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Miscellaneous - 1620 TURNPIKE STREET 4/30/2018
E S ` u r-fi ��� d' o h N O O � ti o o w C � � 0 113 � A U sodo Q�� z b v O G •� L y 0 3a� . ill A v a L Y � O O 0 0 7 o z q q o d o 0 0 W p N N N ��� W �" FV -a •V]i ti o y o wo to O � u � V A �+ O O iia U 0 c� C E � � 0 Q N O O � d U � U Y O C 3 CD 0 0 0 z N w w w =: O O O w� QQQ W c� �2 z a cl N N cV 00M m N O O O O O -It In z > CD (D C> a oa as ca ti a �ca `'i O •V Q � Vj 0 � A wAv�3aa, G z L. � � h i ~~ c o R A o . ill A v a L Y � O O 0 0 7 o z q q o d o 0 0 W p N N N ��� W �" FV -a •V]i ti o y o wo to O � u � V A �+ O O iia U 0 c� C E � � 0 Q N O O � d U � U Y O C 3 CD 0 0 0 z N w w w =: O O O w� QQQ W c� �2 z a cl N N cV 00M m N O O O O O -It In z > CD (D C> a oa as ca ti a �ca `'i O •V Q � Vj � K I ; \ J � ( ( ! R « \ \ \ 0 ° u z . z 9 c c cd CD \ § \ ) u 2 a b § � 3 2 t § ) § \ / / \ \ j \ \ / g @ @ � ° j f z . ] LTJ ) m 2 § \ / / \ \ / \ \ \ \ \ k k � � � \ \ \ \ \ S k \ \ 0 \ ± r . r - Lot' & Street %loom 7.21 Map/Parcel 16 CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit# l Plan Approval: Date:_3///yk0 Approved by: Designer:gawfj �j D J,4 5(/6_ Plan Date: Z 1E16 Y Conditions: Water Supply: To_yw�), Well Well Permit: Well Tests: Chemical Bacteria I Bacteria II Plumbing Sign -Off: Comments: Driller: Date Approved Date Approved Date Approved Wiring Sign -off: Form "U" Approval: Approval to Issue: YES NO Date Issued By: Conditions: Final Approval: All Permits Paid? YES NO Well Construction Approval? YES NO, Septic System Construction Approval? YES NO Certification? YES NO Other? YES NO Any Variance Needed? YES NO I FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: As Built Plan Satisfactory: YES: Approval of Backfill: Date: By: Final Grading Approval: Date: By: i Final Construction Approval: Date: By: Certificate of Compliance: Approval: Date: ' , a SEPTIC SYSTEM INSTALLATION CONDITIONS: Is the installer licensed? YES I NOI Type of Construction: NEW ' New Construction: Certified Plot Plan Review YES NO, 4 Floor Plan Review YES NO Conditions of Approval from Form U YES NO Issuance of DWC permit: YES NO DWC Permit Paid? YES NO DWC Permit # i Installer: Begin Inspection: t YES NO I Excavation Inspection: ' Needed: Passed: By: Construction Inspection: Needed: As Built Plan Satisfactory: YES: Approval of Backfill: Date: By: Final Grading Approval: Date: By: i Final Construction Approval: Date: By: Certificate of Compliance: Approval: Date: [94 51 'ri4mo FL., .l # 4Cc6oflPiewrTe1.1 1S UOTT A x.11► �. �s'TY O f't►� c '5148 �,u>Z4*c,g 14F .L 4Y-e,'MH. rT is ,o, r_Ecoca OF 1,4 F. Laetb�! AW gi.E~le l vF -rj4L, e�-T1w,6 sY"Irw u�HPo�+�►a tom. RECEIVE, AUG 2 n 2004 TVvvN Or 'JDOVER HEALTH L.UL :'.;T L_a3 zA 1� 0� \ G -377 i to \ \ / • c \( AS BUILT PLAN OF SUBSU-RF44A WCAT ED IN CE DISPOSAL SYSTEM iVORTf/ AN,9VF� /G 20 TUQNT'/LSC ST' AS PREPARED TS.D., /NC. Tiyj lD7B DATE: 6 9• 04 TL /7 SCALE: MERRM4ACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 60 PARK STREET • ANDOVER. MASSACHUSETTS 01810 a TEL (617) 473-3553, 373.5721 �1 J" �t a m Eo N ROOM m A � t e 'ri4mo FL., .l # 4Cc6oflPiewrTe1.1 1S UOTT A x.11► �. �s'TY O f't►� c '5148 �,u>Z4*c,g 14F .L 4Y-e,'MH. rT is ,o, r_Ecoca OF 1,4 F. Laetb�! AW gi.E~le l vF -rj4L, e�-T1w,6 sY"Irw u�HPo�+�►a tom. RECEIVE, AUG 2 n 2004 TVvvN Or 'JDOVER HEALTH L.UL :'.;T L_a3 zA 1� 0� \ G -377 i to \ \ / • c \( AS BUILT PLAN OF SUBSU-RF44A WCAT ED IN CE DISPOSAL SYSTEM iVORTf/ AN,9VF� /G 20 TUQNT'/LSC ST' AS PREPARED TS.D., /NC. Tiyj lD7B DATE: 6 9• 04 TL /7 SCALE: MERRM4ACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 60 PARK STREET • ANDOVER. MASSACHUSETTS 01810 a TEL (617) 473-3553, 373.5721 �1 J" �t a m Eo N r� HERNE I G I'L _� D2 _° c m 0 io C m I G I'L Commonwealth of Massachusetts City/Town of NORTH ANDOVER, MIASSACHUSET' a System Pumping Record Form 4 �N DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: forms on the computer, use only the tab key Address to move your cursor - do not Cityrrown State Zip Code use the return key. 2. System Owner: eT- <S' . Name Address (if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) ❑optic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: P0CA^a� l 6. System Pumped By: Name r--� � Vehicle License Number Company 7. Location where contents were disposed: Sigdature dF Hauler http://www.mass.gov/dep/water/approvals/t5forms.htm#inspect Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 TOWN OF SYSTEM PUMPING RECORD DATE: SYSTEM OWNER & ADDRESS oao <�3�4 JAN - 2 2002 SYSTEM LOCATION (example: left front of house) bu\ -� I , J*4 C6 1 _ ,0a DATE OF PUMPING: ` 1 QUANTITY PUMPED: GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAEN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO. C'' `� ca G System Owner Commonwealth of Massachusetts Massachusetts System Pumping Record System Location 90vfi OF F u� 2 5 i99� Date of Pumping:. ld 0 — a Quantity Pumped: gallons Cesspool: No Yes U Septic Tank: No d . Yes l System Pumped by: V4&d&i 451!0� License Contents transrerrred to : Greater Lawrence Sanitary 121strict Date: Inspector: TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: 4 - 1- 0 9, SYSTEM OWNER & (example: left front of house) vk) DATE OF PUMPING: I . G 9-- QUANTITY PUMPED f GALLONS CESSPOOL: NO ZYES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE /EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) CONTENTS TRANSFERRED TO: �' r DATE: TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD TEM OWNER & --T�� 0 , t6a0'(-)cn�\�e s -(- (example: left front of house) DATE OF PUMPING: UaQUANTITY PUMPED � '" GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) CONTENTS TRANSFERRED TRAN FE �-``^'et v`��e- � S TO. TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: 5/-0a 119 (example: left front of house) DATE OF PUMPING: `� QUANTITY PUMPED CESSPOOL: NO YES SEPTIC TANK: NO NATURE OF SERVICE: ROUTINE OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER EMERGENCY GALLONS YES FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: TOWN OF P` Z� SYSTEM PUMPING RECORD DATE: 1a -3 1 10 � SYSTEM OWNER & ADDRESS —�—'s D 1(' av<--Tu�-�\Okz-e SYSTEM LOCATION (example: left front of house) P-3110 r--4 DATE OF PUMPING: QUANTITY PUMPED: JAN -22V CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G , l,- � s ,. �y GALLONS Q G ,, Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 RECEIVED AUG G5 2013 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use, by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left / Right front of house Left / Right rear of house, Left / right side of house, Left / Right side of building(TO Righ ront of buil I Left / Right rear of building, Under deck Address � � � e � ^(^ ^ � C� � ,( q�� Cityrrown !U ` V ` 1(J States 01' � Zip Code 2. System Owner: SD Name Address (if different from location) Cityfrown State ( � e Telephone Number B. Pumping Record �-i-t3 1. Date of Pumping Date 2. Quantity Pumped 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Other (describe): Gallons ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes ❑�fVo Ifes was it cleaned? y ❑ Yes ❑ No, 5. Condition of. . yst a '2V'1- ,'1 6. System Pumped By.- Neil y:Neil Bateson Name Bateson Entemrises Inc Company 7. Location contents were disposed: F5821 Vehicle License Number C-,) I-.\ -3 Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 1.) ALL FILL TO BE IN CONFORMANCE WITH 310 CMR 15.255 (3). ' 2.) STONE TO BE DOUBLE WASHED AS NECESSARY AND FREE OF IRON, FINES, AND DUST. 3.) THIS SYSTEM IS NOT DESIGNED FOR USE WITH A GARBAGE GRINDER. 4.) REMOVE ALL TOPSOIL, ROOTS AND SUBSOIL AND REPLACE WITH SPECIFIED FILL WITHIN' 5 FEET OF SYSTEM. 5.) COVER MATERIAL OVER. THE SYSTEM SHALL BE FREE OF CLAY,- .STONES, MASONRY, STUMPS, OR WASTE CONSTRUCTION MATERIAL. THE TOP 4" SHALL BE LOAMED AND SURFACE SEEDED. MACHINERY WHICH MAY CRUSH OR DISTURB THE ALIGNMENT OF ` THE PIPES IN THE DISPOSAL AREA SHALL NOT BE ALLOWED. 6.) FOUNDATION DRAINS ARE NOT TO BE 'INSTALLED WITHIN FT. OF THE SEPTIC TANK NOR WITHIN " 6 FT. OF.. THE SOILABSORPTION SYSTEM. 7. PIPING SHALL BE 47. DIA. SCHEDULE ' 40 PVC. 1Ox ) ALL f . G S LL 8.) PROPERTY LINES SHOWN WERE TAKEN FROM EXISTING PLANS ,AND RECORDS; I 9.) THE CONTRACTOR SHALLa`BE RESPONSIBLE FOR:.VERIFYING ''THE EXACT LOCATION OF -ALL:: EXISTING UTILITIES SHOWN OR NOT_.., SHOWN ON. THESE PLANS 10.) TH£: ` CONTRACTOR. SHALL NOTIFY THE$ • D£SJGN ENGINEER 48 HRS r 1N AD'VANCE OF - ' r SYSTEM BACKFILL $0 . •.THAT. -AN AS=BUILT: SURVEY. •.CAN BE ,PERF,ORMED:` 11:) THE. CONTRACTOR SHALL BE``RESPONSIBL.E FOR_'PROVDING'sAN AS -BUILT APLA N SUGh PLAN SHALL ZE INCLUDED PART OF ,THE CONSTRUCTfON CONTRACT: q h,' y!" x 44,5 1"i :,/'.� .,.�v �/ V 4 . -_�Lr, � �� - A:A �-- � U . C � q S ri 0:0 ; .ry .. .. '� � w'� �� ~ (0 r `' ' 1 f F �1 C ✓ F 7UTLETS (/ r �,,.,> �., : , ' t --f Wit. . ►� e �! r , . � A.6 Ie V1.% R'Ctil V bl �t✓�!"y if 1 /► �.GI. q R � jet P LLS J5: zz PIfC LA JV lij �' 4A6,iHI" LA 08eL e y DESIGN CALCULATIONS R G Lori 75 rC 7 5d C DESIGN PERC RATE: L M.P.I. + SOIL CLASS.� DESIGN FOR. LEACH FIELD (SEE DETAIL) LEACHING AREA REQUIRED m C'GAL. x 1/ GPD/S.F. 2S.F. LEACHING AREA PROVIDED: ' WIDE x� ` LONG .= I S.F. r ZOO L I CERTIFY THAT ON MAY 9, 19969 I PASSED THE EXAMINATION APPROVEt3. { 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. ' p SIGNATURE / ' ..s. DATE PLA OF ]]�� . LIS/�j ,=A IN AS PREPARED FOR SCALE. AS SHOW hI VA TE: ;10 - -21.-0 ASSESSORS MAP # LOT 1-7 SUBDIVISION LOT i '6 f � PARK STREET AN100 VFW 11fA,5SACHU,5ETT5 01810. it N b Q Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/RS Public Health Director 978.688.9540 - Phone 978.688.9542 - Fax �ERTIq7ICA7E OF CO-1I�LIANCE As of: .flay 1, 2003 ,his is to cert that the individualsu6surface disposafsystem repaired (X) — EuCCSystem by 9l�tike �iCCy at 1620 Turnpike Street North Andover, 5I1A 01845 has been instaffed in accordance with the provisions of'itfe V of the State Sanitary Code and with the North Andover (Board of 0eafth regulations. 'Fie Issuance of this certificate shaff not be construed as a guarantee that the system wiff function satisfactorify. Sandra Starr Public Yfeafth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 A _ 'oma-ief '� FINAL GRADE INSPECTION Date: Address: ❑ LOAMED? ❑ SEEDED? ❑ COVER PER PLAN? Other: TOWN OF NORTH ANDOVER SEWAGE DISPO; INSTALLATION CERTIFICATION DECEIVED AUG 2 A 2004 Y`SUTNRTH ANDOVER HEALTH DEPARTMENT The dersigned hereby certify that the Sewage Disposal System ( ) constructed; ( grepaired: by located at I &W 1U 912 P1 LE was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # dated , with an approved design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 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: 4- 15. Dpi Final inspection date: y-24-03 Installer: Engineer: iAL - ia zc2dz6_.,[J. Engineer Representative Engineer Represent tive Date: 7-1 J o:1 Date: V/+P/y Sunflower Page 1 of 1 Q Dellechiaie, Pam From: Pamela DelleChiaie [pdellechiaie@townofnorthandover.com] on behalf of Dellechiaie, Pam Sent: Monday, July 12, 2004 2:01 PM To: Dufresne Bill (E-mail); Dufresne Bill (E-mail 2) Cc: Sawyer, Susan Subject: 1620 Turnpike Street - Status of Importance: High Sensitivity: Private I do not have an As Built on this property, or any sign -offs. I would like to put this file to bed, so if you can help me, I would appreciate it. Site testing and subsequent work on this property began in July of 2002. Thank you for your assistance. Pamela DelleChiaie, Health Dept. Assistant Town of North Andover Community Development & Services 27 Charles Street North Andover, MA 01845 pdellechiaie@townofnorthandover. com TeL 978-688-9540 Fax 978-688-9542 0 7/12/2004 Town of North Andover, Massachusetts Form No. 3 NORTp , BOARD OF HEALTH is FA x _ Y "^•,..o��'`� DISPOSAL WORKS CONSTRUCTION PERMIT CMUS, Applicant /�I /� III NAME NAME ✓ ADDRESS TELEPHONE Site Location 16 '0 Permission is hereby granted to Construct ( ) or Repair ( 1-1 an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. Fee` CHAIRMAN, BOARD OF HEALTH D.W.C. No. Lj— 11 OJ �v .7G - V I R UM IL -N 1 HL O 64�J7582 O I performed a short review of the design for this lot. There were many corrections P ecessary in the design, so I consulted with the engineer and made several suggestions. A row design will be submitted. 4./14/03 3113 620 Turnpike Road Installer Mike Reilly had requested a bed bottom inspection. The excavation was four to five feet in depth. No deleterious material was evident, all topsoil, subsoil and stones were removed. There was three to four inches of water in one corner of the bed area. The bottom was scoured nicely, I think he did a good job. A stockpile of good very coarse land was on site, it looked excellent for septic installation. 'Mere are new soil data forma available on -fine. I provided copies of these to Mr. Gala and Mr. Caroulis. These will provide detailed soil information of the site. If you have any questions, please contact me. Thank you for the opportunity to be of :service. Sincerely, r Steven Eriksen P. 02 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: I_�)Sc_'� CURRENT INSTALLER'S LICENSE#. LOCATION: i "o --7:3 !s4 LICENSED INSTALLER: SYr�L SIGNATURE: //fl-c�TELEPHONE#ij q"1-�i"14 )moi CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. ---- --_ Administrative Use Only $175.00 Fee Attached? Yes No a Foundation As -built? Yes No Floor plans on file? Yes Approval No Date: )4VA_ : Q Q INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at j t�a!; N relative to the application of R Q-") dated—g- 1.�� for plans by and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the 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 Grade- Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached b) Inspection of the sand and stone to be used c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other Persons shall absolve me of this obligation. Undersigned Licensed Septic Installer Date -0 a©^� Disposal Works Constructio Pn ermit # la VJ— f MGRTry O L F P �SSACNU A .Town of North Andover, Massachusetts Form No. 2 • BOARD OF HEALTH 1^� DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant /?%%° Ale, Test No Site Location r6o?e5> � �✓�/�� � Reference Plans and Specs. k, e✓16-7' j DA Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. r CHAIRMAN, BOARD OF HEALTH oe Fee Site System Permit No. O. v o _ Town of North Andover, Massachusetts Form No. 2 BOARD OF HEALTH P ... ��' DESIGN APPROVAL FOR js SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Appl;i'cant Test No. Site Location Reference. Plans and Specs. GINEER DESIGN DATE Permission is granted for an individual soil. absorption, sewage -disposal system to be installed. in accordance with regulations of Board of Health. CHAIRMAN, BOARD OF HEALTH Fee W4�9; Site System Permit No.- - Lr 0 m m a AS a , f, O Z z r Z Y O U W a S U F z � 0 0 g a w _U O z C -- U, r+ a. w U Z ¢ �- is W W LL CI W W O O E-- 0 v Z w W > tnx W � Z � ir W m m D Z 0 N w US U 1 -* O e Z N z CO W O a O � i Z C/ J M 7) 0 LO a a CN is-(.) I-, N AT S O w w W a Z o z w cm w a ~ m S U � Lr 0 m m a AS a , f, O Z z r Z Y O U W a S U F z � 0 0 g a w _U O z C -- U, r+ a. w U Z ¢ �- is W W LL CI W W O O E-- 0 v Z w W > tnx W � Z � ir W m m D Z 0 N w US U 1 -* O e Z N z CO W O a O � i Q) SEPTIC PLAN SUBMITTAL FORM LOCATION: 16 2-c NEW PLANS: YES $160.00/Plan 4 REVISED PLANS: I'ES) $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES DATE: j - 2 -� DESIGN ENGINEER: 1-t e rri w4,,,,c V -i - DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. C) ' Jan -27-03 11:07 J P.01 + % , Town of North Andover Office of the Health Department �y Community Development and Services Division 27 Clizrles Street North Andover, A4assachusetts 01845 °a1c�w�• Telephone (978) l"-9540 Sandra Starr E;C��= 0, OF 1.11EA _TH Fax (978) 6M-9542 Public Health Ur.re('tor � _._......_�_ � ...� 1 t � _ ��. _�� Bill Dufresne January 27, 2003 Merrimack Engineering 1L—_ _---j 66 Park Strutt Andover, MA 01810 Re: 1620 Turnpike Street Dear Mr. Dufresne: Please be advised that the Proposed plan dated 10/3112002 for the repair of the septic systetn at. 1620 Turnpike Street has technical deficiencies that must be addressed tx>forethe Flan can be approved. They are as follows: ems' iiginal`stiuup find signature missing. (3 10 CMR 15.220(1 & 2)) ✓Ide ffiication of water service as either pressurc or suction missing. (31 Q CMR .2 4)) ding sewer pipe not laid in straight line. (15.222(7)) No eleanouts preceding alignment changes, (15.222(8)) Please remember that all re-subrltittals require a $60 fee. Feel free to call if you have questions about the content of this letter_ Sincerely, Sandra Starr, Health Director Cc: Mark Benton File pe4 e� D1108Post-tt°' Fax Note 76T t y •.� Frartl `� C - K ' phwe K Fax N �! k1U1RI) 011 API'FAI:i bM t)i,il UUI PINC.i688 9%5 C'UNCF.KVATION 688 9530 KVALTIi SK80140 FL,ANNtNC.T 6Nh-9535 -14 0 0 File Edit Tools Data Maintain Process View Report Gr{1j Windows Help r f �� ❑ (� '� i� ®® � Rj ii f I g AP � BM I CM � CR I, EIS 1[ GL l£ PLv��SM L _ _...I-_ _ JJJJJFg!X Project: 1770 A ��j� Office fthe Health Department 27 Charles Street, North An Billing Group ID: Billing Type: Fixed Fee Billing Fee: 150.00 Card ID: ToNA,�'i,!r ^- _� M.Iin Billing Info Contract Info ClassificationTGLAccoonts J3illin Message. g .- _ - [Alerts 1 Staffing Actiyities Assign To -- Proposal Number. ! ;Department: Contract Number: Ji . Contract Date: 11!22!2002 @ Work Start Date: 11122!2002 II, Expected Finish Date: 12!22!2002 _�I _J] Use Government Invoice Style Description: Engineering services required for Plan Review. Merrimack Engineering! 978-475-3555 66 Park Street, Andover, MA Applicant: TSD, Inc. 1620 Turnpike Street, Assesors Map 1078, Lot 17 North Andover, MA r k ave Close a Client Id: ToNA Project Request Record Town of North Andover Date: Z� Card Id: ToNA Client/Company N e: Board of Health Card. Tyge-Client t Contact Name: Ms. Sandra: Starr Phone: 978-688-9540 '.Title: Director Fax: 978-688=9542' r?,l Address: 27 Charles Street Email: sstarr@townofnorthandover.com F I` Notes: Town: North. Andover f State: MA Zip Code:. 01845 r` -Oilier contacts;if'appicable. i nginee Installer r Naive: 2 /�ii1--moi ��i Phone: ;Title:: Fax: Address: Email: , 1 Notes: �State:. Zip,Code: ' Project: Project Id: 1770 *A Project Title: Town of North Andover. Board of Health (JOB NO) (PROJECT NAME & STREET ADDRESS) Manager: NOW Billing Group: Billing CodJ: Fixed Fee f Contract Info. Project Description .for each, billing group • BG/Applicant T S Assessors Map a7 Lot / :2 Street 40 y 7— Ty pe ~Type of service r;. Office/fonns/jbrqutona O 0 . Town of North Andover o 00RTk a Office of the Health Department O Community Development and Services Division -- 27 27 Charles Street ° 4 - North Andover, Massachusetts 01845 �SSACHUSEjI Sandra Starr Public Health Director Bill Dufresne Merrimack Engineering 66 Park Street Andover, MA 01810 Re: 1620 Turnpike Street Dear Mr. Dufresne: Telephone (978) 688-9540 Fax(978)688-9542 January 27, 2003 Please be advised that the proposed plan dated 10/31/2002 for the repair of the septic system at 1620 Turnpike Street has technical deficiencies that must be addressed before the plan can be approved. They are as follows: • Original stamp and signature missing. (3 10 CMR 15.220(1 & 2)) • Identification of water service as either pressure or suction missing. (3 10 CMR 15.220(4)) • Building sewer pipe not laid in straight line. (15.222(7)) • No cleanouts preceding alignment changes. (15.222(8)) Please remember that all re -submittals require a $60 fee. Feel free to call if you have questions about the content of this letter. Sincerely, Sandra Starr, Health Director Cc: Mark Benton File Post -it® Fax Note 7671 Fate/ Phone # Fax # Fax # s: BOARD OF APPEALS 688-9541 BUILDING 688-9,545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING U�J t t NOONAN & Mc DOWELL, INC. i5 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nmO)conversent.net December 18, 2002 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.A/022 1620 Turnpike Street Assessors Map 107B, Lot 17 Dear Members of the Board, Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated: 10/31/02, By: Merrimack Engineering Services. 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- To ensure adequate uniform distribution to all leaching lines raise D -Box outlet to 96.73 (minimum). 2- Soil logs do not match Board of Health files. ,3=-- Identify water services as either pressure or suction 220(4). --4= Identify the existence, or not, of surface water supplies and public wells 220(4). 5- G.W. separation is not adjusted to highest existing grade, but maybe a static G.W. Verify with Board of Health inspector for soil testing. Respectfully, r' John L. Noonan, P.L.S.-P.E. G: office/tonarev/ 1770. A.022 Land Surveyors Civil Engineers Environmental Planners r ' 7 S e , N & M Job 1770 f% ©z-Z� CHECKLIST FOR NORTH ANDOVER SEPTIC SYSTEM PLANS The following is a checklist that incorporates all Title 5 and local regulations for septic plans. Name of Applicant: .- 5 %%. /N C, Plan Date: / 0,63 O Z Revision Date: Name of Designer: j Via, Date of Review: Z/1 7/( Property Address: 6 zy 77/1-z j✓'P/1S4E- 5 7-- Map: / y-7 3 Lot: BOH Reviewer: /— . /f ' O 767 Type of Plan (new or pgrade Number of Bedrooms in Assessor's Records: gpd) Garbage Disposal Allowed: General Information: N.A. = North Andover Septic Regulations Other numbers refer to Title 5 OK Problem N/A o✓"-' Street number and map/lot - 220(4)(u) Maximum scale of 1 "=40' for plot plan - 220(4) Maximum scale of 1 "=20' for profile and component details - 220(4) f Legal boundaries of the facility being served - 220(4)(a) Names of abutters from recent tax map - NA 8.02j Numbed• of bedrooms, design calcs., - NA 8.02i rte' Name & address of record owner & applicant - NA 8.02k t/ Name & address of designer - NA 8.021 Holder and location of all easements - 220(4)(b) r� bate 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 v Location and elevation of foundation drain - NA 8.02y L- 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 i 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) J Locations and logs of percolation tests - 220(4)(i) Date(s) of soil testing - 220(4)(h) & (i) f 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) '-7 Name of soil evaluator - 220(4)0) --tom Sgil logs and perc test logs match BOH records Lpcations of waterlines, drains, and subsurface utilities - 220(4)(m) Obs6tved 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 f' Cross section of leaching facility - NA 8.02w (Not to scale) Location of benchmark(s) within 50-75 feet of facility - 220(4)(q) Nbte listing all variance requests with proper citations - 220(4)(p) Local upgrade approval request form submitted - 403(1) �-_V1, 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 (Win 400'), pub. wells (w/in 250'), pvt. wells (w/indf50') - 220(4)( Location of watercourses, wetlands, wells, etc. Win 150' of system - NA 8.02r ✓" Wetland disclaimer - NA 8.02s ��� RLS plan reference & certification required (prop line setbacks) - 220(3) desigrreP Use approvals / standards checked for I/A system - DEP docs., 0 O Perc rate >30 MPI - not allowed for new, LUA for upgrade - 245(1)&('3) ✓ Perc rate > 60 MPI - must use modified tight tank or UA 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 Existing system location and note on proper abandonment - 354 Leaching facility at least 1' above Base Flood elevation – NA 9.05 All piping Sch 40 minimum – NA 10.01 —1� Basement floor minimum 1' above groundwater elevation – NA 5.04 Foundation drain present with elevation – NA 8.02y On-site Soil and Groundwater Review OK Problem N/A f as 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 ground elevation el. acceptable soil el. Leach facilitv invert el. ground water el. refusal el. bottom of leach facility el. thickness of acceptable soil before & after soil R&R separation to groundwater separation to refusal soil class perc rate loading rate septic tank below g.w. table pump tank below g.w. table l.f in fill Hole Identification Numbers: v _Setback Distances (Given in feet) 15.211 (yes o no (yes or no) -255(l) 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 4 2 �. v 9 / G a?, t` mea •� �f d v _Setback Distances (Given in feet) 15.211 (yes o no (yes or no) -255(l) 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 4 2 �. Z, Drains (Other) 5 Drywells 20 �-- " Downhill slope 20 10 10 10 100 100 100 400 150 325 400, 200 100 50 20 10 25 15' to 3:1 slope w/o barrier Building Sewer OK Problem N/A Inground pool 10 Slab foundation 10 Pipe schedule listed - 222(3) Deck, on footings, etc. 5 Waterline 10 Pipe laid on compact, fin base - 222(5) Pipe laid on continuous grade in straight line - 222(7) @ _ o_ Private drinking well 75 Cleanout provided every 100 feet - 222(8) Irrigation well 75 Wetlands 75 Invert elevation at septic tank: 9 7 • Z Public well 400 Wetlands bordering surface 150 10' offset to private well or suction line - 222(2) water Supply or trib. (in Watershed) Trib. To Surface Water supply 325 Reservoirs 400 Tributaries to reservoirs 200 Drains (wat. supply/trib.) 50 V Drains (intercept g.w.) 25 Foundation drains 10 Z, Drains (Other) 5 Drywells 20 �-- " Downhill slope 20 10 10 10 100 100 100 400 150 325 400, 200 100 50 20 10 25 15' to 3:1 slope w/o barrier Building Sewer OK Problem N/A `_ ✓ Grease trap required for certain uses (check 230 for details) Pipe diameter listed (4" minimum) - 222(1) L_ Pipe schedule listed - 222(3) 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) @ _ o_ 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: ? " / �-" Invert elevation at septic tank: 9 7 • Z Length of run: Slope: ' 6 A Ps:" (minimum of 0.01 - 0.02 desired) - 222(6) 10' offset to private well or suction line - 222(2) 3 3 4 Septic Tank OK Problem N/A y^ Tank is accessible - 228(3) No structures above tank - (228(3) �L Tank can accommodate both primary & reserve - NA 9.04 200% of flow (required & provided given. 1500 min.) - 220(4)(f) & 223)(1)(a) eG 2-3" drop from inlet to outlet - 227(5) Minimum of 4' liquid depth - 223(2) 1c 3" air space above tees/baffles (minimum) - 227(4) _ 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) —o- 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) E` 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) Tank is watertight - 221 (1) G-- 9" of cover over tank (minimum) f 2280 H- 10 loading (min.) - H 20 if traffic - 22b(43 below Top of tank <=36" grade - 221(7) v=— 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: ) )�K Problem N/A / Inlet elevation:��� 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 -'::3 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: __------Z20(4)(r) Pump on eleyaii 220(4)(r) Puelevation: 220(4)(r) arm 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 Pressure dosed l.f. if flow >= 2,000 gpd - 254(1)(a) & 254(2)(a) Cycles per day is consistent with chamber volume - 23 1 Volume calculations include flowback volume - 2') 1(2) 24 hour storage capacity above pump on elevation - 231(2) Number of pumps: 2 if system serves >2 dwelling units - 231(6) Capacity of pump(s) - gpm ' TDH - 220(4)(r) Pump can pass 1 1/4 "solids mum) - 231(7) Pump controls specifj �220(4)(r) Alarm equipments ecifled - 231(2) Alarm is in building and powered on separate circuit from pump - 2') 1(9) Pump sepece correct (off -lead on -lag on-alan-n on) - 231(8) Pump performance curves included - 220(4)(r) ]Manual operating switch - NA 12.01 Check valve, bleeder hole - NA 12.01 1 childproof, 24" riser/manhole to final grade - 1(5), Soil compaction beneath pump chambe ecified (if soil is non-native) - 221(2) 6"of <=3/4"stone beneath chmbr� cified - 221(2) & 228(1), Buoyancy calculations if ch der is at or below water table - 221(8)@ 9" of cover over ch minimum) - 228(1) H- 10 loading (min.) - H-20 if traffic - 226(')), Chamber is watertight - 221 (1) Top of chamber <=36" below grade - 221(7) Leaching Facility (general - complete for all designs) OK Problem N/A e�- f 50% larger if garbage disposal - 240(4) Trenches to be used whenever possible - 240(6) No vehicle or imperv. area above 11 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) 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 11. GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005 - 251(9) Require T removal and replacement if in fill - 255(5) Top of leach facility <= 36" below grade - 221(7) Final grade over l.f. 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 �:1 slope where grading required - 255(2) Toe of fill slope stops T from property line or swale installed - 255(2) Impermeable barrier if < 3:1 slope or < 15 feet to—3:1slope - 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 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, or connected together - 251(9) Pressure dosing guidance followed if pressure distribution - 254(2)(c ), Pressure dosing required over 2,000 gpd or with I/A remedial use - 231(1) Leaching Trenches (Check here if not present: ) . OK Problem N/A Number of trenches: / Minimum of 2 tzendies - NA 9.01(2) Depth of trenches (max eff. 2'): -247(l) Width-crtrenches (2' min., 4' max.): - 251 (1)(b) Wh�th 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 �h.- m1 (1)(d) In fill or reserve between trenches, 1 A 14.01& 14.03 Available leach area given (M' . 0 s. 9.01(2) Bottom = L x W x # — s.f. Sidewall= Lx D x # x 2 = s. f. Effective leach /area given Lpading factor:— ffective area = total area s.f. x LTAR =fid ffective area is >= design flow 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 wa stone - 247(1) Leach Fields (Check here if not present: ) OK Problem N/A / 6` - Length (100' max.): 450 - 252 (2)(b) Number of trenches: / Minimum of 2 tzendies - NA 9.01(2) Depth of trenches (max eff. 2'): -247(l) Width-crtrenches (2' min., 4' max.): - 251 (1)(b) Wh�th 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 �h.- m1 (1)(d) In fill or reserve between trenches, 1 A 14.01& 14.03 Available leach area given (M' . 0 s. 9.01(2) Bottom = L x W x # — s.f. Sidewall= Lx D x # x 2 = s. f. Effective leach /area given Lpading factor:— ffective area = total area s.f. x LTAR =fid ffective area is >= design flow 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 wa 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.): 450 - 252 (2)(b) Width: 0 r ,, Total area: L -05-0 x W f. Minimum 900 square feet - NA 9.01(1) Distribution lines connected with solid pipe — NA 15.01 Effective leach area given ✓ Loading factor: • low Effective area = total area AA 6 Al x LTAR g/dav �^ Effective area is >= design flow of facility being served Minimum of two distribution lines - 252(2)(a) t� 6' line separation (max.) - 252(2)(d) v 4' maximum separation from edge of field to line - 252(2)(e) Lam' 10' minimum separation between adjacent leach fields - 252(2)(f) �c 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) �c Grading shall divert drainage away from leach area — 240(l 1) Grading slopes away from dwelling 5/24/01 f./office/forms/tonackltr.doc 6 Location: Ztf �I,jVA I Owner's Name: MA _. Map/parcel:_ Irl � � 1-7 Address: �Llj�) Installer. Tel �:�G�.-� c��j New tso Repair_ Date:- 16% 'ti% WetlandsZh ne II --Soil Symbol4- 2 --Soil Rime Soil CI F Class Deep Observation Hole Logs Elevation Depth Soil Horizon Soil Tenure Soil Color Soil hiottlin; %Gravel, Stones, etc F1 i.L GVet-. . s97- t;3011 6h ��G �°Y��� Lia 46 Parent Material +1 uv De th to Bedrock* P "� Blandin; s_� g.. \Yater in the Hole: W-Plnt from Pit Face ICy 51-01 075 Z-'SY y�Z 51 Parent Material Depth to Bedtoclt �standin• \Yater— in the Holr.�Vu i � eepinp from Pit Face _L�¢__ESHGIY:,�_ Date Percolation Tests Observation Hole # ,. Depth of Perc Start Pre-soak l Time at 12" Time at 9 Time at 6" Time, (91._ 6to -Rate b1imanch •. • I I Performed BY:_�, V U �Witnessed Bv: . JI 0 P_ -SOL=. i (ON :20-1 —1 otvl mac- i, : Cj-_,,-.0 i T: iNl � C = -Z 4\ctp_ ini[ltrcl; d j j iME itME S NEXT C.-. . .r.^.. i i NI 0 r, 4 OMFA MN O BOARD OF IIEEALTH Q NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: MAP & PARCEL: lo -7 17 LOCATION OF SOIL TESTS: OWNER: -r* p 115 e'- TEL. NO� ADDRESS: 11,7,0]���ti: ENGINEER: H 1K ILI EMr,, nXjlQffiTEL.NO.: 0.7,9 CERTIFIED SOIL EVALUATOR: 6 L� �✓�� Intended Use of Land: Residential Subdivision Single Family Home !Omme2a Is This: / Repair Testing: L/ 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 $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 $200.00 per lot for repairs or upgrades. (If time is not critical, fee for repairs is $75.00) 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: % 7/4,9 Check Amount: ✓ Check Date: 7l6/ o a� Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH s� F q4, Q STLED ,bx Q o :_ m o '°A.EEw APPLICATION FOR SITE TESTING/INSPECTION �9SSACHUS�S ApplicantL����/VC NAME A;DDpRE,SSI TELEPHONE Site Location Engineer�E.ryr>�ac.���v��-���e_ Test/Inspection Date and Time f'l &61), T d��, �d�Q� /n 'C MAN, BOARD OF HEALTH Fees Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. w' • ' NORTH 3�O� qti ��t`ED /646 OI Applic Site Location own of North Andover, Massachusetts Form No. 1 BOARD OF HEALTH / 71 7 APPLICATION FOR SITE TESTING/INSPECTION Engineer de rp V, )Qc� 1��ff NAME ADDRESS I tLtrHUNt Test/Inspection Date and Time 11i o k SEPTIC PLAN SUBMITTAL FORM LOCATION: I ZO I wL.tj Vi LA% e:;7 -T NEW PLANS: $160.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: (`YES/ NO DATE: DESIGN ENGINEER:M t2jj W���/�� JLjj� DATE TO CONSULTANT: / When the submission is all in place, route to the Health Secretary. (1) BOARD OF HEALTH Q NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: & PARCEL: [ o 7 03, LOCATION OF SOIL TESTS: OWNER: '�' i� i �� TEL. NO(q 7 q Lf , J ADDRESS: 1(7 UyetJ rl VA;-_ !21� , t� ENGINEER: TEL. NO.: IP CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Is This: Repair Testing: (/ Single Family Home (�!mme 'al 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 $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 $200.00 per lot for repairs or upgrades. (If time Js not critical, fee for repairs is $75.00) GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Register -.ed 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: eck Date: MANUA,•.. AM— - DACE OF INSP►caN:,... .1SAU Location:—Al,—Z.10 Owner's Name: I M�nr. Map/Parcei:_ _ ] —7 Address: I&J,4 Installer. Tel : New ("-")—.Repair V" Date: &-Wetlands 7jL&}Ane II -- Soil Symbol4 Soil Rime Soil Class - Deep Observation Hole Logs FEICN-Ation Depth Soil Horizon Soil Tcaure Soil Color Soil Mottlin; %Gravel, Stones - et c. b-(vl N Fi 71 .87 L• s• Z. 5`3 z 5; Y' s% MAG=I v E- Fh Parent Material +1 ty -Depth to Bedrock- "'-- Staadin• �Yarer in the Hole: �• W.cpin; from Pit $�� Face ��_ESHGIY.•�7_' _ CL F, 0 Z,I'thZ — 06, Ivt� r L.�,. t ��� fa&ae'73 !44*1:4vt;-r�� 51 WZ, Parent MaterialDepth to Bedrock; -- Standing. Water In the Holr. Wec*.- from Pit Face�_.t ESHG%V. Date Percolation Tests Observation Hole # Depth of Perc Start Pre-soak- rti soakTime Timeat 12" ( Time at 9 I Time at 6" Time (9"-6") I Rate Min/Inch I Performed Br-I�f � i u Witnessed By:—f Pe7rLp C 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 DateZZa Z 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/ 7;r ; `Z_ Assessors Mapl.22 153 , Lot 1_ Dear Members of the Board, Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated / //0, Z, 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: l//'iCt7GZ17 iQ -tel r> c- Gc�G S /tea �v�i /7"Z1�'/� % a %� fre- e_ S �Z $� ✓�� Q Z S cis= �! c� cel -2 0 6.) Sde�s�c� tv�r�z r✓��L/ S tea+ O Pv�LfG Gv�z�S tsr Respectfully, z 2 e;, NV T it®f�U; T�b'� J`v /�/G/�'c�c %— G= V fi d1 T f '/ Gem 7-1-1 John L. Noonan, P.L.S.-P.E. G: office/forms/tonarev Land Surveyors Civil Engineers Environmental Planners OC 7-1 Vit: 60 COL=. 710 N i .0 ► i 0INI mac= i =f Cr C I- = _=-� I _ . ' _._ ,a THVIE i Divi= TlviE i ;. 4 ,2 � x 00, Y , i 1 � ` 6 t }�S 1; i= q� y' f f 1 - A.e P Az f1 r, /l{,J Ili ..+VV Y ••• \ ... - . ove OF iNSPE ODN:_..egn-..- r N I a M \ � I �C.1! • Af t j TOUi;zm Pr k E. s-recE r1 r. •. i I. 1 � -riy Z' I NATHIA STAt91HAT IN MY PAOFMIdNA North Andover Board of Health 120 Main St. North Andover Ma.01845 Haul Lic. #151 -OOH Install Llc. # 128-0 Date Name & Address 12/1/2000 Murphy - 16 Crossbow Lane 12/2/2000 Manzi -72 Foster St 12/4/2000 Grifin - 240 Candlestick Rd 12/5/2000 Mcilvien - 57 So .Cross Rd 12/6/2000 Small - 440 Fosrer St 12/6/2000 Orlando - 274 Foster St 12/7/2000 Weger - 29 Barco lane 12/8/2000 Walton - 161 Bridges Lane 12/11/2000 Coflan - 73 Christian Way 12/12/2000 Orlando - 7 Laconia Cir 12/12/2000 Fitzgerald - Sharpner Pond Rd 12/18/2000 Mangano - 324 Bradford St 12/19/2000 Galea -= 1589 Salem St 12/19/2000 Johnson - 91 Boston St 12/22/2000 Senton = 1620 Turnpike St Andover Septic 47 Railroad St. Bradford Ma. 01835 Gallons Comments 1500 1000 1500 1500 Flooded 1000 1000 1000 1500 1500 1000 1500 1500 1000 1000 1250 Flooded December 2000 TOWN OF NORTH ANDOVER. q QF "�oAA SYSTEM PUMPING RECORD"51-2:5 e�5 ° -- ` DATE: 1 --CSL{ _S� D b a 0, -Tu �n (example: left front of house) FJ Li DATE OF PUMPING: 7F QUANTITY PUMPED 0�� GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER EMERGENCY SYSTEM PUMPED BY: G)c�-�V,\ COMMENTS: CONTENTS TRANSFERRED TO: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Locatiam Address l V v City/Town 2. System Owner: Name (if different from location) D-cy N(-� State Zip Code Citylfown StatZip Code L_F- [ � Telephone Number B. Pumping Record 8 -0 % 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other (describe): ,� 4. Effluent Tee Filter present? E] Yes LAN- If yes, was it cleaned? ❑ Yes ❑ No 5. Condit System: 6. Syste P mped By: Name Vehicle License Number Company 7. of Hklef Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 Commonwealth of Massachusetts City/Town off . RECEIVED System Pimping. Record JUL 16 2015 Form 4 TOWN OF NORTH ANDOVER � t�ALTEtR7MENT DEP has provided this form for use -by Foca oa s o Health. Other forms may be'used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility. Information 1. System Location: Left / Right front of house Left / Right rear of house, Left / right side of house, Left / Right side of buildin , eRigh r n of buildin , Left / Right near of building, Under deck Address JI� c-�o �� Cy/Town L/ State Tip Code 2. System Owner. Name Address (4 different from location) CiVrown Stag Zip Code ; � r'a Telephone Number 3 � B. Pumping 1. Date of Pumping rd 3. Type of system: ❑ ❑ Other (describe): Date Cesspool(s) — 2. Quantity Pumped eptic Tank Gallons i ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes 9-4 O If yes, was it cleaned? ❑ Yes ❑ No: 5. Condition of, til ice- 1�`-'/ - r �V 6.- System Pumped By: Neil. Bateson Name Bateson Enterprises Inc Company 7. Location where contents -were disposed: Waste Water F5821 Vehicle License Number Date t5form4.doc• 06/03 System Pumping Record •Page 1 of 1