover.com April 26,2006 Merrimack Engineering Services,Inc. Attn: William Dufresne,Project Manager 66 Park Street Andover,MA 01845 Re: 1292 Osgood Street Dear Mr.Dufresne, The Health Department has reviewed your letter in response to the Board of Health comments made on April 19, 2006.Your request to utilize the test pits has been placed on the next meeting agenda for the Board of Health meeting scheduled on Thursday,May 25,2006. As this is a routine item,Health Department personnel do not have an issue with presenting the request without presence of the owner or engineer.However,you are welcome to be present if you choose. With that variance,the plan will be approved the next business day.The time available before the meeting should be sufficient to begin to address the outstanding issue of the holding tank.Please submit information regarding the status of the tank permit prior to May 25`h so that the board members can be provided with all information on this project. Thank S an Sawyer,REHS/R Public Health Director Cc:Owner: LETTER OF TRANSMITTAL North Andover Health Department poRTh 400 Osgood Street 6 North Andover,MA 01845 0 o� �" 7p 978.688.9540-Phone 978.688.8476 -Fax '♦ �rA c�.; o.WKR healthdent(a,townofnorthandover com - E-mail 3� ��ATto www.townofnorthandover.com - Website Page_ of SSgCHUsti� TO: DATE: WILLIAM (BILL) DUFRESNE, PROJECT MANAGER COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant MERRIMACK ENGINEERING SERVICES RE: �I Phone: 978.475.3555 . Fax: 978.475.1448 We are sending you: OPlan Review Letter OAPPROVED ONOT APPROVED OSystem Construction Follow-Up OOther These are transmitted as checked below: OForour File OAs Required e wired OAs Requested Q q ed OFor Your Use REMARKS: COPY TO: Fax# Homeowner or Mailed COPY TO: Fax# File or Mailed COPY TO: Fax# or Mailed i ' HP Fax K1220xi Log for NORTH ANDOVER 9786889542 May 012006 4:13pm Last Transaction Date Time Toe Identification Duration PneS R suit May 1 4:11pm Fax Sent 819784751448 1:34 2 OK .fr TOWN OF NORTH ANDOVER Ot NORTa Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER,ANDOVER,MASSACHUSETTS 01845 �'4 CHUs t� Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdept@townofnorthandover.com www.townofnorthandover.com April 26,2006 Merrimack Engineering Services,Inc. Atm:William Dufresne,Project Manager 66 Park Street Andover,MA 01845 Re: 1292 Osgood Street Dear Mr.Dufresne, The Health Department has reviewed your letter in response to the Board of Health comments made on April 19, 2006.Your request to utilize the test pits has been placed on the next meeting agenda for the Board of Health meeting scheduled on Thursday,May 25,2006. As this is a routine item,Health Department personnel do not have an issue with presenting the request without presence of the owner or engineer.However,you are welcome to be present if you choose. With that variance,the plan will be approved the next business day.The time available before the meeting should be sufficient to begin to address the outstanding issue of the holding tank.Please submit information regarding the status of the tank permit prior to May 25`x'so that the board members can be provided with all information on this project. TZhanky S an Sawyer,REHS/RS Public Health Director Cc: Owner: lnOIf.11i 11 - fi®�..EVALUA'POR �ItM Page Z Onview • Deep HoleNumber _ .. Weather .� ...� Location(Identify on alto plsnl -- & ' ` _........ Land Use ---•-. -• tflope M -- 8urfeoe Stones ..- ............. Vegetation .J __ ___------..._ .___. _.r. . ,__....._........__....._......._.� Landform-LbAa,64W-•---_� position on landscape laketch on the baokl - - --��•� ••- - w- -�- ----- Distance$from: • open Water Body ?52- feet Drainage wsv-A�_. feet, sible Wet Area � _ feet Pr Una-35— feat ' Po a. amt► Ddnkinp water WON ?_.. feet other DFM 01BISERV&TION ROLE G T- 2, atm Isom Sanaa boa tlal:an 6ca taaout� boa Go14t Baa IAAUM4 Itnah�d IU8D1U llAutidM 18tniopxM, •� Q-io1�' �� SSG �-�b� 3� -- c� �r�►.�..I�r E 'o-�/2 4/ nassfwe re1413 e- �55�� ce.� hsI'vf-- e 27 .Gor►�,f�r�th, Perant Material Igoologlol (- :;.7'i Depth to Bedrock: & _- Deod�tg(trouadwater: fftandlq Water in the Hole:!V, --- Weeping from Pit Face: A-94 l Estimated Seasonal High Ground Water: .. , • �� FORM 11 - Son, EVALUATOR [ORM ('age Z On. W • . _ , . _ 0 Date. Time1' Weather �Deep Hole Number _ Location(identify on site plant _--- 0' t Land Use oen --w� !Elope( Surface Otbnea _.N ............ Vepbtadon Landform Position on landscape(sketch on the back) ?'19��—���-���� w_••_ -�--_---�--. � ,� _ �_ Dlitanoel from' Open Water Body -:�!5 o feet Ordnege WAV--4 fobs" Posalbie Wat Area >i feet Property Une.�!Q _. foot ' Drinking Water Wal?.!66_.. feet Other S Ogn1►from 6urlaa B"118tim col us lips Gotar BoM uAt ft Itnalu►d 1U8D1U MAunooltl 16tnabutr. s, . o-a4 h A� z 10 ye _ 9� �,Q�ab E a� -30 '� raw ��eiAb� 4 Y �G�SI t"r7. p'ter• //Ys/ Parent Matedel 1 Bolo Ie1 --- L__- _---------- _--..... Depth to Bedrock: Par A fi ���` Qw fi to Mwwwiter; standing Water In the HOW Weeping from Pit Face: fatlmatad Seasonal High Ground Water: 3 jown of North Andover Health Department Date: Location: (Indicate Address,if Residential,or Name of Business) Check#: Q r - Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ 0--Septic ict -Design Approval $ � ❑ Septic Disposal Works Construction(DWO$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) 5 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 978.688.9540 -Phone Susan Y.Sawyer,REAS/RS 978.688.8476-..-FAX Public Health Director E-MAIL:healthdept&ownoffiorthandover.com WEBSITE:http://ivww.townof.northandover.coni. SEPTIC PLAN SUBMITTAL FORM RECEIVED Date of Submission: ZZ, 1'7�z —d7c' MAR 13 2006 TOWN OF NORTH ANDOVER Site Location: HEALTH DEPARTMENT Engineer: New Plans? Yesv/$225/Plan Check# (includes I't submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes No Local Upgrade Form Included? 4",Yes No Telephone#: Fax#: E-mail: � W Homeowner Name: OFFICE USE ONLY When the submission is complete(including check): > , // Date stamp plans and letter > Z/Complete and attach Receipt > Copy File;Forward to Consultant > Enter on Log Sheet and Database r .• e - I Location:_- I I.Z. 0 C-6vO'nmeesName: MaplPamel:_ 4 U?7 Address: Installer: Tel#:���r New L54g, �� _ rn50I Pair —1 Date: 2'��of Wetlandt j vZ. e II_Soft Sptdbo1 5o11 Rhine p Deep Observation Hole Logs Elevadon Depth Soil HWurn Sell Temre Soft Color Soil Mottlial %Gravel,Stones,etc,• 10, lz G moi. �•�Yl� �r �Z7 �,,�ss� 5y1, � 7si� lo Parent material. LI. to _ _ the Hasa W !f�nlit Faoe__ Parent MaterW depth to a �vaterla�Hota �{► . . Date percolation Tests Obserradon Hole# Depth of Pere Start Pmgoslr Time at n t Time at 9" Time at 6" ' Time(9"-61— •Rate 114iadnch- • Performed B�: �l,�r � Witnessed Br: (/� 61 Yllk I,/I 1 TRANSMISSION VERIFICATION REPORT TIME 08/07/2006 10:13 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE,TIME 08/07 10:12 FAX N0./NAME 89784751448 DURATION 00:01:06 PAGE(S) 02 RESULT OK MODE STANDARD ECM North Andover Health Department �� °TFT 1604 Osgood StreetLetter 4' Transmittal Q0 Building 20, Suite 2 36 - o North Andover, MA 01845 IL x� 978.688.9540 . Phone Aa�..°�.�.�A Page of�` ,� '4ATAP 978.688.8476— Fax Sspcwufr healthde t tow o 0 over.com-E-mail mm-town_druoi thandoveram-Website TO: WILLIAM(BILL)DUFRESNE,PROJECT MANAGER DATE:. COMPANY: MERRIMACK ENGINEERING SERVICES FROM: Parmla DelleChicie,Health Department Assistant Re: q Phone: 978.475.3555p�f GO 4Y Fax: 978.475.1448 We are sending you: /an Review letter Cd40APOVED f7N0TAPPfOVj0 D System Construction folio w Up C Other These are transmitted as checked below: MAs Required QAs Requested ❑For your File REMARKS; COPY TO: Homeowner Fax# Or North Andover Health Department °� N°RTII q !D 1600 Osgood Street Letter of Transmittal y - Building 20, Suite 2-36 North Andover, MA 01845 _ a 978 688 9540 - Phone ° -f 09 c«w[iwK■ 1. Page / of� �9 °RAT.D'�''�cti 978.688.8476 — Fax SSgrep healthdept(a7townofnorthandover.com-E-mail www.townofnorthandover.com-Website TO: WILLIAM(BILL) DUFRESNE,PROJECT MANAGER DATE: D� COMPANY: MERRIMACK ENGINEERING SERVICES FROM: Pamela DelleChiaie, Health Department Assistant q Phone: 978.475.3555 Re: Fax: 978.475.1448 We are sending you. '9'P/an Review Letter U-APPROVED ONOTAPPROVED O System Construction Follow-Up O Other These are transmitted as checked below: 0 A Required ❑As Requested ❑For your File REMARKS: COPY TO: Homeowner Fax# Or Mailed COPY TO: Fax# Or Mailed COPY TO: Fax# Or Mailed I TOWN OF NORTH A,'NDOVE11 f p�sRrk Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT � p 400 OSGOOD STREET NORTH ANDOVER. MASSACHUSETTS 01815 usE` Stosan Y. Sawyer, RENS/RS 978,688,9540—Rhone Public Health Director 978.688.9512—FAX (�eatthdept��ito1vnofhortt�ando�er.coni cvww.t owr)o fno rtha ndovcr.coin Wendy Forgetta 1292 Osgood Street North Andover,MA 01845 May 27, 2006 Re: 1292 Osgood Street Dear Ms.Forgetta, The North Andover Board of Health has completed the review of the septic system design plan for the above referenced property,submitted on your behalf by Merrimack Engineering Services,dated,March 10,2006,last revision date April 20,2006 and received April 20,2006. The design has been approved for use in the construction of an onsite septic system. On May 25,2006 the North Andover Board of Health approved the allowance of test results greater than 2 years old. With this variance to the local regulations,the system,designed to handle 435 gallons per day has been approved for use in the construction of a fully compliant,Title V,subsurface disposal system.This approval is valid for two years from the date of the approval in accordance with current local regulations and during this time a licensed septic system installer should obtain a permit and complete this work,and a Certificate of Compliance be endorsed by the installer,designer and the Town of North Andover. Failure to act within these time frames and the approval will become invalid. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void,installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. 2. 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 or imply compliance with any of the aforementioned requirement 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 may have. Sincerel , Y. Sawyer,REHS/RS Public Health Director Encl: list of licensed septic system installers Cc: Merrimack Engineering Services TOWN OF NORTH. ANDOVER f ,�oRry Office of COMMUNITY DEVELOPMENT AND SERVICES ®�°'`# HEALTH DEPARTMENT A 400 OSGOOD STREET * NORTH ANDOVER, V1ASSACHUSETTS 01845 ,SSA<HUs�� Susan Y. Sawyer, RENS/RS 978.698.9540—Phone Public Health Director 978.688.9.542—FAX hcalthdept�r townotnorthandover.com ,Ntiviv.townofno rt handover.cont Wendy Forgetta 1292 Osgood Street North Andover,MA 01845 May 27,2006 Re: 1292 Osgood Street Dear Ms.Forgetta, The North Andover Board of Health has completed the review of the septic system design plan for the above referenced property,submitted on your behalf by Merrimack Engineering Services,dated,March 10,2006,last revision date April 20,2006 and received April 20,2006. The design has been approved for use in the construction of an onsite septic system. On May 25,2006 the North Andover Board of Health approved the allowance of test results greater than 2 years old. With this variance to the local regulations,the system,designed to handle 435 gallons per day has been approved for use in the construction of a fully compliant,Title V,subsurface disposal system.This approval is valid for two years from the date of the approval in accordance with current local regulations and during this time a licensed septic system installer should obtain a permit and complete this work,and a Certificate of Compliance be endorsed by the installer,designer and the Town of North Andover. Failure to act within these time frames and the approval will become invalid. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void,installation shall stop,and the applicant shall reapply for a new Disposal Systems Construction Permit. 2. 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 or imply compliance with any of the aforementioned requirement 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 may have. zY awyer,REHS/RS Public Health Director Encl: list of licensed septic system installers Cc: Merrimack Engineering Services TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET ", . NORTH ANDOVER MASSACHUSETTS 01845 Susan Y. Sawyer, RENS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdept(ato;vnofnorthandover.com wrvw.towaiofiiortha ndover.com Wendy Forgetta 1292 Osgood Street North Andover,MA 01845 May 27,2006 Re: 1292 Osgood Street Dear Ms.Forgetta, The North Andover Board of Health has completed the review of the septic system design plan for the above referenced property,submitted on your behalf by Merrimack Engineering Services,dated,March 10,2006,last revision date April 20,2006 and received April 20,2006. The design has been approved for use in the construction of an onsite septic system. On May 25,2006 the North Andover Board of Health approved the allowance of test results greater than 2 years old. With this variance to the local regulations,the system,designed to handle 435 gallons per day has been approved for use in the construction of a fully compliant,Title V,subsurface disposal system.This approval is valid for two years from the date of the approval in accordance with current local regulations and during this time a licensed septic system installer should obtain a permit and complete this work,and a Certificate of Compliance be endorsed by the installer,designer and the Town of North Andover. Failure to act within these time frames and the approval will become invalid. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void,installation shall stop,and the applicant shall reapply for a new Disposal Systems Construction Permit. 2. 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 or imply compliance with any of the aforementioned requirement 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 may have. Sincerel , - Y. Sawyer,REHS/RS Public Health Director Encl: list of licensed septic system installers Cc: Merrimack Engineering Services TOWN OF NORTH ANDOVER o<Nor+rM 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 April 19,2006 Anthony Donato,P.E. Merrimack Engineering Services 66 Park Street Andover,MA 01810 Re: Subsurface Sewage Disposal Plan for 1292 OsEood Street,Map 34,Lot 43 Dear Mr.Donato: The proposed wastewater system design plan for the above site dated March 10,2006 and received on March 13,2006 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. 1. As the Health Office was aware,the deep hole tests have not all been performed within the previous two years (NA 7.05) Please submit a simple request to utilize the older soil tests. The Health Office will support this request. Also, the logs show test holes T-3 T-4 & T-5, whereas the site plan shows only test hole T-5. As all the tests, past and present,were conducted by Merrimack Engineering,it should not be difficult to locate all testing related to this system. 2. Please provide a draft copy of the non-sanitary non-industrial wastewater holding tank application which will be filed. Please be advised that issuance of a Disposal System Construction Permit will only be issued upon completion of and obtainment of all permits for the holding tank. 3. Please provide greater clarity regarding the intended re-use of the sand in the vicinity of the soil absorption system. Please indicate how you,as the engineer,will work to determine of the existing sand is suitable for re-use. The Health Department will be available to observe the site as needed, but will defer to your expertise as to the viability of the sand for reuse. Concerns to be addressed include,but are not limited to,the presence of biomat,the extent and depth of soil removal,the area of sand placement,and the suitability of the sand fill material. Please feel free to contact the office with any questions you may have. Once these few items have been addressed,the Health Department will be able to approve the design. 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. Sincerely sem`" Susan Y. Sawyer,REHS/RS Public Health Director cc: Owner File N&M Job number 1770/ TOWN OF NORTH ANDOVER INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Site: l7 9 Q C 0-0 V Final Date: Installer: I/1'7 dv'a�.) k--",A) Tel: 9,7 Date Yes No Initials A. Bottom of Bed 1. Excavation to proper depth 2. With trenches,sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation,etc. Comments: (Use back of sheet for diagrams.) B. Retaining Wall 1.. Wall height and width as specified 2. Waterproofed 3. Wall minimum 10'to leaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" f 2. Schedule 40 pipe f 3. Inlet to tank cemented 4. Slope minimum 0.01 or 1/8"per foot minimum 5. Pipe properly set on compact firm base 6. Pipe laid on continuous grade in straight line —� 7. Cleanouts precede all change in alignment and grade 8. Manholes at any 90°change —�'- 9. 10'minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum �l 3. Gas baffle present on outlet —4- 4. Manhole to w/in 6"of grade 5. Manholes ova and each tee 6. 3-20"manholes 7. Outlet line cemented ' 8. 2"-3"drop from inlet to outlet 9. Pipe set 10. Compact base with 6"of 3/4"crushed stone under tank 11. Tank is watertight 12. Tees 12"off side of tank ;� N&M Job number 1770/ Comments: Date Yes No Initials E. Pump Chamber 1: If separate from tank,compact base with 6"of/4"stone underneath 2. Minimum 2"pipe to d-box if gravity system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present .: 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12.dump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum 0.1 T'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution . 5. Compact base with 6"of stone beneath box 6. Box is watertight �G 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe 9. First 2'from box laid level Comments: G. Soil Absorption system // O( 1. All stone double-washed—3/4"— 1 '/2" E� -pea stone Bucket test done? 2. Minimum-2"of pea stone above distribution lines 3. Minimum 6"stone th pipe 4. Distribution lin capped connected together 5. Toe of slope stops nnum 5' from edge of property; 5a. if not,then swale. Comments: N&M Job number 1770/ Date Yes No Initials H. Leach Trenches �� OC 1. Minimum 2 trenches 2. Length of trenches agrees with plan. (Max, length 100') 3. Width of trenches agrees with plan Minimum 2';maximum—4'. 4. Vent present if>50 feet or specified - 5. Minimum distance between trenches 10' 6. Pipe slope minimum 0.005 or 6"per 100' 1 7. Depth of trenches below outlet invert minimum of 6". 8. Pipes set on stable base. —�--� Comments: RYA' I. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6" 3. Separation between pipes 6' um 4. Pipes connected at en vent end raised 5. Separation be adjacent fields 10'minimum 6. Pipes set on , le base 7. Maxim 4' separation from edge of to first line 8• um two distribution lin Comments: J. Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall betwee and 48"wide 4. Access maxLMes on each pit 5. Pi mented with hydraulic ceme Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" ,;7 - 4. Grading slopes away from dwelling 5. No areas over system that may pond 6. Grading meets 3:1 slope f'' 7. Minimum of 9"of fill graded over system � A Town of.Nbrth Andover Health Department Date: 313 Location: X21�1 (Indicate Address, if Residential,o Name of Business) Check#: Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type. $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEEPUC PERMITS: 0--'4tic-Soil Testing $� ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Tras4lSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) 1187 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer R BOARD OF HEALTH • NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: I'" '��� MAP&PARCEL: LOCATION OF SOIL TESTS: �� _!5 b, OWNER by U i L Fm 66 1V„d TEL.NO.: ADDRESS: ENGINEER: J—i E12j kfoW' a:W;;'m n1 E C-e—ljs6 TEL.NO.: (17e,) CERTIFIED SOIL EVALUATOR: 1;1 t..i- "t Intended use of land: Residential Subdivision Single Family Home mmerci Is This: Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No 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=airs or wades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A.Conservation Commission Approval: Date Received: Check Amount: Check Date: TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET " r NORTH ANDOVER, MASSACHUSETTS 01845 �1SswcHus t� Susan Y.Sawyer,RENS,RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX bealthdept@townofnorthandover.com www.townofnorthandover.com APPLICATION FOR SOIL TESTS DATE: MAP&PARCEL: LOCATION OF SOIL TESTS: OWNER: Contact#: APPLICANT: Contact#: ADDRESS: ENGINEER: Contact#: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) ➢ 8.5"x 11"Plot plan&Location of Testing(please indicate test nit sites on the plan) ➢ Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent. Date back to Health Department: (stamp in): cru�.�.,.�..` ., r/•• �-1=� RISE . .R71 0►Ilkm •■ . •■ ■ MM4 r� 44 I'lu Y. e2 Of i i I BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: 1& 20 CURRENT INSTALLER'S LICENSE# LOCATION: I Z`1 9L 5 G- oC,C) 5 I,, l�_ . A--("(D' LICENSED INST LLER• Oj u k ry LA SIGNATURE.. ; Gwj ZZTELEPHONE# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only $160.00 Fee Attached? Yes ✓ No Foundation As-Built? Yes No Floor Plans? Yes V No Approval Date: aJ € Rn� 1�via/ KINGSTON READY-MIX CONCRETE 9/25/01 KINGSTON MATERIALS 0 A Division of Torromeo Industries, Inc., P.O. Box 2308, Methuen, MA 01844 978-686-5634 Kingston Plant at 18 Dorre Road, Kingston, NH Methuen Plant at 33 Old Ferry Road, Methuen, MA INDIVIDUAL CUMULATIVE PERCENT PERCENT TOTAL% PROJECT SIEVE SIZE WEIGHT RETAINED RETAINED PASSING ASTM C33 SPEC. 3/8" 0 0 0 100 100 TO 100 #4 9.3 1 1 99 95 TO 100 #8 79.3 10 11 89 80 TO 100 #16 151.5 19 31 69 50 TO 85 #30 128.8 17 47 53 25 TO 60 #50 139.8 18 65 35 10 TO 30 #100 135.6 17 83 17 2 TO 10 #200 107.4 14 97 3 0 TO 5 PAN 26.4 3 TOTALS 778.1 100 F.M.: 2.4 2.1 TO 3.1 0 SIEVE ANALYSIS OF SAND -TOTAL%PASSING --[]—MIN.DEVIATION —tet 120 -MAX.DEVIATION 100coQ -- -- 80 g0 o � 40 . 0 1 2 3 4 5 6 7 8 SIEVE SIZES 0 BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: JQA"/Cx� LOCATION OF SOIL TESTS: la32 OSGOO P StC'eQ�- Assessor's map& parcel number._ "34 Lgkz; 63 OWNER: 'b���; �or,�nv►,r � TEL. NO.: � . ADDRESS:_ 124 Z cis SCT ENGINEER: H ".i"AcC &I it ,TEL. NO.:_ CERTIFIED SOIL EVALUATOR: Intended use of land: residential subdivision, single family home, amme,,cial Repair testing Undeveloped lot testing N. A. Conservation Commission Approval: 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 12Z5,00 per lot forear construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75,00 per lot for repairs or u2gr des. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than 1'-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Te y DATE INVOICE AMOUSIT FORGETTA'S FLOWERS 1210 OSGOOD STREET 8839. NORTH ANDOVER, MASSACHUSETTS 01845 AI • 53-7047/2113 PAY /AL1 �� DOLLARS CHECK NO. TO THE ORDER O 7j DAT GROSS AMOUNT DISCOUNT • i . ANDOVER BANK ANDOVER, MA 01810 11•008839om is2LL370477i: 65 22052922211' ,y SEE PLAT NO.61 w yb to n IZ 8 339 Pc• � ' 8 � 9 See inn , � �� e w. 52 � 1.63 Ac. 9 23 Q ! / STREET 45 to i I �•t 3� tr.:i t3 I 1 O I t5 0, IZ9� a w F... Y� j tb AO I TZ IA.*24 • � Nn - • -- �I � 1111 11!x. 11 - I u 1 it iE./N 11 111111 . :. - � 1 In Ir %�sG' IT�1-111 � nl 111 111 . In , 9 FORM 11 - SOIL EVALUATOR FORRI Page 1 No. ...................................... C .C2.4 mmonwealth of Massachusetts mbev 4voule e, , Massachusetts Suitability Assessment for On-site Sewn Dis ot�sal. Performed By: .. �.4-u a t:�............ ..4tt�...R,�s n/�. .... . �r+�-�v Y 206 N 4m) ............................ Witnessed BY: B .................................................................................................................. ...::.......::::::.................::::::.........................................................,... � . p 6000 000 S ltlepl�e/ �/q NOR N- ANOwec- 01 biG AA6NT 11 47882 - 3 � New Construction Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes Year Published ,/x'31... Publication Scale .I..:...1984O Soil Map Unit .s ..... DrainageClass ...C.......... Soil Umitationns,./.............................................................................._........:................................... Surficial Geologic Report Available: No Yes ❑ Year Published ................... Publication Scale GeologicMaterial (Map Unit) ................................................................................................................... Landform ... ..........................q........... .5_...�........................................................................................................ Flood Insurance Rate Map: z50c� S . Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No ❑ Yes ❑ 2� Within 100 year flood boundary No ❑ Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) .......WA...........................................___.._....................................... Wetlands Conservancy Program Map (map unit) .J./A..........................................................-...-.......... Current Water Resource Conditions (USGS): Month Range : Above Normal ❑ Normal [3e"" Below Normal ❑ Other References Reviewed: FORM 11 • SOIL EVAWATOR PORM P age 3 Method Used: ❑ Depth observed standing in observation hole--- inches ' ❑ Depth wee in fro m side of observation hole Inches 1106811th to Boll motiles .. .. .... Inches 3 G a� fi sf P� 3 , ❑ around water adjustment..�...._._. feet Index Weil Number _ .__ Reading.Date _ Index well level ,..... Adjustment factor Adjusted ground water level _. ftWb of N�etutelly OoouCring NrWoue Mathrill Does at least four feet of naturally occurring pervious Material exist In.ell areas + observed throughout the area proposed for the soil absorption system? If not, what is the'deptli of naturally occurring pervious material? 1 certify that on Natal 1 have passed the examinadon approved by the Department of Environmental Protection and that the above analysls was performed by me consletent with the required training. expertise and experience described in 310 CMR 16.017. Signature Dataor O , j FORM 12 - PERCOLATION TVsT COMMONWEALTHF 0 MASSACHUSETTS Messa chu � Bette Percolation Test Date: _l��lc. . _ _ Time: Observation Hole �3 J.., __ Depth of Perc 3v �- aa = Sa _f- Start Pre-soak end Pre-soak Time at 12" L { 1`4w t Time at 9" _ Time e 6 Time 19"-6"I Rate Min./Inch Site Passed Site Failed Performed By: / V Witnessed By: -: Comments: ............................. .... ; ............... SEPTIC .FLAN SUBMITTAL FORM LOCATION: 4-' - '/L p,Ul�/ 4 �Z CASE Y,� i (& /2S`) SNEW PLANS: YE / $125.00/Plan. REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: S NO DATE: G 1&0 DESIGN ENGINEER: DATE TO CONSULTANT: *If you want your plane expedited, please submit three plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in place, route to the Health Secretary. 2� °f "O oT"qti Town Of North Andover Community Development & Services William J. Scott . - A Director 40 27 Charles Street (978) 688-9531 '� -R•�,'' • North Andover, Massachusetts 01845 Sc"WUs try Fax 978-688-9542 November 6, 2000 Board of Appeals (978) 688-9541 Bill Dufresne Merrimack Engineering Building 66 Park Street Department Andover, MA 01810 (978) 688-9545 Re: 1292 Osgood Street Conservation Department (978) 688-9530 Dear Bill: Health This is to inform you that the proposed plans for the site referenced above have Department been disapproved and have technical deficiencies as followed: (978)688-9540 Public Health 1. Lot dimensions are not defined as required by NA 8.02 h. Nurse (978) 688-9543 2. Location and elevation of foundation drain is not provided as required by Planning NA 8.02y. Department (978) 688-9535 3. Benchmark is proposed but not provided as required by 310 CMR 15.220 (4)(n). If you have any questions,please do not hesitate to call the Board of Health Office. Sincerely, Sandra Starr, R.S., C.H.O. Health Director cc: Forgetta file MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET•ANDOVER,MASSACHUSETTS 01810•TEL(978)475-3555,373-5721 •FAX(978)475-1448•E-MAIL:merreng@aol.com November 15,2000 Town of North Andover Board of Health 27 Charles Street North Andover,MA 01845 Attn: Sandy Starr,Director RE: Subsurface Disposal System Florist Shop Facility Daniel and Joanne Forgetta 1292 Osgood Street(Route 125) North Andover,MA 01845 (978)682-3885 Dear Ms. Starr: Enclosed are four(4)copies of the subsurface disposal system plans(sheets 1&2,dated-1,1/15/00) and septic plan submittal form. The plans have been revised to address your review comment letter dated November 6,2000. Specifically: Comment 1: The lot dimensions have been defined. Comment 2: Foundation drain location and elevation is provided. Comment 3: Note number 10 has been added as recommended by your office during a telephone conversation November 14. Given the above,if you have any questions or comments,please do not hesitate to call. Respectfully yours, MERRIMACK ENGINEERING SERVICES,Inc. Anthony Donato,P.E. a m m Om Z D D o rn ^ Z ( ) FORGETTA'S FLOWERS DATE INVOICE GO (D_ Q m z 1.210 , MAS STREET 8 8-.� D m 'z NORTH ANDOVER, MASSACHUSETTS 01845 8 V/ PAY . 53-7047/2113 m 46 • z CHECK NO. DOLLARS m r TO THE ORDER OF DATE GROSS AMOUNT DISCOUNT • Z 77 � m c/) V m a o /;u ANDOVER BANK ANDOVER, MA 01810 \ • m 11000888 211' 1: 2 i L 3.704 7 7i: 6 5 2 20 5 2 9 2 2 2iP N � • z z M A m m D r7 3 m m 0 0 o 3 Nov-06-00 11 :40A Paul D. Turbide, PE/PLS 978-465-0313 P.02 l October 20, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School Street North Andover,MA 01845 RE: Title V review for SDS upgrade at 1292 Osgood Street Dear Sandra, Enclosed find our review of the"Checklist for North Andover Septic System Plans" for the septic system upgrade at the above-mentioned site. The following is a list of technical deficiencies that Port Engineering has found. o Lot dimensions are not defined as required by NA 8.02 h. ❑ Location and elevation of foundation drain is not provided as required by NA 8.02y. ❑ Benchmark is proposed but not provided as required by 310 CMR 15.220(4)(n). If you have any questions or comments please feel free to contact me. Sincerely Paul D. Turbide, LS P01?Tit I ENGINEERING Civil Engineers& Lend Surveyors One Harris Street Newburyport,MA 01950 (978)465.8594 VSetver MAMP288410sgood 1292.DOC FORM - U - LOT RELEASE FORM . INSTRUCTIONS: This form is use a to verify that all-necessary approval/permits from Boards.and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT f - tai►�!C ( l� �u� �jCi)c' � PHONE ASSESSORS MAP NUMBER 0 LOT NUMBER SUBDIVISION LOT NUMBER • STREET STREET NUMBER 12'?Z• ....■..■■.................■....■■...■r....■■■.............................■ OFFICIAL USE ONLY BONBON among RECOr✓IlbIENDATIONS OF TOWN AGENTS ......... ................................■.......r...................... DATE APPROVEDbt NSER .I C VATION ADMII�IISTRATOR ,( � f DATE REJECTED COMMENT'S. f LA,e `��`t fir)d n DATE APPROVED TOWN DATE REJECTED -2 ,I0 /0 I CONOAENTS a A 0 h13 &A4 tO-� DATE APPROVED FOOD IN JMCTOR- DATE REJECTED DATE APPROVED ?r- •SE C S CTOR-HEALTH � ' DATE REJECTED COIvSr�-NTS _ PUBLIC WORKS—SEWER/WATER CONNECTIONS DW Y DATE APPROVED F DEPAR DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Town of North Andover f aORTOI a?Qb+�tc Ys'b�OO70 Office of the Health Department ow Community Development and Services Division y William J.Scott,Division Director "/q • '� ' 27 Charles Street 9SSACHUS North Andover,Massachusetts 01845 Sandra Starr Telephone(978)688-9540 Fax(978)688-9542 Health Director I December 1, 2000 Anthony Danato Merrimack Engineering 66 Park Street Andover, MA 01810 Re: 1292 Osgood Street Dear Anthony: l This is to notify you that the plans dated 11/15/00 for new construction of Forgetta's Flower business have been approved. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: Forgetta File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 Town of North Andover, Massachusetts Form No.2 NORT1, BOARD OF HEALTHAaj p � A DESIGN APPROVAL FOR SSACHUSEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. : Site Location Reference Plans and Specs. • - % • ENGINEER DES IG DATE Permission is granted for an individual soil absorption sewage Isposal system to be installed in accordance with regulations of Board of Health. AIRMAN,BOARD OF HEAL Feeo7J� Site System Permit No.� Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH 0 0 ...,... `G.. A 4MewiC � APPLICATION FOR SITE TESTING/INSPECTION ��SSAC HUs���y Applicant NAME UADDRESS TELEPHONE Site Location < < Engineer NAME DDRESS TELEPHONE Test/Inspection Date and Time —CHAI RMA ,BOA HEALTH �. �4 Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH Q�S.LED ib�tiO . �f 0� 19 *7 APPLICATION FOR SITE TESTING/INSPECTION 7 AERATED PPP\ 5 �SSACHUS�� Applicant NAME ADDRESS TELEPHONE Site Location >' ` Engineer NAME ,'ADDRESS " 7 TELEPHONE Test/Inspection Date and Time • r CHAIRMAN,BOARD OF HEALTH Fee vi Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Address ttix s--t— Title of File Page of Date File Open: Date fete closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes action Document/ document/ Num. Action Department Board of Appeals - Board of Health - Planning Board - Conservation Commission - Building Departrne�t I G I MERRIMACK ENGINEERING SERVICES',_INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS,,--o PLANNERS 66 PARK STREET•ANDOVER,MASSACHUSETTS 01810•TEL(978)475-3555,373-5721 •FAX(978)475-1448•E-MAIL:merreng@aol.com I October 27,2000 Town of North Andover Board of Health 27 Charles Street North Andover,MA 01845 Attn: Sandy Starr,Director RE: Subsurface Disposal System Florist Shop Facility Daniel and Joanne Forgetta 1292 Osgood Street(Route 125) North Andover,MA 01845 (978)682-3885 Dear Ms. Starr: Enclosed are four(4)copies of the subsurface disposal system plans(sheets 1&2,dated October 22,2000) and septic plan submittal form. The soil absorption system(S.A.S)has been revised slightly from our Planning Board submission(plans dated 10/06/00)to reflect the additional soil tests performed October 13, 2000 As you requested,I have had conversations with Tim Willet at North Andover DPW and Mike Rosati at Marchionda Associates,with regards to the schedule of the proposed Endicott Plaza development currently under site plan review. The project is tentatively scheduled to begin late winter/early spring with construction of the sewer pump station sometime in the summer. We are seeking planning board approval for the above referenced project so that construction may begin early next year,and the installation of the S.A.S.in the spring. Additionally,the location of the proposed pump station for Endicott Plaza is located several hundred feet from the proposed florist shop and would require easements across private property. No existing sewer line exists within the vicinity of the site. Given the above,if you have any questions or comments,please do not hesitate to call. Respectfully yours, MERRIMACK GINEERING SETInc. Anthony Donato,P.E. cc: Town of North Andover Planning Department,w/Enclosure(7 copies) VHB Inc. Attn:Rick Carey,w/Enclosures - 101 Walnut Street Watertown,MA 02471 i Oct-18-00 02:01P Paul D. Turbide, PE/PLS 978-465-0313 P.01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Paul D. Turbide Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 465-0313 Date October 18, 2000 Pages Including This Cover Page: 2 Comments: Sandy, Attached are field book notes for the soil evaluation at: 1284 Osgood Street T`vo deep hole observations and two pert tests were completed on October 13,2000 POUT ILI Thanks, ENGINEERING Paul Turbide Civil Engineers& Land Surveyors One Harris Street Newburyport,MA 01950 (978)465-8594 North Andover Board of Health • 27 Charles Street • North Andover,MA 01845 • 978-688-9540 • Fax 978-688-9542 facsimile transmittal To: Port Engineering Fax: 978465-0313 From: Sandy Starr Date: 10/10/00 Re: Soil tests Pages: 1 CC: [Click here and type name] ❑ Urgent ❑For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle Ok to do additional testing at 1292 Osgood S iset,Forgetta Farm. This was called both 1210 and 1284 but its really 1292 Osgood Street. Osgood St. Map 34,Lot 43 Eng: Merrimack Engineering—Bill Dufresne. Tel.No. 978-475-3555 . . . . . . . . . . . . . . . . . . . . . . . . . . . . FORM 4 SYSTEM PUMPING RECORD RECEIVED Commonwealth of Mas$gMhusetts usetts OCT.,.°1,`4-Zal1' Ma$saoh,. /� TOWN OF NORTH ANDOVER S stent �M, n — eC r'" HEALTH DEPARTMENT ystem ocatton r Syste n Uv✓ner �,`r]vJfiGCJlN<C d L o � �iUa� ►�lJ y,, 7 c.� Foy cfil"a �h J�1©cit' 2 t . " l,ouo,` Sa 0si" I O o AU S ,?fl F Gee Odor ry Gr�S eeP i •LM .. i Tape; Emergency ❑ Routine j c .�I: No ❑ Yes ❑ 'LSLptic Tank:. No Yes ❑ Cessp • 1I—7— 11 Quantiry Pumped: ?.SPO gallons ` Date c ' Pumping: B0RAGZEW Permit • S�step:: pumped by (Company): - Conte .ts transferred to: 'Cont:.tts disposed at: &Z-S Pumper Signature Date Pump .. Conc:ition of system/other comment DEP APPROVID FORS• 1a0719S I , � mom Air Quality Expertsv Inc. 3 Brentwood Avenue Salem, N.H. 03079 603-894-6465 OCTOBER 14, 1993 NO. ANDOVER BOARD OF HEALTH 120 MAIN STREET NO. ANDOVER, MA 01845 DEAR SIR: ENCLOSED PLEASE FIND A COPY OF NOTIFICATION SENT TO THE STATE FOR AN ASBESTOS ABATEMENT PROJECT. THE JOB WILL TAKE PLACE ON OCTOBER 14, 1993. PROJECT: FOR8ETTA 1210 OSGOOD ST. NO. ANDOVER, MA 01845 ANY QUESTIONS CONCERNING THIS MATTER SHOULD BE DIRECTED TO MY ATTENTION. SINCERELY, 04,15 / { /1/�/ �*�''`Y'" ` CHRISTOPHER THOMPSON PRESIDENT o° Commonwealth of Massachusetts 7 Asbestos Notification Form— ANF-001 • :Y - Asbestos Abatement Description 1. Facility location: .EL.G.I.O.....FOR.GE.TTA................................ ............... OS GOOD.....STREET..:......................... INSTRIICTWNS Narrn Address 1.All seclionsofthisAN�DOVE.R............................................... .qiAS-4.5................................ . _.�..-845.................. form must be completed W'r�"""' 7iIdp{.�h6,8.�. in order to complywith the Department of Environment-'"g ,aoaroorn Protection notification requbemerb of 310 CMR 2 Is the facility occupied? ❑No (ren working prix 3. Asbestos Contractor: prior notification is requkedolanyabalement AIR QUALITY EXPERTS, INC. 349 SO. BROADWAY #8 ptojecq;and the Department of Labor Name address and Industries SALEM, NH 03079 603-894-6465 notification requirements ..................................................... ......................................................................... of 453 CMR 6.12 (ten Cry/%wn tp rode Telephone days priornotirication is requkedorANY AC 000167 WRITTEN abatement pro/ea pveater Otllitense/ Cunnari tyre(wdtterWerm) than three linear or squarelaer). 4, On-Sfte Project Supervisor/Foreman: 2.Submit Original Form CHRISTOPHER THOMPSON SF07797 To: ,Janne OU Ceniliraliun/ Commonwealth of Massachusetts 5. Project Monitor: Asbestos Program NSA . P.O.B.120087 ..................................................................................................... ................................................................................................................... Boston,MA 02112- Name IX I Ceniliratiun/ 0087 6. Asbestos Analytical Lab: 3.This loan may be usedfor notifying the ...............................................................:...................................... .................................................................................................................................. . U.S.Environmental Narne DUCenilirah'uul Protection Agency Region / I of asbestos demolition/ 7. Project startdllolb03 end data�� pecificworkhours(Mon.-Frit b - C3_(Sat.Sun.) renovation operations subject to art M). S(40 8 What type of project is this? circle one dernozition rear varion onrer(explain CFR Subpart M). yp P I ( )� ��( ) for Q1cWLim 0* 9. Describe the asbestos abatement procedures to be used (cir ): glove enclosure lull containment deanup encapsulation disposal only ofher(expla, raotaCM I PAcww Do 10. Is the job being conducted ',doors ❑outdoors? Aaorra POW ,w 11. Total amount of each type of asbestos Containing Materials(ACM)to be handled on pipes or ducts(linear ft.) or other surfaces(square ft.) 3 to be removed,enclosed or encapsulated: linearlsquare feet boiler,breaching,duct lank surface coatings.'.. thermal,solid core pipe insulation.....,._ corrugated or byered paper pipe insulation.... insulating cement.................. spray-on fireproofing..................... bowellsprayercoatings.............. cloths,woven bbrks....................._/ uaraile board,wallboard............. other fpbase dwibe).................... 12. Describe the decontamination system(s)to be used: GLOVE.....B.AG................................................................................................................................................................................. ............. . ..... .. ......... 13. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2)(8): .—WE.T....REMOVAL....I.N.T..0 6MIL....ROLY...ASBESTOS...LABELED....BAGS................................................. .. ..... .. ................ ._. . .. . . ...._— .. ........ ..........._............ 14. For Emergency Asbestos Abatement Operations,the DEP and DLI officials who evaluated the emergency: Olaf Nacre waUakial .... .... ... ... . .... _ INSPECTOR . Tine ffikaar li>Ail.4__g. ................................................. .ii W"7................................g..310.8..4.,8........................................... ........... ..................................................................................................... .............................:.................................................................................................... Nam of au taridal rine _.......................................-....... ......... ........................................................................................................................ WreW Audxxuariwr wideer/ 15. Do prevailing wage rates apply as per M.G.L.c.149,§26,27,or 27A-F to this project? ❑Yes a 0 Rev.6/92. Facility Description- 1. Current o r prior use of facility: 2. Is the facility owner-occupied residential with 4 units or less? !e 0 No 3. Facility Owner: ............... .................................................. ................................................................................................................................... MW Mass Zip axle r e I ep hon e 4. Facility's Owner's On-Site Manager: N/A One Address 1X,,1'',*. e**' .......... Cirygmw Pcode 5. General Contractor: N./.A.A...................................................... .A.d t or.as.$...................................................................................................................... Name .......... ''*CQ'0 '* * 'T**e'1ePho'ne ........... Ciry/rownZip d Contractor's Workers Camp•Insurer Policy! Exp.Dale 6. What is the size of the facility? 2 0 0 asq ft) 2 (1 of floors) 13 Asbestos Transportation and Disposal 1. Transporter of asbestos-containing waste material from site to temporary storage site(if necessary)to final disposal site: AIR QUALITY EXPERTS, INC. 349 SO. BROADWAY #8 � * * **'** * , *......................... Md'f-e's's, , ' .... ........ ..... ...................... .... ...................................................... .........*............... �;, SALEM, NEW HAMPSHIRE 03079 603-894-6465 ...............— Cirtl7off, lit)axle relellholle l 2. Transporter waste material from removal/temporary storage site to final disposal site: SAME Name " MIMS Note:Transfer All axle r elep holle Stations must 3. Refuse transfer station and owner(if applicable): comply with the Solid Waste Divisionreguhi- ...................N/A........................................................ ane tions 310 CMR 18.00 .......... ........... ..... ...... ........... ........ . Ciry/fown 4. Final Disposal Site: TURNKEY LANDFILL WASTE MANAGEMENT OF NEW HAMPSHIRE ........... ...................... .......... Laolkm Name 90 ROCHESTER NECK RD. .................................................................................................................................................................................................................. ................... Was ROCHESTER, NEW HAMPSHIRE 03867 603-332-2386 fdryrlrnvn al code Telenh*one Certification The undersigned hereby states,under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts Regulations for the Removal,Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 7.15,and that the information contained in this notificatigg,is true and correct to the best of his/her knowledge and belief. CHRISTOPHER THOMPSON ............. ftt AAM Auffaked Ygualure Note:Contractor 603-894-6465 must sign this PRESIDENT AIR QUALITY EXPERTS, INC...................... form for DLI notification purposes 349 SO. BROADWAY #8 SALEM, NH 03079 ...................I...................................................................................................................................................... ........................................................ citylTowp Z111 axle Fee exempt(City,Town,district,municipal housing authority,owner-occupied residential of four units or less)?Z/yes 0 no Sticker I(from front of form): Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH 3�O�AS�Eo ibq�OL 19 O + r A oQm • EE„,< APPLICATION FOR SITE TESTING/INSPECTION ORATEO PPP��GJ SSACHUS� rJr Applicant NAME ADDRESS TELEPHONE Site Location 4- Engineer Engineer ' NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee ' ' Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: 2000 LOCATION OF SOIL TESTS: Assessor's map & parcel number. n?--3f 3 OWNER:J�yfr W. TEL. NO.: 7 ADDRESS:_ ENGINEER: TEL. NO.: �S -- i CERTIFIED SOIL EVALUATOR: Intended use of land: residential subdivision, single family home, commercial Repair testing Undeveloped lot testing r/ N. A. Conservation Commission Approval: 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 J2Z5.00 per lot forenv construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or uporades. 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 scaledkplan4no smaller than 1'-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. _ 7 1 j BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: .2 -� LOCATION OF SOIL TESTS: /2L0 6S�'ocvY] ' Assessor's map & parcel number: 11*77xf rk'- 3 OWNER:� i.e� TEL. NO.:_ —� ADDRESS:_&��0 0566- � 57 ENGINEER: TEL. NO.:- CERTIFIED SOIL EVALUATOR: Intended use of land: residential subdivision, single family home, cam ercial Repair testing Undeveloped lot testing N. A. Conservation Commission Approval: a 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 1276.00 per lot forear construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for reaairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled,plan.(no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. MAR 2 7 _, w N la SEE PLAT NO.61 'A 44 w 7 `M1I\ fix. .P I�zs to bb 3.39 Ac. n 8 4 12A p, S►� ►•3 Ac, 9 °°�� � 23 ff 12 x. Lp >K L•oa m g•�� STREET i 3* 43 Ste. 13 I Llsix I ► 40; th is o \.eyd Z I � I J rl I W W N 1 ea .o s I , I 23 t � ♦ was 40 ♦ ` 4 ♦\ \ i u.e m. ,.re r ♦ . `. SEE PLAT N0. SEE PLAT N0. 76 Aug-11-00 08:50A Paul D. Turbide, PE/PLS 978-465-0313 P.01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Paul D. Turbide Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978)465-0313 Date August 11, 2000 Pages Including This Cover Page: 2 Comments: Sandy, Attached are field book notes for the soil evaluation at: 1.284 OSGOOD STREET, Map 34, Lot 43 Two deep hole observations and two perc tests were completed on August 10, 2000 Thanks, Paul Turbide Au -11-00 08:51A Paul D. 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