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Miscellaneous - 1589 SALEM STREET 4/30/2018 (3)
__ - - `� ?,aAi _� b • t s > i'a.;, - gas. u ; ,' y, s; t "�' F e n •.;yp, - � _ '"'`+�' w�'�i '14'���` r'�`� {; �{y.:��Q �.:' � � t a� '#dh �fOIE S Map/Parcels a �r t �8 r ° Y: 4 � ,x '_; CONSTRUCITION APPROVAL` , aHas;planreview"fee been paid NOTF Pgermi 4. Plan Approval: Date: G' pproved by: fF r Designer: �I �� Go6� �► r PlahZ to ��&AM � �$ '" J - Conditions: S� `g 25 } s Water Supply. . ' Town Well UVeIt Permit y Drillert < ; Well Tests:: Chemical4 Date Approved x f Bacteria I' Date Approved Y 1;,- 81--,Bacterial1 Date�Approved t Plumbing,Sign Off, 1Niring rvSign-off Ilk t Comme`rits 3.. t g , .. Form„” " Approval Approval to�lssue YES No $. Date issued By Conditions: �? � .'� `-S nam�, '' FinalApproval �c• � �:'�, � � a r�4a tri" 4' All Permits.Paid? YES NO A W'.61lifConsttuctioh Approval? NyO r� �, - Septic,System Construction Approval?�� ' Certifcation? �Y NO ry ,. Other YES NO _ Ai AR Variance Needed? ES NO FINALIBOAR MOF HEALTWAPPROVAL: DATE .. �.►%.�" atiDU- • , ;, s i�APPROVED BYE r , + r F + lAA � 4 — 'fes- '-�',�M k. •'� i�`� S �, t+e ��y�C �� IK w a e r CeNDITIONS:� . : `' � 44 TO 'Is:the�installer'licensed? . ,VP NO T ' e of Construction: W, REPAIR ,YP�. ._ New v Construction: Certified Plot.Plan-lReview YE'S . FloorPlan Review YES N`O `o- Conditions of Approval'"from Form U 'YES NOS n, Issuanceyof DWC permit: . �arts' Lr e DWC Permit Paid NO DIIVC 'Installer L(� , -��rte. Cc u�'y P� Begin Inspection: �ES NO .;, f Excavation=Inspection: i Needed: `5, b Passed: By. Co nstructionflnspection Needed: As'Built'PIan�Satisfactory; R u. N!Es - b Approval of Backfill: Date: �o l D By: �M Final Gratling Approval: Date 3 i k , 4 > Final -dnstructionf, pproval Date: .°o ?S� By: c Cebrtificate of Compliance ApprovalDate ° 7T Town of North AndoverNQRTM Office of the Health Department Community Development and Services Division % ; a 27 Charles Street North Andover, Massachusetts 01845 Ss"C"°5� Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 08/12/2002 This is to certify that the individual subsurface disposal system constructed () or repaired (X) by W. Tom Sawyer at 1589 Salem 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 BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 Town of North Andover �Ownt O�stee e 1ti0 Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 "sSAC"°Stip Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 08/12/2002 This is to certify that the individual subsurface disposal system constructed () or repaired (X) by W. Tom Sawyer at 1589 Salem 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. Y Board of Health Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 k� rs€§r` Form No 2 11 of4.Nor~th Andover Massachusetts, k �� ,.�;:,1s7 '" '.b,,�,'' ;s°2�' } � '`r"'";,L �m r�.: E a, y B X BOAAk RD OF HEALTH ' fr '" �f • 1 '�a`Cf. dei '2' "`' •<� • ti� t T3 n r a d= s ' ; s.. € a �Y g �* r e x,61 J` ¢r r ^C t �. so-,(' ALLNZ ..• b %c <xr s >40 ' '.0 €v do( 9" r ;'*�,;.o:•'' IDESIGNPAPPROV �FOR dr _ � ass atA x - 4 "US SOILABSORPTION SEWAGE DISPOSAL SYSTEMx � i `�AppliIn' t Test No r< SKr / x M 'Site Location 9 ,, '4, k/ ` ! s s a� o � �w ReferencelPlans �z w ENGINE R a �x may, ,r ESIGN: j DATE Permisslon Is„granted for an individual:Ysoll absorption sewage disposal'system tobe Installed ,�, ... ' } q, , yln accordance with' regulations of Board of"Health qp; b 46 CHAIRMAN,BOARDOF HEALT q� Fees Site System.Permit No t r- y �, ,.. - 2 ._ .q, - j q AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES &LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, IN CLUDIIVG RESERVE v TIES TO LOT LINES &DWELLING, WELLS a. FROM SEPTIC TANK / b. FROM LEACH AREA LOCATIONS OF DEEP HOLES &PERE TESTS l/ ELEVATIONS OF DISPOSAL SYSTEM V TOP OF FDN ELEVATION V 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. L/ NORTH ARROW y LOCATION &ELEVATIONS OF BENCHMARK USED 1 :i�".�-: may:��•�t��-�- c� - :�:•. .�v'�3.\��'=:=:�; :\ .rir�. n? _ :T _ i TOWN OI' ,tORTH ANDOVER SF SV.�Gr DISPOS:�I: SZ'S'�El-t I_STALI,A-rioN CERTIFICATION The unce:sinned hereOv certiiv that the Se:L•a2e Disposal Systenn i ! consu-uci::d- (�() rewired: by -} — -- located at I.C-"LA -- S-v_� _---—- was installed in cbnfe-mance with the n.-ih Andover Board of Htaith a-fprovea plan, System Design Pe::rit-- , dated. :with an approved deli an flow of eailons per day The mate a?s;usec were in coniormar:� :With those specined on the app'rov.a plan; the system was instiled in accordance ,Neth the previsions of 3110 C� 15.000, Title 5 and local ret-ilatiors, and the final sradicla agrees substantially with the approved plan. :til work is accurate:v represented or, the As-built .which has been submitted to the Board e:t-iealth. Bed inspection date: Lo 2 C 0 S�C_ _ Eneinecr Represtr::ative Final inspection date: 617_ c , ~ug,EITS d, Engineer Represe:-:tat_:e O o �. Lnsta?:er: <;�� �' "' L.C. f: Date: Cesisln EnQinee Date- i NEW ENGLAND ENGINEERING SERVICES INC July 24, 2002 Sandra Starr, Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, NIA 01845 Re: 350 Forest Street and 1589 Salem Street,North Andover Dear Sandra: Enclosed are copies of as built plans and certifications for the above referenced properties: If you have any questions regarding the information submitted, please do not hesitate to contact this office. Sincerely, Benja>2C. Osgood, J-, President JUL 2 6 2002 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initial 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: 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" 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to tank cemented t/ 5. Slope minimum 0.01 or 1/8"per foot minimum 6. Pipe properly set on compact firm base 7. Pipe laid on continuous grade in straight line ✓ 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change 10. 10' minimum offset to water line Comments: D. Septic Tank n 1. Level ✓ ��J�IJ 2. 1,500 gal minimum +� 3. Gas baffle present on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20"manholes 7. Inlet tee minimum 12"under invert 8. Outlet tee minimum 14"under invert 9. Outlet line cemented E-- 10. Air space 3"above tees 11. 2"-3"drop from inlet to outlet 12. Pipe set 13. Compact base with 6"of/e"crushed stone under tank �-- 14. Tank is watertight Comments: Yes NO E. Pump Chamber 1. If separate from stank,compact base with 6"of/<"stone underneath 2. Minimum 2"pipeto d-box if gravity system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specifica� 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. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum 0.IT'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distributiony 5. Compact base with 6"of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-3/4"' 1 %i" ✓/ -pea stone Bucket test done? _ice 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stone beneath pipe ✓ `C 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan-Minimum 2';maximum-4'. 4. Vent present if<50 feet or specified 5. Distance between trenches minimum 4'and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". v Yes NO 9. Pipes set on stable base. Comments: 1. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6"per 100' 3. Separation between pipe 6'maximum 4. Pipes connected at end 5. Separation between adjacent fields 10'minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: I Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12"and 48"wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement 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" 1/ 4. Grading slopes away from dwelling e/ 5. No areas over system that may pond / i t BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: - CURRENT INSTALLER'S LICENSE# LOCATION: 5 LICENSED INSTAL R: SIGNATURE: �1 TELEPHONE# 979-,�r3S- S//3 CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative,Use Only 160.00 Fee Attached? Yes_/ No Project Manager Ob. Yes L.,_ ^ No Foundation As-Built? Yes No Floor Plans? Yes No Approval Date: �� INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at lr; 9' /&i;I ST relative to the application of i % / dated for plans by z and dated 3 3 with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Gradez-Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Lice ed Septic taller G Date: Disposal Works Construction Permit# �a,V� I 1 I Town of North Andover, Massachusetts Form No.3 BOARD OF;HEALTH NORTH pf 4, •o "'1•x•0 a,Ar O., p DISPOSAL WORKS CONSTRUCTION PERMIT �SSACHUSEt " I. f Applicant TELEPHONE NAME ADDRESS Site Location AJ Permission is hereby granted to Construct ( ) or Repair (1, an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. �� -• CHAIRMAN,BOARD OF HEALTH D.W.C. No. Fee' Town of North Andover f t%ORTN Office of the Health Department 3� "='° o 1 Fit Community Development and Services Division 27 Charles Street -" --- °4ATtY North Andover, Massachusetts 01845 �SSACHU Sandra Starr Telephone(978)688-9540 Health Director Fax(978)688-9542 April 19,2002 Ben Osgood, Jr. New England Engineering 60 Beechwood Drive North Andover,MA 01845 Re: 1589 Salem Street Dear Mr. Osgood: This is to notify you that the plans dated 11/06/01 and revised 1/24/02 for the repair of the septic system at 1589 Salem Street have been approved. The approval includes a waiver from the North Andover Septic System regulations to allow the use of a 45 mil EPDM rubber membrane for slope reduction instead of a poured concrete wall. With the granting of this variance,the plans are 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 cc: Galeazzi File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONTSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 L .NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm(a,netway.com Date: January 14, 2002 Town of North Andover _ TOWN OF NORTH ANDD' Office of the Health Department BOARD OF HEATH Community Development and Services Division 27 Charles Street [JAN 2 2 2002 North Andover, MA 01845 1 - � RE: Subsurface Sewage Disposal System Plan Review, 1770/063 1589 Salem Street Assessors Map 106 B, Lot 5 Dear Members of the Board, Please be advised that Noonan &McDowell, Inc. has reviewed the plan dated March 13, 2001, and revised 11/6/01,by New England Engineering Services Inc. It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health "By-Laws"if the following is addressed: 1) Add a Benchmark 220 (4)(q) 2) Provide DEP Guidance Approval for use of 45 mil EPDM rubber membrane 3) In design data change system size provided to 20' x 45' from 15' x 60' 4) Length of sewer line from septic tank to D-Box is 10 ft.. Adjust pipe slope Respectfully, John L. Noonan, P.L.S.-P.E. G:office/forms/1589 salem.doc Land Surveyors Civil Engineers Environmental Planners NEW ENGLAND ENGINEERING SERVICES INC January 30, 2002 Sandra Starr,Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 1589 Salem Street,North Andover, Septic system design Dear Sandra: Enclosed are five copies of revised plans for the above referenced property. The following changes have been made. 1. An additional benchmark has been set. 2. The location of the septic tank has been revised along with the distances between the tank and the foundation and the tank and the d-box. 3. The system size has been revised in the design data section of the plan. If you have any questions regarding the information submitted,please do not hesitate to contact this office. Sincerely, Benjamin C. Osgoo Jr.,EITv`"� President Ja 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 NEW ENGLAND ENGINEERING SERVICES INC August 17, 2001 Sandra Starr,Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover,MA 01845 Re: 1589 Salem Street,North Andover, Septic system design Dear Sandra: The owner of the above referenced property would like to do additional testing in a new area so his septic system can be re designed. I have enclosed a check in the amount of 200 dollars to cover the fee for additional testing. If you have any questions please do not hesitate to contact this office. Sincerely, B /, -IT ena>�n COsgood, President TOWN O Nt)RTH AND0\ R/ - BOARD OF HEALTH Pijo 19 2001 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 i SEPTIC PLAN SUBMITTAL FORM LOCATION: Is- NEW PLANS: YES $160.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES NO DATE:_tTt �z DESIGN ENGINEER: Ne, , l.v�� feria rwe2c DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm@netway.com Date / ®�— Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/ Q G 3 /589 SPf - `z S7` Assessors Map /06 B,Lot -5— Dear Members of the Board, Please be advised that Noonan &McDowell, Inc. has reviewed thelan dated p , /7•e` •✓ ��OyGc -9 -�c��,i �-vc s c vcc; It is our opinion that the proposed design will meet the requirements of Title 5 and the North i`vcf Andover Board of Health `By-Laws" if the following is addressed: 1 Z C7 `¢ ..�-ice/ � �-- E!�1,�v7 rL r✓131��� l7�-H3/��-�✓�-- 3� 4�X7 � r=ctvri S �-a�7i c ?7t '� Tv Respectfully, John L. Noonan, P.L.S.-P.E. G:office/forms/tonarev Land Surveyors Civil Engineers Environmental Planners CHECKLIST FOR NORTH ANDOVER SEPTIC SYSTEM PLANS N&M Job 1770/ (740� The.following is a checklist that incorporates all Title 5 and local regulations for septic plans. Name of Applicant: Name of Designer: Plan Date: Revision Date: / Date of Review: / / a Z— Property Address: SS SSG Ei`? S % Map: l d6 5 Lot: BOH Reviewer: Type of Plan(new or upgrade): Number of Bedrooms in Assessor's Records: gpd)Garbage Disposal Allowed: 1V07 General Information: N.A.=North Andover Septic Regulations Other numbers refer to Title 5 OK _F;oblem N/A Street number and map/lot-220(4)(u) Maximum scale of i "=40'for plot plan-220(4) Maximum scale of 1 "=20'for profile and component details-220(4) Legal'boundaries of the facility being served-220(4)(a) Names of abutters from recent tax map- NA 8.02j Number of bedrooms,design calcs.,-NA 8.02i o� Name&address of record owner&applicant- NA 8.02k '. Name&address of designer-NA 8.021 Holder and location of all easements-220(4)(b) Date plan drawn&any revision date- NA 8.02m All dwellings and buildings,existing and proposed-220(4)(c) Location of all existing or proposed impervious areas-220(4)(d) All distances on site plan—NA 8.03a-c Elevation of proposed driveway-NA 8.02t Location and elevation of foundation drain-NA 8.02y Location and dimensions of the system incl.reserve(new const.)-220(4)(e) Limits of excavation of leach area on site plan-NA 8.02z 1G _ Locus plan-220(4)(t) (Not to scale) North arrow-220(4)(g) Existing and proposed contours-220(4)(g) Locations and logs of deep holes-220(4)(h) Locations and logs of percolation tests-220(4)(i) Date(s)of soil testing-220(4)(h)&(i) °�— Existing grade elevation of each deep hole-220(4)(h) Elevation of percolation tests—N.A. 8.02n Name of approving authority representative-220(4)(h)&(i) Name of soil evaluator-220(4)0) Soil logs and perc test logs match BOH records re Locations of waterlines,drains,and subsurface utilities-220(4)(m) 3 ¢ Observed and adjusted g.w.elevation in the vicinity of the system-220(4)(n) Complete profile of the system to scale-220(4)(o),NA 8.02c Cross section of leaching facility-NA 8.02w (Not to scale) Location of benchmark(s)within 50-75 feet of facility-220(4)(q) Note listing all variance requests with proper citations-220(4)(p) Local upgrade approval request form submitted-403(1) Original R.S./P.E. stamp,signature&date-220(1)&(2) If P.E.,discipline specified within stamp. MGL C. 112 s. 81M sfc.supplies(w/in 400'),pub.wells(w/in 250'),pvt. wells(w/in 150')-220(4)( Location of watercourses,wetlands,wells,etc. w/in 150'of system—NA 8.02r Wetland disclaimer—NA 8.02s RLS plan reference&certification required(prop line setbacks)-220(3) ''�+ Use approvals/standards checked for I/A system-DEP docs., 4t. 2 Perc rate>30 MPI-not allowed for new,LUA for upgrade-245(1)&('3) Perc rate> 60 MPI-must use modified tight tank or IIA technology-245(4) Proposed system qualifies as"shared" system-002(definitions) �? Flow is over 2,000 gpd-No R.S.allowed-220(1) Design flow was set in accordance with code-203 i Existing system location and note on proper abandonment-354 Leaching facility at least F above Base Flood elevation–NA 9.05 ✓ All piping Sch 40 minimum–NA 10.01 Basement floor minimum F above groundwater elevation–NA 5.04 Foundation drain present with elevation–NA 8.02y On-site Soil and Groundwater Review OK Problem N/A Proper deep observation hole logs on plan--220(4)(h) All deep holes and peres shown,including aborted tests–NA 8.02n Soil evaluation forms submitted within 60 days of field work-018(2) Proper percolation test log-220(4)(i) Ample deep observation holes in primary disposal area(minimum 2)- 102(2) Ample deep observation holes in secondary disposal area(minimum 2)- 102(2) �-- Ample perc testing(one in each disposal area,3 in prim.>2,000 gpd) - 104(4) Deep hole testing conducted within two years–NA 7.05 Hole Identification Numbers: ground elevation el. c� acceptable soil el. L-- Leach facility invert el. ground water el. C— refusal el. bottom of leach facility el. 4--- thickness /thickness of acceptable soil before&after soil R&R separation to groundwater G� separation to refusal soil class (/ perc rate loading rate septic tank below g.w.table —�% (yes or no) pump tank below g.w.table (yes or no) l.f in fill -255(l) Setback Distances(Given in feet) 15.21 1 YES NO Is the lot in the Lake Cochiewick Watershed? NA 6.00&5.02 OK Problem N/A / Septic Tank Leach Facility Property line 10 10 Cellar wall 10 20 2 vo 3 Inground pool 10 20 Slab foundation 10 10 Deck,on footings,etc. 5 10 Y Waterline 10 10 Private drinking well 75 100 Irrigation well 75 100 Wetlands 75 100 Public well 400 400 Wetlands bordering surface 150 150 water Supply or trib.(in Watershed) Trib.To Surface Water supply 325 325 Reservoirs 400 400 Tributaries to reservoirs 200 200 Drains(wat.supply/trib.) 50 100 Drains(intercept g.w.) 25 50 Foundation drains 10 20 Drains(Other) 5 10 Drywells 20 25 Downhill slope 15'to 3:1 slope w/o barrier Building Sewer OK Problem N/A T Grease trap required for certain uses(check 230-for details) ¢ Pipe diameter listed(4"minimum)-222(1) ZL Pipe schedule listed-222(3) _y Pipe cast iron or Sch 40 PVC—NA 11.02 Watertight joints specified-222(3)&(4) Pipe laid on compact,fin base-222(5) Pipe laid on continuous grade in straight line-222(7)@ Cleanouts precede all changes in alignment and grade-222(8) Cleanout provided every 100 feet-222(8) Manhole at any 90 degree alignment change-222(8) Invert elevation at building: `J Invert elevation at septic tank: Length of run: Slope: (minimum of 0.01 -0.02 desired)-222(6) 10'offset to private well or suction line-222(2) 3 C 4 , Septic Tank OK Problem N/A 2 Tank is accessible-228(3) �—� No structures above tank—(228(3) Tank can accommodate both primary&reserve—NA 9.04 200%of flow(required&provided given. 1500 min.)-220(4)(f)&223)(1)(a) yCc 2-3"drop from inlet to outlet-227(5) Minimum of 4'liquid depth-223(2) v 3"air space above teesibaffles(minimum)-227(4) c� 9"air space above flow line(minimum)-227(4) Tees are not to be replaced by baffles-227(1) Tees extend 6"above flow line-227(1) Inlet tee extends 10"below flow line(minimum)-227(6) —� Outlet tee extends 14"below flow line(more for deeper tanks)-227(6) `^ Gas baffle installed on outlet-227(4) Access manhole cover above center of tank&each tee(except 2 compart)228(2) �— 3-20"manholes-228(2) 1 childproof,24"riser/manhole Win 6"of final grade if<1000gpd-228(2) Inlet and outlet tees on center line-227(1) Soil compaction below tank specified(if soil is non-native)-221(2) 6"of<=3/4"stone beneath tank specified-221(2) &22 8(1) If> 1,000 gpd AND not a single fam.dwell.must be 2 tks or 2 comp.-223(1)(b) If plan specifies disposal must be 2 tanks in series or 2 compart.tank-223(1)(c) Buoyancy calcs.required if tank at or below water table-221(8) 4 Tank is watertight-221 (1) 9"of cover over tank(minimum)-228(l) H- 10 loading(min.)-H-20 if traffic-226(3) Top of tank<=36"below grade-221(7) `+ All pumping to tank(if applies)in accordance with-229 Tank is set to keep old system in service during install if possible Distribution Box(Check here if not present: ) OK Problem N/A C_ Inlet elevation: c--� Outlet elevation: 0.17'drop from inlet to outlet(minimum)-232(3)(b) `—' 6" sump(minimum)-232(3)(e) All outlets at same elevation.-232(3)(b) Outlet pipes laid level for first 2 ft.-232(3)(c) Pipe Sch 40-NA 10.01 Number of outlets: Number of laterals: Size of outlets: Inlet baffle/tee min. 1" over outlet invert for all d-boxes-232(3)(a), Soil compaction below distribution box specified(if soil is non-native)-221(2) '— 6"of stone beneath distribution box specified-221(2) Box is watertight-221 (1) Top of box<=36"below grade-221(7) Buoyancy calculations required if box is at or below water table-221(8) Pump Chamber(Check here if not present: ) OK Problem N/A Volume specified: 220(4)(r) Pump o vation- 220(4)(r) p off elevation: 220(4)(r) Alarm on elevation: 220(4)(r) Number of cycles per day-220(4)(r)(also 254(1)(d)if gravity from d-box) Minimum 2" delivery line to d-box if gravity-254(1)(c) 4 5 Pressure dosed l.f. if flow>=2,000-gp-d 254(1)(a)&254(2)(a) Cycles per day is consistent vviiirchamber volume-23 1 Volume calculations ' elude flowback volume-2') 1(2) 24 hour storage acity above pump on elevation-231(2) Number of ps: 2 if system serves>2 dwelling units-231(6) Capac' of pump(s)- gpm @ 'TDH-220(4)(r) P9pass 1 1/4"solids(minimum)-231(7) ump controls specified-220(4)(r) Alarm equipment specified-231(2) Alarm is in building and powered on separate circuit from pump-2') 1(9) Pump sequence correct(off-lead on-lag on- o 3 alan-n 1(8) Pump performance curves included-220(4)(r Manual operating switch-NA 12.01 Check valve,bleeder We NA 12. 1 childproof,24"riser/manhol- final grade-2'31(5), Soil compaction beneath p'chamber specified(if soil is non-native)-221(2) 6"of<=3/4"stone be th. kbr.specified-221(2)&228(1), Buoyancy calcu ons if chamber is at or below water table-221(8)@ 9" of cover 9,rer chamber(minimum)-228(l) H- 101 ing(min.)-H-20 if traffic-226(')), er is watertight-221 (1) Top of chamber<=36" below grade-221(7) Leaching Facility(general-complete for all designs) OK Problem N/A 50%larger if garbage disposal-240(4) ) -� Trenches to be used whenever possible-240(6) No vehicle or imperv.area above U.unless unavoidable-240(7);NA 13.02 Vented if under impervious cover-241 (1) Vented through same pipes as distribution system-241 (1)(a) "--� Vent protected from precipitation/animal entry-241 (1)(b) Vent is placed beyond traffic or impervious area-24 1 (1)(c) c� All lines connected to vent if bed or trenches-241(1)(d) 9"cover over peastone-240(9) ` Reserve area provided(new construction)-248(1) Reserve 4' from primary leach area-NA 9.04 4'(5'if perc rate<=2 MPI)separation to g.w.-212(a)&(b) 4'(down to 2'with variance or UA-upgrades only)of natural soil under l.f. `r GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005 -251(9) Require 5'removal and replacement if in fill-255(5) Top of leach facility<=36"below grade-221(7) Final grade over It minimum 0.02 ft/ft-240(10) Surface&subsurface drainage away from 11-240(1 1) &245(5) ��,, - Minimum design flow 440 gpd without deed restriction-NA 13.01 (/� -""""" 3:1 slope where grading required-255(2) e4 Toe of fill slope stops 5'from property line or swale installed-255(2) L- Impermeable barrier if<3:1 slope or< 15 feet to-3:lslope-255(2) Impermeable barrier/retaining wall poured concrete-NA 9.02 —� Retaining wall stamped by P.E.-255(2)(b) Top of retaining wall>=top of peastone elevation-255(2)(f) 10'offset from edge of leach facility to edge of ret. wall-255(2)(g) Perc test(s)done in most restrictive layer- 104(2) Perc test 4' below leaching elevation-NA 7.06 v Design flow listed and required/provided leach area given-220(4)(f) Leach pipes SCH40 PVC-NA 10.01 ✓' Leach pipes minimum 4"diameter except for dosed system-NA 14.04 Leach lines capped,vented,o�ted toget e 251(9) Pressure dosing guidance followed if-pressure 'bution-254(2)(c), Pressure dosing required over 2,000 gpd or with UA remedial use-23 1( ) 5 I 6 Leaching Trenches(Check here if not present: ) IOK Problem N/A Number of trenches: Minimum o enches-NA 9.01(2) Dept trenches(max eff.2'): -247(l) idth of trenches(2'min.,4'max.): -251 (1)(b) Length of trenches(100'max.): -25 1 (1)(a) Trenches are vented(when>50')-251 (11) Trenches follow contour lines-251(2) Trench spacing 3 times effective width or depth minimum-251 (1)(d) In fill or reserve between trenches, 10' - �1�4:01& 14.03 Available leach area given( s.f.)-NA 9.01(2) Bottom:iarea L x W x# – __ s.f. Sidewax D x# �c^2 mss.f. Effect given factor: Effective area=total area s.f.x LTAR = g/day �Eoading ective area is>=desig w of facility being served 2"of 1/8"- 1/2"2x washed peastone,247(2) Trench depth of 3/4"to 1 1/2"double washed stone-247(1) Leach Fields(Check here if not present: ) OK Problem N/A Number of fields: (need dosing chamber if> 1,231 (1)) Length(100'max.): -252(2)(b) �-� Width: e_ Total area:L x W = s.f. Minimum 900 square feet-NA 9.01(1) Distribution lines connected with solid pipe–NA 15.01 1G Effective leach area given Loading factor: Effective area=total area s:f x LTAR = g/dav Effective area is>=design flow of facility being served 1? Minimum of two distribution lines-252(2)(a) 6'line separation(max.)-252(2)(d) 4'maximum separation from edge of field to line-252(2)(e) 10'minimum separation between adjacent leach fields-252(2)(f) Between 6"and 12"of 3/4- 1 1/2"stone beneath field-252(2)(g)&247(2) 2"of 1/8"-1/2"2x washed peastone.-247(2) Final Grading OK Problem N/A Slope over leach area minimum of 0.02 feet/foot–240(10) _z-� Grading shall divert drainage away from leach area–240(l 1) Grading slopes away from dwelling 5/24/01 f:/office/forms/tonackltr.doc I i I 6 FJe Edit Run a s M62N Process iew 69eport Indo s e p �X o)ect 1770 '? Office ofFlealth Depa""rtment 27 C ar es S r�eet, o. ndover, Brllmg Gro p ID: 063 YJ filling Type Fixe Fee � Billing Fee: 1.50'00 Card ID. ToNA Mgrn Billing n contract Info C assifica i-n l GLAccogn s �', Qi mg Messages les a Ing ctiyities .Assign To P oposa umber: Dep rtment Contrac umber: Contrac ate 12I28l2001� or to Date. 12/28l2001� xpected Finish Date. 0171'_4/? Use Go ernment In oice Siyle Description: Engineering services required for Pian Review Engineer:NEES,Inc.#978-686-1768 Assessors Map 1068,Lot 5 1589 Salem St Save Close Notes... Project Request Record Town of North Andover Date: Client Id:ToNA Card Id:ToNA Client/Company Name:Board of Health i Card Tyne-Client: ,Contact Name -Ms.:SandraStarr Phone: 97&688=9540.: Title:,D'irector Fax: 978-6&8-9542':`•; J Address 27:Charles;Street. Email:sstarr.@townofnorthandovercom 1 Notes , T0. North.Andover r State: MA. Zip Code:: 01-845 rf rr; Other contacts if applicable :Engineer nstallerJ r Name:. !V Phone: 5' 75 — Tttl'e:' Fax: Address: Email: Notes: Town: ,State:'. Zip Code: Project: Project Id: 1770 Project Title: Town of North Andover,Board of Health (JOB NO) (PROJECT NAME&STREET ADDRESS) Manager:NOW Billing Group: �(D. Billing Cod4:Fixed Fee d Contract Info:Ptoject-Description for each billing group BG/ Ap licant /0>� /-;7ez Z_ Assessors=Man 16'W 4F Lot: Street l�-8,9 SSG 's�-r r 5 Type of service U' Office/forms/jbrqutona oa „OL 2..i ION 1 5GI i0lti1 IDE::=.i: Or , i i N1= CV`=:V1C - St .=.. . IV`..♦ i ID-a.y S r -.i _ n - A-- e� 3 _, !O C ^. ION E:O; N= �OL i ICON r / tit =0 I 1 oIvI �`=-i .*: CIS ==C i i: / TIME CV= NIC ilii= E i_LD I r��— • U .� ^i / � Lit- – —i!'' '-__� - . n — n I „ . ,. `k eP 'a gyp. 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[�Il!�lliilillillili@R�lilii ! . iii!!!®!!i i�i�l�il�lll�lill # !lilill!!®!!llliiii!lliit�i !!!!�!!!!!®illliiliillii !_ ���1lll!!!lll�illiliiiili®= ®I�!!!ii!!i!!liiilili!!ii *6�1IL1Cm l�1i�lilE�!!iili 4" tA a. r FORM 11 - SOIL EVALUATOR FORM Page I of 3 No. Date: Commonwealth of Massachusetts /11/1' -pAoa)4-zZ Massachusetts Soil Suitability Assessment for On-site Sewagre Disposal Date: Performed By: ........ ............... WitnessedBy: ............................................................ ............... Loudon Addre3s0W=*& LO(I Addrus.and Ttkpbom I vew Construction ❑ Repair .Office Review Published Soil Survey Available: No ❑ Yes Year Published ... Publication Scale Soil Map Unit C '7) Drainage Class /{GL...•.... . Soil Limitations ................................ Surficial Geologic Report Available: No Z Yes El Year Published Publication Scale GeologicMaterial (Map Unit) .................................................................................................................................... ........ Landform ............................................................................................................................................................................ ......... Flood Insurance Rate Map: Above 500 year flood boundary No [-]Yes Within 500 year flood boundary No Dyes 0 Within 100 year flood boundary No ElYes F] Wetland Area: National Wetland Inventory Map (map unit) ....................................................................................... Wetlands Conservancy Program Map (map unit) ......................................................... ....... ........... ...... Current Water Resource Conditions(USGS): Month^4P4ZWL'5—'� Range :Above Normal E]Normal OBelc-wNormal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 -D FORM ll - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. On-site Review Deep Hole Number .., Date:.... Time:..Time:.. .: �� Weather �—. �. Location (identify on site plan) Land Use �5� Slope (%) - Surface Stones . 7.. Vegetation . ,:� :....... . Landform .��.pCs�CiiV :. .. . .... :. ...:.::::.... ..,:..... .....:....::. . .....: . . Position on landscape (sketch on the back) l�'G. �� _. . Distances from: Open Water BodyG feet Drainage way ��.��feet Possible Wet Aream� feet Property Line . feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Gravely C—Z— A5 mamas M TL AREA Parent Material(geologic)_ �p L�- DepthtoSedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: _ 3a „ Estimated Seasonal High Ground Water: _. ..�.._ DEP APPROVED FOPW-12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. A© 45Z On-site Review Deep Hole Number ..-. Date:.:. Time:. .: Weather ,�..... C' r TR.:::.... :..,::..,. ... Location (identify on site plan) Land Use . �� l �774i�7 Slope M Surface Stones - Vegetation Landform .... .... /x,/ :::.. ...,.. ... .....:.,...:.. . .....: . Position on landscape (sketch on the back) Distances from: Open Water Body�� feet Drainage way �� � feet Possible Wet Area . . feet Property Line .:. .......... feet Drinking Water Well feet Other %, ........... DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) Z-111 <� t-- Cr MINIMUM OF 2 HOLES REQUIRED AT EVERY PROT AREA Parent Material(geologic) �oG�� L._ //G G DepthtoBedrock: Death to Groundwater: Standing Water in the Hole: — Weeping from Pit Face: Estimated Seasonal High Ground Water: �4 n DEP APPROVED FORM-12/07!95 FORM fl - SOIL EVALUATOR FORA1 Page 3of3 Location Address or Lot No./ Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole......... inches ❑ Depth to soil mottles .......... inches ❑ Ground water adjustment ................... feet - 4d-Z-7 �4 Index Well Number .................. Reading Date .................. Index well level ................. Adjustment factor ................... Adjusted ground water level .... .......... Depth of Naturallv Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in 11 areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on r2 �� (date) 1 have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORN,I Page 1 of 3 No. Date:/0 / /0/ Commonweal of ]Massachusetts A/o. , vDo l , Massachusetts Soil Suitabili Assessment for On-site Sewage Disposal Performed By: ...... � d h�, /..... :..... X/G � Date9// Witnessed By: A / /mit/......................................... . // > Location Addrus or / �'�rr's Namc, /cy ,'f� �✓I� La S ACdress,and / O �j, uTckphom/ �y- �J� /,I- i� • New construction ❑ Repair Office Review Published Soil Survey Available: No ❑ Yes Year Published ............. Publication Scale Soil Map Unit SGL..._...._. .. Limitations �Z�.... T�/ _ Drainage Class Soil �� Surficial Geologic Report Available: No ® Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) ...._........ ......---......................_............ .... _. . . Landform ................................................................................... ........................................ .. . . Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Q Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) __............. .... ..... ... Wetlands Conservancy Program Map (map unit) - - --_ - Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ❑Bele^i Normal Other References Reviewed: hi DEP APPROVED FORUM• 12/07/95 FORM 11 - SOIL EVALUATOR P ORnj Page 2 of 3 Location Address or Lot No. On-site .Review Q Q o Deep Hole Number .:�� Date :../:/-/�/ Tlme:./.. .. Weathe /,V— ;vV Location (Identify on site plan) Land Use ...:. Slope M . d Surface Stones Vegetation .. .. .. ��� Landform Position on landscape:(sketch on the back) . . ! G '..,. Distances from: Open Water Body � � feet Drainage waYs—. feet Possible Wet Area Z feet Property Line .���., feet Drinking Water Well>/Sn feet Other .... DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon S0"Texture Soil Color Soil Surface Ilnches) (USDA) (Munsell) MottlingOther (Structure, Stones, Boulders, Consistency, % Gravel) �3 I re MIN Parent Material (geologic) DepthtoSedrock: Depth to Groundwater: Standing Water in the Hole: / Weeping from Pit Foce:_'— Estimated Seasonal High Ground Water: DEP APPROVED F0"1• 12/07/95 FORM 11 - SOIL EVALUATOR F Okn1 Page 2 of 3 Location Address or Lot No. On-site ,Review Dee Hole Number .._.... Date:.. q Q /.v– o?� P '3 /:,�� Tlme:.%..�.,. Weathe� Location (identify on site plan) Land Use .,...: Slope M .�d Surface Stones �`T�- .. Vegetation :. .. .. � ..,...:...:.: .......:.......... :.......:.. :.., Landform Position on landscape:(sketch on the back) Distances from: Open Water Body feet Drainage way'—- feet Possible Wet Area Z feet Property Line .���.. feet Drinking Water Well/S0 feet Other ..... ......- DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) , ( I iv7— APO Parent Material (geologic) DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: / Weeping from Pit Face:_ Estimated Seasonal High Ground Water: DEP APPROYED FORM- t2/O7/9S FORM 11 - SOIL EVALUATOR uojO 111 Page 2 of 3 Location Address or Lot No. On-site ,review Deep Hole Number ...::/... ...: Date:.f,��/l Times. �.� Weather?-/s" Location (Ide Ify on site Ian . .. .. _..,..,......:.. .:. . Land Use Slope (%) Surface Stones �2= J Vegetation ... ........:.........: :.......:: :... Landform yn'!L/x/ Position on landscape,(sketch on the back) .. .�� .. Gmf��....,.._ Distances from: Open Water Body feet Drainage way-537v. feet Possible Wet Area Z-�. feet Property Line .....Z�� feet Drinking Water Well,�s� feet DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) _/ _ 6C s o �� /ep �L�s MINIMUM OF 2-14OLES REQUIRED A I EVERY PROPOSED Parent Material (geologic) i G L- DepthtoSedrock: Depth to Groundwater: Standing Water in the Hole: _ Weeping from Pit Face: Estimated Seasonal High Ground Water: '' — ---- DEP APPROVED FO"I- 11/07/9S FORM 11 - SOIL EVALUATOR D'oRAI Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole........... .... inches ❑ Depth weeping from side of observation hole ........... ... inches ® Depth to soil mottles .: :✓. inches �— y ElGround water adjustment ................... feet - .4 ' Index Well Number .................. Reading Date .................. Index well level Adjustment factor ................... Adjusted ground water level ..............._.................... ...... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in qI1 areas observed throughout -the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? ` Certification I certify that on q-- (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature ate'1414ml DEP APPROVED FORM- 12/07/95 ) C) G Z. L r, IN 0 i ICON i i = < �C' I I0ItiI 'J� " 1 - 0 , f I i[VI= l-. i I livi= i IN X- y mac= I i 1,v = ` - J 77 s R All * ` IIIIIIINIIIIII®®�IIININIIII; n = ,�j _�� k IIINIIN Y IIIENNEIIIIIIiN1111NN111 11k � NIIIIINIII Ii1N11111111111111 P. , _ �_-r� �.., ' ` 1111111 11 IIINIICIIi1111111 1 e �s _ �R�f�Yk4 . �fi1111111 11 IIIi1N1111111111111 � � a MillIIIIIIIiiN�i®1®11111111 NIIII IIIIIIIIINNIilllllllllll� NK IIIIIIIIIIIIIINIIIIIIIIIIIIIIII n. ,. 3 1 IIIIIIIIIIIIIINIIIIIIIIIIIIIII� ��� A >>. n w d ` � Ililill®1o1 IIININIII®®lllllr = ® T �� ®NIIIi111Ni111Nilllllllsliilr 1 y :R a� �� . if , 1111111®1111®INlalllllilli�l �- ° .� yr' } ¢ p `� ' 1/111111 111 IINIi111111111111_ � � �� , ° � 1 IIIIIIIiI� militlilll . N 11� IIIi1�1�1iN111111i11 111, � . , k A� , � �-� ✓� fir. ' - Wm � A.:ek- mar :F -•R. a..,_ C ;? a k r r 1111 I AL M#,-v X , i - 11 1111 111111 �� _ 1111111 � � MIME 1111 h 111111111 1111 111 111111// .,1r,�, 11111 11111/11/1 .,I 111111111111111 �` Y 11111 IY11i11�1111N11 al r � : � ��� n 11i_ r1i11��11111111 � � _ - I`,-) -1 o � C A- h J • ; N_S l �0L i ICN i j iNlc i C. illvi= �. .i_L-I Nom\ i 7�.—. - ter•.. .. —.l .___. n— I ilvl� FORM 11 - SOIL EVALUATOR FORM Page I of 3 No. Date: ///,3 Commonwealth. .of Massachusetts assachusetts Massachusetts Soil Suitability Assessment 0rOnsite SeWai eDisposal ft..... qsql Performed By ......... Date: ............................................ .....................................Witnessed By: ......... ............... . Location Address or/�l."/e? Owm's Nanbc, Address.and Lo(I Tekphonc New Construction 0 Repair CSS Office Review Published Soil Survey Available: No ❑ Yes Year Published ................... Publication Scale Soil Map Unit Drainage Class �yG4Z.................... Soil Limitations ...... Surficial Geologic Report Available: No RK Yes El Year PublishedPublication Scale GeologicMaterial (Map Unit) ...I................... ................................................................................................... Landform. ................................................................................................................... .................................................... Flood Insurance Rate Map: Above 500 year flood boundary No []Yes Within 500 year flood boundary No E]Yes 0 Within 100 year flood boundary No E]Yes EJ Wetland Area: National Wetland Inventory Map (map un-it) ........................ .................................... ........ Wetlands Conservancy Program Map (map unit) .................................................................. . ....... Current Water Resource Conditions(USGS): Month Range :Above Normal E]Normal 0l3e1c,.1/ Normal ❑ Other References Reviewed: DFP APPROVED FOR.%1-12/07195 16 Cp FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot iqa./�� On-site Review / o Deep Hole Number / ... Date:.:..-.:l.5 a!�� Time:.. .: Weather �- . �. Location (identify on site plan) Land Use ..... � ` Slope (°kl Surface Stones --.: Vegetation . ..::... _ : Landform Position on landscape (sketch on the back) �l�'G• G� :._ Distances from: Open Water Body � feet Drainage way feet Possible Wet Aream� feet Property Line feet Drinking Water Well feet Other :.:...:.:. .::..v..:::. DEEP OBSERVATION'HOLE LOG` Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Grav�- L 1-5 .-Milway z5r 2 HOLES REQUIRED AT EWRY PR,- )AL AREA Parent Material(geologic) L- OepthtoBedrock: Depth to Groundwater: Standing Water in the Hote: i Weeping from Pit Face: _ Estimated Seasonal High Ground Water:DEP APPROVED APPROVED FOR.At-12/07/95 FORM 11 - SOIL EVALUATOR FORM . Page 2of3 Location Address or Lot No./��� On-site Review Deep Hole Number Date:.:. Time:. .:: Weather ��. . ...... C' r T ..:.:. :..:::...........::....:......:.,.:. ..:... Location (identify on site plan) ...:..:.'� Land Use .!' �ll ��T Slope (°r6} Surface Stones Vegetation . :. .... ..:...:.: . .:::.:..:.:...:.. . ..::.. Landform .... ,. .�PC/ri'JG✓x/ :::.. ..::..... .....:....::.. . .....: . Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area 3O feet Property Line .-j��... feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Gravel) y Y/Z Ila .-MINIMUM OF 2 ED AT EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) �G�� �- - //G G DepthtoBedrock: Death to Groundwater_: Standing Water in the Hole: — Weeping from Pit Face: Estimated Seasonal High Ground Water: ---- DEP APPROVED FOtLnt-12/07/95 FORM 11 - SOIL LVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole............. inches ❑ Depth weeping from side of observation hole .......... ... inches ❑ Depth to soil mottles .::.::` inches 3 ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................. Adjustment factor ................... Adjusted ground water level ...................................................... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system7. If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature 'WJDate DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORN13 Page 1 of 3 Date: No. Commonweal of Massachusetts A/0. 1Z)o,(4 , Massachusetts Soil Suitabili Assessment for On-site Sewage Disposal Performed By: .. � ? ......�..... X�G /� Date Witnessed By: .. .X,/ �?��/�� _... ................"".... ... L LoOw:rr's Name, ,�//�t7j�J�� �✓v� nrion Address or \ ncafess,and ��, Lot Telephone I �� New Construction ❑ Repair _Office Review Published Soil Survey Available: No ❑ Yes Year Published � � - Publication Scale �� "� Soil Map Unit Drainage ClassG ..... Soil Limitations Surficial Geologic Report Available: No ® Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Q Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No El Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) - - - ........................... Wetlands Conservancy Program Map (map unit) .. - - Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ❑Belc,.v Normal Other References Reviewed: DEP APPROVED FORM- 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 2of3 Location Address or Lot No. On-site ,Review Q Deep Hole Number .. Date:..l:,�� Time:. ... Weathe /'V' ;�Pv Location (Identify on site plan) f ....:.' y�'>? :....,...... ........:... Land Use Slope M d. Surface Stones Vegetation . . . .......:.... . . .. Landform ..:::.. �lM.�/ _:...... . .. Position on landscape-(sketch on the back) .. � ... G .:..:... . Distances from: Open Water Body feet Drainage way'S�b. feet Possible Wet Area feet Property Line .���.. feet Drinking Water Well>S0 feet Other ....::..:.... ..:...:.:..:.......:. DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) o . elC. eyr—46— .— 1 MINIMUM OF 2 HOLES REQUIREU AT EVERY PAZrubtu UIZ)PUSAL AREA Parent Material (geologic) L DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: _ Estimated Seasonal High Ground Water: C� DEP APPROVED FO"I• 12/07/9S FORM Ii - SOIL EVALUATOR FORn1 Page 2of3 Location Address or Lot No. On-site .Review 0 Deep Hole Number /... Date:./ /Zn1 Time:. : Weather'Z5xw—x Location (Ide ify on site plan) 2T. .............:... Land Use : :.. ......,..:.!�% G" Slope (%) %.....Surface Stones 72*tJ Vegetation .: Landform Position on landscape (sketch on the back) .. . �� .. Gm��-�....:..... Distances from: Open Water Body feet Drainage way`� feet Possible Wet Area Z:57. feet Property Line .....z;' 7 feet Drinking Water Well!; -' -a feet Other .....:... ..... ....:....:..:...r,,.. i, DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) 3/ er s �y mea. �ml n/ MINIMUM Ul- 2 HULLS KLUUMM7 EVERY PROPUSEU DISPOSAL AREA Parent Materiel(geologic) CO�� / L /i G L DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: — Weeping from Pit Foce: Estimated Seasonal High Ground Water: DEP APPROVED FORM• 12/07/95 NEW ENGLAND ENGINEERING SERVICES INC December 21, 2001 Sandra Starr,Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 1589 Salem Street,North Andover, Septic system design Dear Sandra: Enclosed are the following documents in reference to the above referenced property. 1. 5 sets of septic system design plans. 2. Soil evaluator sheets. 3. Application for approval. 4. Check to cover the approval fee. If you have any questions regarding the information submitted,please do not hesitate to contact this office. Sincerely, Benj ahvn C. Osgod6, Jr.,EIT President ti 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 SEPTIC PLAN SUBMITTAL FORM LOCATION: NEW PLANS: YES $160.00/Plan �^ REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES NO DATE: 121 Z,10 DESIGN ENGINEER: DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. Town of North Andover, Massachusetts Form'No. 1 NORTH ww BOARD OF HEALTH O��1 LEO /b�•r0 3� e1� a 0 19- 0 9O A * 6 r.- DRATEAPPLICATION FOR SITE TESTING/INSPECTION QD PPP`��'J 9SSACHUS�� Applicant ,N*ME AD ESS TELEPHONE Site Location Engineer 6 Aka- NAME AD ESS TELEPHONE Test/Inspection Date and Time d CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No//W D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 ORTH BOARD OF HEALTH o�,S pIED i6 6 1 9 R6 OL APPLICATION FOR SITE TESTING/INSPECTION �q QOAATED PPa��S SSACHUSE Applicant �. �. t� .r I _ li ✓ ._. � ?'1.,� NAME ADDRESS✓ (r TELEPHONE Site Location iOrN �� Engineer ` .41',,� NAME ADDRESS ; TELEPHONE Test/I nspection Date and Time /, iY CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. //`/x D.W.C. No. C.C. Date Plbg. Permit No. nom,: t Town off North AndoveMassachusetts Y r yd s ate„ r - e NOR,,, ABOAR !,,0 FHEALTH' Vi o : s xr f ^i ' `� �, DESIGN APPROVAL FOR;' : �� ;tau "�f���'� `r�� a'• x� xd "c""s`` SOILABSORPTION SEWAGE°DISPOSIAL SYSTEM k :. ' Applicant"' Test NoMY Site Location' /� : y+ s Reference'Plansand S ecs e ` f s p�. GINEER _ DESIGN DATE? cfim APer,mIssIon Is granted for an individual soil absorption sewage°disposal system to be�ins'falled V. 3 in accordarice with_ regulations of Board of Health:` 'CHAIRMAN BOARD BOARD OF HEALTH ? - 1 Site"System.Permit No rM 011, W � � VIIIMEN Town or" North Andover OF aORTM q tt iE° 6 yO Office of the Health Department 3? " Community Development and Services Division * William J.Scott,Division Director ° - �5��(27 Charles Street Sq�HUSE Sandra Starr 1' ( )978 hone North Andover,Massachusetts 01845 Tele 688-9540 Health Director Fax(978)688-9542 April 6, 2001 Ben Osgood, Jr. New England Engineering 60 Beechwood Drive No. Andover, MA 01845 Re: 1589 Salem Street - Dear Ben: This is to notify you that the plans dated 3/13/01 for the repair of the septic system for 1589 Salem Street have been approved. If you have any questions,please do not hesitate to call the Board of Health O#figa 4� 978-688-9540. Sincerely, Sandra Starr, R.S., C.H.O. Health Director SS/smc cc: Galeazzi File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANTNNG 688-9535 _ i Apr-06-01 10: 24A Paul D. Turbide, PE/PLS 978-465-0313 P.02 April 4, 2001 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 1589 Salem Street Dear Sandra, I find that the design plan dated March 13, 2001, as prepared by New England Engineering Services,Inc. on behalf of Richard Galeazzi adequately addresses the minimum design criteria as set forth by the Town of North Andover and Title V regulations. For the purpose of clarification, the design plans should be modified using a soil Class H for sandy loam(SL)with a LTAR loading rate of 0.6. Since North Andover regulations require a minimum of 900 s.f. of leaching facility, the LTAR will not effect the proposed design. If you have any questions or comments please feet free to contact me. incerely aul D. Turbide, PE/PLS P DT 01ti ENGINf�RING Civil Engineers& Lend Surveyors One Harris Street Newbury" t,MA 01950 (978)465-8594 \\Server PWABH\P2884\SALEM ST 1589.DOC Addresst.��Y SW C-a s7—, Title of File Page of Date File Open: mate file closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes T action Document/ document/ Num. Action Department Board of Appeals — Board of Health — Planning Board — Conservation Commission — Bonding Department---' «8 9- �a���a-��� �� �����- Apr-06-01 10: 24A Paul 0. Turbide, PF/PLS 918-465-0313 P_01 Facsimile Cover Sheet To: SANDRA STARR Company: NORTH ANDOVER BOH Phone: 978-688-9540 Fax: 978-688-9542 From: Paul D. Turbide, P.E.IP.L.S., President Company:. Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 455-0313 Date April 4, 2001 Pages Including This Cover Page: 2 Comments: Sandy, I have attached our review of the SDS upgrade at 1589 Salem Street Thanks, Paul D. Turbide,P.E.M.L.S. PORT ENGINEERING Civil Engineers& Land Surveyors One Harris Street Newburyport,MA 01950 (978)465-8594 NEW ENGLAND ENGINEERING SERVICES lk INC March 26, 2001 Sandra Starr,Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 1589 Salem Street,North Andover, Septic system design Dear Sandra: Enclosed are the following documents concerning the above referenced property. 1. 5 sets of design plans, 1 with original signature. 2. Submittal form for approval. 3. Soil evaluator sheets. 4. Check to cover the fee. If you have any questions please do not hesitate to contact this office. Sincerely, Benjar=-n C. Osgoo /r, IT President ,_::;Ori; •.� .,..: _ of j_ !T WR 2 920 a 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 SEPTIC PLAN SUBMITTAL FORM LOCATION: NEW PLANS: YES $125.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES NO DATE: DESIGN ENGINEER: DATE TO CONSULTANT: *If you want your plans 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. FORM 11 - SOIL EVALUATOR FORM Page I of 3 No. Date: Commonwealth of Massachusetts Massachusetts Soil Suit�b_WO Assessment for On--site &�vage Dis,posat Performed By: L^ � �lG� c.. .. Date: WitnessedBy: ........... �-�J .... ........ ................................................................................... t.o.Ion nea�as«/�� .�j i��f a.=•.rwR�c��J NewConstruction ❑ Repair �x7 .Office Review Published Soil Survey Available: No ❑ Yes Year Published Publication Scale �.�/ fir Soil Map Unit Drainage Class �4�'...•............ Soil Limitations / ......f .......... .......... Surficial Geologic ReportAvailable:No © Yes ❑ Year Published V __ M . Publication Scale GeologicMaterial (Map Unit) ..................................._.:........................................................................ .......... Landform ................................................................................................................................................................. Flood Insurance Rate Map: Above 500 year flood boundary No []Yes ❑ Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map(map unit) ......................................................... Wetlands Conservancy Program Map(map unit) ................................................................................... .. Current. Water Resource Conditions(USGS : Month nftd6VZ%A-r-,' _ . ... .. Range :Above Normal ❑Normal ©Below Normal ❑ Other References Reviewed: -- DEP APPROVED 110K 1.12/0719S r FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot iso./�! �'Q` T �© �• G�� On-site Review . o Beep Hole Number �� _� Date:....-A-51� Time:•. . '� Weather��—. �. Location (identify on site plan) ,`.��l '�' '�' Land Use :.,, �- /�� '� G Slope M Surface Stones . . ..... . , . . .. Vegetation • :.G,.-tom-' . ..�... ,w ..w� Landform — Position andform Position on landscape (sketch on the back) Distances from: Open Water Body 's feet Drainage way feet Amo Possible Wet Area feet Property Line .4:17 feet , Drinking Water Well feet. Other DEEP OBSERVATION HOLE LOG" Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) �3 MIMMUM UF 2 HULES REQUIRED AT EVERY PROPOSED DISPOSAL Aht:A Parent Material(geologic)_ Dapthtoft&ock: `r Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: _ Estimated Seasonal High Ground Water: DEP APPROVED FORM-12107/95 FORM 11 - SOIL F,,VALUATOR FORM . Page 2 of 3 Location Address or Lot No.��� � Al On-site Review Deep Hole Number Date:.�//:Y`�� Time:/�.� � Weather Location (identify on site plan) Land Use Slope M Surface Stones , Vegetation . _.,CG �-... . �...._... _.. ... w. �. Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way '�� feet Possible Wet Area .�. . feet Property Line . �� ... feet Drinking Water Well feet. Other %.,. - DEEP OBSERVATION HOLE LOG" Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency, % Gravel) 2 O c: -� YP— .� Z�v cl/y � t:gt X .1 MINIMUM ut-Z HOLES REQUIRED:XT EVERY PROPOSED DISPOSX17AREA Parent Material(geologic) _C7jC Depthto8edrock• Death to,Groundwater: Standing Water in the Hole: -- Weeping from Pit Face: Estimated Seasonal High Ground Water: -f4 ° DEP APPROVED FORM-12107/95 a FORM i I - soli. L VALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for e onal Fripj Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole.. inches © Depth to soil mottles _..: inches ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................. Adjustment factor................... Adjusted ground water leve( .........---........._..--...........,................ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurrin pervious observed throughout the area proposed for the soil abso pt onrsystem�n as If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the soil evalu approved by the Department of Environmental Protection and that the abor ove analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signatureate �(�( DEP APPROVED FORM-121077 1 BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: MAP & PARCEL: toy ' LOCATION OF SOIL TESTS: 1 ,50q_ SyA S E M ��M OWNER: tc i1Ai2D �d eGc z 2.+ TEL.NO.: �i -(�bg, ADDRESS: JP t' ENGINEER: NE TEL. NO.: CERTIFIED SOIL EVALUATOR: Q,.c j4 4-(L9 C -1-6--)UAyzp Intended Use of Land: Residential Subdivision Singl�Fami�IyHome Commercial Is This: Repair Testing: x Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of$275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or up rg ades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing---- 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100') shall be su'bmrtted to the$oard of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. } 16 Please Do Not Write Below This Line --.--------- ----- - i S N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: i 4 �._l�. �x ins 9� •oy + /' �: �� �''�� I f LUT !! i rx�sT�N�- �. i ( � I; /02/� `�77 r- ZoT 'Sc_a'C.:._7L__�_.!_.,�:✓lt�.�'e - { �_/�_max �� y� •oy �- �, �; ,,�� i �f l Tei i �_. /_=x/,5T//V G- t � `i el e 1r TO: NORTH ANDOVER, MASS �� 19 77 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at 1- 0.7- 11 S '1 L611/! North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans an_ 'fications dated /mss w,s`�` 19 ~% JOSEPIH, RP ('Keg neer . P f. itarian .°f�r•nl5r, �,. . ..... ..... z z c 7- k =A/,>T/NQ NORITI A 3TY}V�R BOARD OF I_AZTH IruSi:;LLAIr1C1� CrID✓It LIST APPROVED �-� DISA,F'PP.GVED _._._._.. :._ EXCAVATION OK Date: 5 ,3-76 Date: 17 -. 2,7 R , Reason: & l 1. As Bizilt Submitted `~- Check: Lot location, dimensions of system, local on4in regard to percolation tests, depth of system, tinter table 2. Distance to ?-Jetl^nd Areas, Drains, Street & House, Drainage Easement and Wells. 3. Water Line Location 4. No PV_Pip 5. - c T T em- t-Pipe to ank-`Jo' s on both side of Tank.. 6. Distribution Box - No crack, i b cover, a lines flow erz<ally from boy. a _ 7. Leach Fields - Dir;en _.ons, Stone De' qhs, Cappe -nds, Clean dvukile-;sashed stone 8. Leach Pits - Dimensions, Depth of Stone, Spl-ash pads tees, Cemont-pipe to tank- joints on both sides of tank, Clem-i double-i%-ash-ed store 9. No Garbage Disposals Final Grading *�barricading of sub-surface syst m �y #4 7t . d-v'tL141W �. ` •�l'�l /77//4, &A-,/.2 2 A i TOWN OF NORTH 'ANDOVER NORTH ANDOVER BOARD OF HEALTH REPORT OF PERC TEST ADDRESS OF SYSTEM! lj»��-� d� DATE NAME OF PROFESSICNAL/ENGINEER. OR SANITARIAN CONDUCTING TESTS ✓ / NAME OF LOT OWNER ����,�-r�C� 3--G,r ADDRESS SHOW APPROXIMATE LOCATION OF PITS ON SKETCH ON REAR OF THIS SHEET Total Soil Log: T . soil • SubsoilDepths & Types" Water Level Pit Depth Time to Time to Perc Tests Depth Saturation Time Drop 1211 - 911 Drop 911 - 611 83 Other Considerations: . } Recommendations: f Signature t f ' Q i �9 C)C7> ` ) �G�-7 [—Wind2 FMS-Noonan McDowell,-: FiEdit��Tools�,Dataamtam, �pr�ess��yiew ���por r �sldire�p, _ ;�,��"�' OIT I 1210 k94l�. e—Billing Groups F SO FEE Brllrng*Ty�e ;x Fixed FeeSti 200.00 i To NA I Main ,BillingRlnfo� iln Caatmn #cco ii [I 161 &- rt „ sr ' „i Rropo aIN�u be VF1 = Contract�Number���� ConiractDiat Dat� 812012001 `� ¢ag 1g, BN , � 'N-RimorkStart * 8/20/2001 ar Fit IJU a �n Y'� o' ►. Survey engineering services required for soil testing. Engineer: New England Engineering Services,978.686.1768 Applicant Richard Galeazzi Assessors Map 1068,Lot 5 1589 Salem Street _ — y3 `fig a Ripe n-^ -aa i� T1 MR, 5g ANA ��� ' ,��,.^ sY'� 4-# ��.w.��"� ,,,�,''.+a�} v�"``�'S" �j �yt^'R" .�,-,+ "-aa��'3�a"�`��=�����`��•r"3+.t.� 2i' _ ve:;d J� i FORM 11 - SOIL EVALUATOR FORA Noe 2 of 3 Location Address or Lot iJo. [ 5 IE�9 f A 4. C,`'"'i S y i i On-site Review _ Deep Hole Number Date: ! me: ®% / / � Weather G �'�- 72 Ti Location (identify on site plan) Land Use Slope (%) ' Surface Stones Vegetation 24~A-J - Q A l Landform Position on landscape (sketch on the back) Distances from: Open Water Body fees Drainage way-Lo-!Zfeet Possible Wet Area 7/ '0'9 feet Property Line 5Q feet Drinking Water Wel! feet -Other #q)c1 ^,4,p t a DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Sol Texture Sol Color Sol. Other I Surface(Inches) (USDA) lNlunceln Mottling (Structure,Stones,Boulders,Consistency, % Graven I HOLES REQUIRED AT EVERY PROPUSED DISPOW ARLA Parent Material(geologic) OaipCttaBa�nele o Depth to Groundwater: Standing Water in the Hole: I1/1�N/ Weeping from Pit face: 04V® - Estimated Seasonal High Ground Water: DFP APPROI.IM FORM-t"71lS FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot iJo. On-site Review _ Deep Hole Number _ Date• �It Time: 9 Weather Location (identify on site plan) Land Use 010005 Slope (%) Surface Stones ` ? Vegetation /5- 001- C_ - a0l )e— Landform i Position on landscape (sketch on the backs Distances from: s+t�a fj i > Open Water Body PQ feet Drainage way feat '' t Possible W /90 Z S' � ) 1 2 0 Wet Area feet Property Line feat Drinking Water Well >209 feet Other 3 loll n�z DEEP OBSERVATION HOLE LOG . i I Depth from 5oii Horizon Sol Texture Sol Color Soil ! In Other Surface (inches) 1USDA) tMuncelq Mottling 15trucZure,Stones,Boulders,Consistency. !f, Graven Q Q� L --� i � n SL -� 9 S Z` Y ,�!f► $5/�C� ��1�`1 Al' ss�v a- c,r i Parent Material(geologic) Dgghtotledroc,: 7 Q Depth to Groundwater; Standing Water in the Hole: tom!0/,v6.. Weeping from Pit Face: �"'V �✓� Estimated Seasonal High Z",rour+d Water: J? sr DF.P APPR01*7M FORM•UM7r95 r" FORM 12.- PERCOLATION TEST 1-7 7 3,' Location Address or Lot No. 1s"8,9 j'A4 37— COMMONWEALTH OF MASSACHUSETTS *J&'' Massachusetts Percolation Test` Date: .. /ji/e / Time:. Observation Hole #r ? Na--"M Depth of Perc o Start Pre-soak C2' s- 3 End Pre-soak Time at 12 Time at 9" Time at 6" Time (9"-6") Rate Min./Inch ,. / Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed ISite Failed ❑ .......:............ ........................ Performed By: x �� Witnessed By: Comments: . ...... t DEA AMOVED TOOStM.nW&S Project Request Record Town of North Andover Date: 7 P Q / Client Id:ToNA Card Id: ToNA Client/Company Na e:Boar of Health Card Type-Client - Contact Name: Ms.Sandra Starr Phone: 978-688-9540 Title:Director Fax: 978-688-9542 "'Address: 27 Charles Street Email: sstarr@townofnorthandover.com Notes: - - „Town: North Andover State: MA Zip Code: 01845 Other contacts if applicable:i Engine / nstaller= p ",Name:. 'y, div"G Gi L "7 C,. 5 phone: nTitle Fax: Address:. Email: ' Town State ; Zip Code l'�r rj;h42-1—V Project: Project Id: 1770 Project Title: Town of North Andover Board of Health (JOB NO) (PROJECT NAME&STREET ADDRESS) Manager:NOW Billing Group: —Billing Cod FxedFd p� ee Contract Info.Project Description for each billing group €'BG/ Applicant 'Assessors Map r"la6 0"Lo't S, Street l �8� S/���C> �` .,Type of service - � s. t Officelforms/jbrqutona NEW ENGLAND EI EE I SERVICES INC August 17, 2001 Sandra Starr, Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover,MA 01845 Re: 1589 Salem Street,North Andover, Septic system design Dear Sandra: The owner of the above referenced property would like to do additional testing in a new area so his septic=system can be re designed. I have enclosed a check in the amount of 200 dollars to cover the fee for additional testing. If you have any questions please do not hesitate to contact this office. Sincerely, Be jam C. Osgood .,EIT President I 9 ?001 9 4 610 BEFCHWOOD DRIVE.-NORT'�i AN DOVER, MA 01845-(378)686-1768-(888)3-59-7645- FAX(978)685-1099 is atrt' r AS I , + • 'r r t t ��f � `{ysii �f"'"h n7�ft l} t , s S • r • !'),���7."1 -�6i" r'tli �fir's' t rr •� }'t �'. �.� 4 t la � TQC O NORTH ANDOVER`" OF NORTH HEALTH w , SYSTEMP EOR OF H�,,��H XJWWG RECORD - ►,, _p m i tir`.�. + i •`P "k ' +/�; i�s , i i r �7�J Y LUQI ,�.}��'Lt:.V � P }..i �{ � .... 1 L..L.. ,rt e ; t*1•l..r..�i CR�7Q}�'9$•.(';}pl � - al r' of ���• ,�. �1 � � t r ee r� r �rl.''�•,f t' I"ri SYSTEM O�N . jj :!',,.'S _ f. t ,: .,j M &ADDRESS SYSTEM WCATION rr (exa4iPle. ft front of house) r ' trttt�' ?? `�ktrt'ya.�* ,�} ��tl �' r.t 1 � j`,'l� Yd' 1 '��•'" i v� �/ fi .A�+r►'�Ci�� �+64lef�irll.-++••M�i..4d"r�a�:.s-..'. ..L•: � a a' � < .t I r + r �I.t P�T�`.� t r AD p =� GALLONS DOLT NO J 1 ,:a ri►7 »c ,t,, ►7EPZ'IC TANK t• n.a��;,� `r;� � ,; J ----- : NO YES M7 r 1J ,SERVICE ROUTINE f r x _ A:�.- MERGENCY t �fi � kr� i� rn S r'`I r i j I T'^"t !■r A�^On.T^ VA►TiONS;;� li�F:1; v i t'd�rhSM •GQOD'GOND �' HEAVY GREASE CONDITION:,. FULL TO COVER ROOTS . BAFFLES IN PLACE ........� I4 ti4rvl Yvyr If rJ .... RUNBACK EXCESSIVE SOLIDS :' ACK ji ► ��" s �� `s 5{4 ;.SOLIDS CARRY "�-- FLOODED O� THER,.v'�::•6t j�l1 .}jr! J ,�,ww•� O (EXPLAIN) �� i��i��i�►"��=.Tq>�� �h�t�'r,�t±l� til ,�'�>�..�� try..y�p;rf'y 7 J '+ �.'� � `_ 7777. J w ��� v,'�1, e �1�T�•��-a V•�V �� I �� {4'ipy k,� �'-`3•r� .tit",h�`�`h.. tA%A��,^�s �F.. t - r! �•,� rJ+'F.1r�{t t{*'�'t �� v..r 1, P r-..i 2�'' ' r1 ;1`� , .,_ • .. _ +�r D � � ;t a'frc{1e�trb"aa4.r�.>•ri� i '4i"; � -�, 4 - - � t �y}T1t D���\T �j 1■I�■ Tn �'� +iF�� y ;�r{ i, r ,. ,� kt.'•p`F�.{•t�A. ..._x"`rF'"^"�4"k�U�/,A�/• � . t � ..r,: I , k rah � t`�g kky � { �,n, . ,} � rrr��o•-o•� P,{ $rSrj�r"ti ",W iA�. /i North Andover Board of Health . Andover Septic 120 Main St. 47 Railroad St. North Andover Ma.01845 Bradford Ma. 01835 Haul Lic. #151-OOH December 2000 Install Llc. # 128-0 Date Name &Address Gallons Comments 12/1/2000 Murphy - 16 Crossbow Lane 1500 12/2/2000 Manzi -.72 Foster St 1000 12/4/2000 Grifin - 240 Candlestick Rd 1500 12/5/2000 Mcilvien - 57 So .Cross Rd 1500 Flooded 12/6/2000 Small - 440 Fosrer St 1000 12/6/2000 Orlando - 274 Foster St 1000 12/7/2000 Weger- 29 Barco lane 1000 12/8/2000 Walton - 161 Bridges Lane 1500 12/11/2000 Coflan - 73 Christian Way 1500 12/12/2000 Orlando - 7 Laconia Cir 1000 12/12/2000 Fitzgerald - Sharpner Pond Rd 1500 12/18/2000 Mangano - 324 Bradford St 1500 12/19/2000 Galea -=L1589 Salem St 1000 12/19/2000 Johnson - 91 Boston St 1000 12/22/2000 Senton - 1620 Turnpike St 1250 Flooded �I p. 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