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Miscellaneous - 2009 SALEM STREET 4/30/2018 (3)
� N 4 C> D v C) r OM M N cn p mi C) -' North Andover Board of Assessors Public Access t ,AO RT1y 1 F T •'s„ Fi Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 North Andover Board of Assessors roperty Record Card Parcel ID :210/108.A-0002-0000.0 FY:2011 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO Click on Photo to Ci Click on Photo to Enlarge Location: 2009 SALEM STREET Owner Name: RICHARDS, GUY N CAROL A RICHARDS Owner Address: 2009 SALEM STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 5 - 5 Land Area: 10.00 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1243 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 382,400 390,400 Building Value: 116,700 124,700 Land Value: 265,700 265,700 Market and Value: 265,700 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkId=1709111&town NandoverPubAcc 5/19/2011 00 r � O O N N 0 0 0 ooXW,Q 'OI J w Co N >N m 0'16 N -;of 6. UL7 U '.- (n C. L) 0 �(UCNCL ;Co yrN C Cl) ami - v0i a S2wUS O N ~ d LL I.. of N w H '>,v I W WAM co W '4 Q i l0 V) :) IN: ;tolii U Oaf tm?ti U' w V h CU Q 1 CO Q Z O` CL i CL' ! � O .,U..�IQ:Of Co;i C C p >i0 -040 f 4) (D a) a) , C l y e Co , Co Co 'l, Co � - W 0 h i N O 0;N �.O G '� H- Oly.fn N:a, r a , U) <-a fn 10 Co'c{c, U - co q ,06 N (U;o,O313 0 D H'f- f -I Q O Z O O O O -I 0 m 01 C J m E E 0 U N Q c Oc o O `c OQ0 LL Z OW `s o J W Z W �Q �u N 0 V y C �I rY d aQ Qe J W ap yNF U Q3d'U-0N. NVQ 20< 0 a y O O N CoLd L6 N fo C� N N U _o N LO O J J U M Y Y 3 ^ o 2 00)o Z 00 W :LL Q '� � r - o LeZ co Co 'o Z(VN c O Z V- O Oho H LL,O0o Q o 0 ?o Lo CC J co MZQ LUN CO LLJ OO'VOO 0" LLOO LLN Q`�rn slam ? 00 V'o' Z CON z O �r p .. ,LL Co ZN'am _ pi} 0 o OD co -0 -0 V ' o; U !W 0) 0) p � 1fn m i O O O O Z in d 2 O O N O ,p00 co M Lf)V �. 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First/Prev 1 1 2 1 3 1 4 1 5 1 6 ext/Last Fiscal Year Parcel ID St.No. Street Owner Name 2011 210/106.13-0058-0000.0 1620 SALEM STREET GUILD, DONALD W, JOAN GUILD 2011 210/106.13-0081-0000.0 1631 SALEM STREET MCEACHERN, DIANA, MCEACHERN, TIMOTHY 2011 210/106.B-0059-0000.0 1634 SALEM STREET ADAMS, BARBARA J, 2011 210/106.B-0082-0000.0 1641 SALEM STREET RUSTUM, RAMI & YOUSSEF, RULA, 2011 210/106.B-0023-0000.0 1689 SALEM STREET SHEA, MARK R, BRENDA A SHEA 2011 210/106.B-0154-0000.0 1701 SALEM STREET NICOLOSI, GUY, NICOLOSI, RENEE 2011 210/106.B-0086-0000.0 1725 SALEM STREET BROUGHTON, WINN, PAIGE, JULIE 2011 210/106.B-0088-0000.0 1749 SALEM STREET DE COSTA, JOSEPH M, HELEN R DE COSTA 2011 210/106.B-0150-0000.0 1756 SALEM STREET AHERN, RAYMOND S, 2011 210/106.B-0089-0000.0 1761 SALEM STREET 1761 SALEM STREET REALTY TRUST, 2011 210/106.13-0149-0000.0 1770 SALEM STREET HANCOCK, LAWRENCE F, MARY E HANCOCK 2011 210/106.B-0090-0000.0 1773 SALEM STREET ALSTERBERG, RICHARD W, C/O HENRY, JAMES 2011 210/106.13-0148-0000.0 1782 SALEM STREET BIANCAVILLA, BRIAN, BIANCAVILLA, KELLY 2011 210/106.B-0091-0000.0 1785 SALEM STREET SWEETRA, RONALD G, CARLA M SWEETRA 2011 210/106.B-0147-0000.0 1794 SALEM STREET WHITLEY, PATRICK H, SHIRLEY R WHITLEY 2011 210/106.13-0092-0000.0 1797 SALEM STREET RAMSDEN, DOUGLAS L, SHEILA C RAMSDEN 2011 210/106.B-0146-0000.0 1806 SALEM STREET BONENFANT, ROBERT A, ELIZABETH A BONENFANT 2011 210/106.B-0093-0000.0 1809 SALEM STREET SEVERIN, JOHN P, SUSAN M SEVERIN 2011 210/106.B-0106-0000.0 1818 SALEM STREET DIXON, SIMON, ANN MARIE ERRICO 2011 210/106.B-0022-0000.0 1850- 1852 SALEM STREET HUDSON, PAUL D, MARIA A HUDSON 2011 210/106.B-0060-0000.0 1895 SALEM STREET ROY 2010 FAMILY TRUST, P. ROY & L. ROY, TRUSTEES 2011 210/106.13-0012-0000.0 1907 SALEM STREET HEYDENREICH, JONATHAN T, MARSHA P HEYDENREICH 2011 210/106.B-0013-0000.0 1925 SALEM STREET CAMMARATA, MICHAEL, 2011 210/106.B-0042-0000.0 1929 SALEM STREET THE R.E RINGDAHL IRREVOCABLE TRUST, CORINNR P. PLOTZ, TRUSTEE 2011 210/106.B-0015-0000.0 1935 SALEM STREET LACHAPELLE, MICHAEL, LACHAPELLE, LAURA 2011 210/108.A-0002-0000.0 2009 SALEM STREET RICHARDS, GUY N, CAROL A RICHARDS 2011 210/106.B-00 14-0000.0 2050 SALEM STREET TAEGER, WILLIAM H, C/O PAULA R. CROCK 2011 210/108.A-0001-0000.0 2051 SALEM STREET RICHARDS, RUTH T, REVOCABLE TRUST 2011 210/108.A-0018-0000.0 1 2053 SALEM STREET RICHARDS, CLEON L, JANE M RICHARDS 2011 210/090.13-0016-0000.0 2177 SALEM STREET GRAHAM, RICHARD, GRAHAM, lVli I FFTT http://csc-ma.us/PROPAPP/newSearch.do?noOwneI-027%3BO84%3BO59%3B 136%3B 1... 5/19/2011 North Andover Board of Assessors Public Access 2011 210/090.B-0044-0000.0 2189 S 2011 210/090.B-0045-0000.0 2201 S 2011 210/090.B-0046-0000.0 2211 S 283 items found, displaying 251 to 283 Page 2 of 2 STREET SKINNER FAMILY REALTY TRUST, EDWARD J. & ROSEMARY, TRUSTEES STREET PERIATHAMBY, ANTHONY R., THIRAVIASAMY, CECILY T. STREET COUGHLAN III, BASIL J, MARY K COUGHLIN First/Prevl 1 1 2 1 3 1 4 1 5 1 6 fNext/La http://csc-ma.us/PROPAPP/newSearch.do?noOwner--027%3BO84%3BO59%3B 136%3B 1... 5/19/2011 SUMMARY OF INVERTS SEWER ® FDTN. 127.52 SEPTIC TANK IN 126.60 SEPTIC TANK OUT 126.33 DIST. BOX IN 126.28 DIST. BOX OUT 126.09 INV. IN CRAM.. 125.97 BOTT. CRAM. 125.67 BUILDING TIES BLDG. CORNER A B C SEPTIC TANK OUT 17.7 24.7 DIST. BOX 22.5 27.4 Y NOTE: '3 THIS PLAN & CERTIFICATION IS NOT A WARRANTY OF THE SUBSURFACE DISPOSAL SYSTEM. IT IS A RECORD OF THE LOCATION AND ELEVATION OF THE EXISTING SYSTEM COMPONENTS. "I HEREBY CERTIFY THE LOCATIONS, ELEVATIONS, TIES, COVER MATERIAL; EXPOSED COMPONENT COVERS ETC., SHOWN ON " THIS AS—BUILT SUBSTANTIALLY AGREE WITH THE APPROVED PLAN AND HAVE DETERMINED THAT THE BREAK OUT ELEVATIONS, IF APPLICABLE, HAVE BEEN MET." APPROVED DESIGNS PLANS. ✓L �BZ/lll� �/�.cL ���tC 't2 �o/i SIGNATURE ' OF DESIGNER DATE CONC. 0RtyMAY f k�g4 41.42 � N F` i � e 4 EAST. ,a t 3 BDRM. AS BUILT PLAN OF �44yr.C'p„ s q - 5.7 Cs \, Sp. ti SUBSURFACE DISPOSAL SYSTEM LOCATED IN NORTH ANDOVER, MASS. /2009 SALEM STREET AS PREPARED FOR GEORGE HASELTINE TM: 108 DATE: 12-2-11 TL: 2 SCALE: l"=40) 0 20 40 80 MERRIMACK ENGINEERING SERVICES 66 PARK STREET ANDOVER, MASSACHUSETTS 01810 PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division Cenificate o f Compliance As of 1Decem6er 20, 2011 TFiis is to cert that a SATIS FACTO T INST EC�l �IOX Was completed for the: fairRMair Zggfitcement o{an On-site Sewage MTosa[S� UW'zam T Sawyer at: 2009 Salem Street Wap-108.A-Tarcel/Lot 2 North Andover, 91IA 01845 The Issuance of this certificate shall not be construed as a guarantee that the On Site Sewage IDisposalSystem willf-unction satisfactorily. z /_1 SulanTSa er, 1REVSk Pu6Cic 9feaftFi Director 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com c NORTH ti&f' A 4S♦l0 l� tiQ / T ,s f PUBLIC HEALTH DEPARTMENT [2HETALTH WN OF NOOTH ANDMIlt Community Development Division DEpARTME r TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM — INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (4/constructed; ( ) repaired; By: (Print Name) Located at: (Installation Address) \ Was installed in conformance with the North Andover Board of Health approved plan, originally dated and last revised on �"—' , with a 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. Bottom of Bed Inspection Date: NOkX,::: Engineer Representative (Signature) And — Print Name tt Final Construction Inspection Date: Engineer Represe tative (Signature) And — Print Name Installer: (Signature) Date: L -Z.2 _1 Enginer• l%�,4o�,r��'2 N46VWA1*(Signature) And — Print Name Date: %2 GLS Zo/r And — Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com 4 DelleChiaie, Pamela From: Isaac Rowe [irowe@millriverconsulting.com] Sent: Thursday, November 17, 2011 9:26 AM To: DelleChiaie, Pamela; 'Daniel Ottenheimer'; 'Peters, Marianne'; 'Randy Burley' Cc: 'Susan Sawyer(ssawyer@townofnorthandover.com)' Subject: RE: 2009 Salem Street - FC Inspection ok'd by Bill Dufresne Attachments: 2009 Salem Street (Existing Dwelling) - Construction Inspection Form 11-16-11.doc Susan, Attached is the inspection form for the above referenced property. As you would expect from Tom, everything looked great. It was what I would hope to find at every inspection. All covers opened and everything exposed for an easy inspection. Please let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone: (978) 282-0014 Fax: (978) 282-1318 irowe@millriverconsulting.com www.miUriverconsulting.com -----Original Message ----- From: DelleChiaie, Pamela[mailto:pdellech@townofnorthandover.com� Sent: Tuesday, November 15, 20113:02 PM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley' Subject: 2009 Salem Street - FC Inspection ok'd by Bill Dufresne -----Original Message ----- From: Bill Dufresne [mailto:wrdufresne@comcast.net] Sent: Tuesday, November 15, 20113:01 PM To: DelleChiaie, Pamela Subject: Pam 2009 Salem Street is ready for final inspection. Thanks Sent from my Bill's i phone Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. l North Andover Health Department (ommunity Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 2009 Salem Street MAP: 108A LOT: 2 INSTALLER: Tom Sawyer DESIGNER: Vladimir Nemchenok PLAN DATE: 9/2/11 BOH APPROVAL DATE ON PLAN: 10/20/11 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11/16/11 DATE OF FINAL GRADE INSPECTION: '� ibj, I SITE CONDITIONS Comments: SEPTIC TANK N/A Contractor reports any changes to design plan ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered ® Building sewer in continuous grade, on compacted firm base N/A Cleanouts per plan ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction ® Water tightness of tank has been achieved by Visual testing ® Inlet tee installed, centered under access port l ® Outlet tee installed, centered under access port (gas baffle & effluent filter) ® 24" inch C.I. cover to finish grade installed over outlet access port ® Hydraulic cement around inlet & outlet Comments: 24" C.I. cover installed to within 6" of finish grade over inlet access port DISTRIBUTION -BOX ® Installed on stable stone base ® H-20 D -Box N/A Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM (General) ❑ Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan N/A 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel -less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers — Low Profile ® Number of chambers per row: 7 ® Number of rows (trenches): 5 Comments: Total Chambers = 35 :d r BM = 127.94 H R = 2.68 Hl = 130.62 SYSTEM ELEVATIONS ROD ELEVATION AS -BLT INVERT ELEV DESIGN INVERT ELEV Benchmark 2.68 127.94 Building Sewer OUT 2.68 127.59 126.70 Septic Tank IN 3.57 126.70 126.50 Septic Tank OUT 3.92 126.35 126.25 Distribution Box IN 3.99 126.28 126.20 Distribution Box OUT 4.14 126.13 126.03 Lateral 1 TOP 4.26 Lateral 1 INVERT 126.01 125.98 Lateral 2 TOP 4.26 Lateral 2 INVERT 126.01 125.98 Lateral 3 TOP 4.25 Lateral 3 INVERT 126.02 125.98 Lateral 4 TOP 4.23 Lateral 4 INVERT 126.04 125.98 Lateral 5 TOP 4.26 Lateral 5 INVERT 126.01 125.98 Top of Chamber 4.24 126.38 126.37 Bottom of Bed/Chamber 4.96 125.66 125.70 }- CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- Waterline 10 10 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other) Foundation 10 (5) 20 (10) ® Drywells 20 25 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA wetland bylaws AS -BUILT CHECKLIST 0� c/ _.�.All.changes to the design plan have been reflected on the as -built Is of suitable scale; (one inch = 40 feet or fewer for plot plans and one inch = 20 or fewer for details of system components) Lot number, Street Name, Assessors Map and Parcel Number Lot Lines and Location of Dwellings served by the system_ - / � ���L%✓� J Locations & Dimensions of system, including r e (if applicable Ties to dwelling or Permanent Structure & Wells a. From Septic Tank b. From Leach Area / Ties to Lot Lines from leach area Locations of Deep Holes & Peres Elevations of Disposal System Top of Foundation Elevation Locations of Wells, Drains, Watercourses within 150 feet of system / Location of water, gas, electric lines, cable ✓ Distances from Comers of House to Center of Tank & D -Box t! Location of Structures within 6 Inches of Finished Grade / Original Stamp & Signature / Location and holder of any easements which could impact the system Impervious Areas; Driveways, etc v North Arrow Location & Elevations of Benchmark used STATEMENT ON PLAN (NA 5.3) "I certify the locations, elevations, ties, cover material; exposed component covers etc. shown on this as -built substantially agree with the approved plan and have determined that the break out elevations, if applicable, have been met. " Signature of Designer Date or, if a STUCTURAL WALL IS PRESENT (NA 4.9) Letter or statement on the as -built indicating the wall was, or was not, constructed in accordance with the intended design and any manufacturer's specifications Signature of Designer Date As of: Wednesday, April 27, 2011 December 6, 2011 Regarding Septic COC, 2009 Salem St North Andover MA 01845 To Whom It May Concern: I, George Haseltine, owner of 2009 Salem St and trustee of the 2009 Salem St Realty Trust understand that the seeding is not a requirement of the State Title V regulations and am I requesting the final grade be conducted prior to seeding. If you have any questions please feel free to call me. George Haseltine 603.785.8768 cell George. Haseltine@gmail.com .rnA, Commonwealth of Massachusetts Map -Block -Lot BOARD OF HEALTH 108.ao002 ------------------ P.I. North Andover Permit No BHP -2011-0815 ---_ F.I.----------------------- - FEE DISPOSAL CORKS CONST ----- $25000 $250.00 RUCTION PERMIT -_ Permission is hereby granted William Sawyer ------------ -- - - to (Construct -NEW SEPTIC SYSTEM) an Indi- - ---------- ---------------------- ------------------------------------------------- vidual Sewage Disposal System. at No 2009 SALEM STREET as shown on the application for Disposal Works Construction --- Permit No. BHP -2011-081 ------------------- ---- Dated November�03 2011 Issued On: Nov -03-2011 -.FI-LE------ -copy BOARD OF HEALTH °.°RTS, Application for Septic Disposal System �r •�'`Construction Permit -TOWN OF ��°• 'A'ORTH ANDOVER. MA 01845 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key v l� Application ipr6r-eby made fora permit to: onstruct a new on-site sewage disposal system* ❑ Repair or replace an existing on-site sewage disposal system* ❑ Repair or replace an existing system component — What? A. Facility Informat'r " City/Town TODAY'S DATE 250.00 u I I $125.00 - Component 2.- *TYPE OF SEr PTUC SYSTEM*: ❑ liu—m—pX ravity oose one) ***If pump , attach copy of electrical permit to application*** ❑ Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. Telephone Number 4eo zoff Name of Company Address Cityrrown [ % State - Zip Code LTelephone Number (Cell Phone # if possible lease) Address R Name of Company ela Z6 - State Zip ode Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 p+bORTh Application for Septic Disposal System 5.9 ,4'iaa Construction Permit - TOWN OF TODAY'S DATE TH ANDOVER, MA 01845 $ 250.00 - Full Repair $125.00 - Component PAGE 2 OF 2 A. Facility Information co'ntinued.... 5. Type Of Build'Ing:esidential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore -described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H 4V/_A Name Date lfkatiorf,Approvetl By Board Health Representative) me Date o Application Disapproved for the following reasons: For Office Use Only: 1. Fee Attached. Yes, 2. Project Manager Obligation Form Attached? Yes 'V 3. Pump System? Ifso, Attach cQRX ofElectrical Permit Yes r�4 foundationAs-Bur'It? (new construction ronly): / (Same scale as approved plan) (. DgFloor Plans? (hew construction only): Yes Yes No No No L� No f No Application for Disposal System Construction Permit • Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: ?- col SV"-LF_M (Address of septic system) Relative to the application of w� i ��A,-en SAw�/�2 (Installer's name) Dated p` o ay s ate For plans by c �-��%`�%�a✓K �+-�'I�-R�? (En ee And dated/ riga aidatee) With revisions dated �, // (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and 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 manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against me and/or my" co_ =any. a. Bottom of Bed — Generally, this is the first (VS inspection unless there is a retaining wall, which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection — Engineer must first do their inspection for elevations, ties, etc. As -built of verbal OK (or e-mail to: healthdept antownofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade — Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of thesl:stem 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, p pes, 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 appr�plans No instructions by the homeowner, general contractor, or any other persons shall absolve me of this oblation. Undersigned Licensed Septic Installer: ame —Print) (Today's Date) Commonwealth of Massachusetts t City/Town of North Andover Form 9A - Application for Local Upg r Opir, M DEP has provided this form for use by local Boards of Health. Other fo ' ` e - information must be substantially the same as that provided here. Before using this form, cy ec wi your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. tab System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information 1. Facility Name and Address: George Haseltine Trustee, 2009 Salem Street Realty Trust Name I cra Zo �� Street Address -�ortt4b'P terry --V G Pr NH 03053 City/ i own State Zip Code 2. Owner Name and Address (if different from above): SAME Name CI %rcwn I Zip c 3. Type of Facility (check all that apply) Zl Residential ❑ institutional 4. Describe Facility: 3 Bedroom House 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) Street Address�� State (603) 785-8768 Telephone Number ❑ Commercial ❑ School ® Conventional ❑ Other (describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): Unknown LUA FORM t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval- Page 1 of 4 Commonwealth of Massachusetts City/Town of North Andover Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: Design flow of proposed upgraded system Design flow of facility: �13. Proposed [upgrade of System Unknown gpd 330 gpd 330 gpd 1. Proposed upgrade is (check one): ® voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: Total Replacement (see plan) 3. Local Upgrade Approval is requested for (check all that apply): ❑ Reduction in setback(s) — describe reductions: ❑ Reduction in SAS area of up to 25%: SAS size, sq. ft. ® Reduction in separation between the SAS and high groundwater: Separation reduction 1.0 Percolation rate Depth to groundwater ft. 7 min./inch 3.0 ft % reduction LUA FORM t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 2 of 4 rY �� Commonwealth of Massachusetts City/Town of North Andover ..Form 9A - Application for. Local, Upgrade Approval �^M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 12 -inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met — describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Randy Burley Evaluator's Name (type or print) Signature C. Explanation 9-12-11 Date of evaluation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Full compliance would result in mounding the system which would also require a pump causing unreasonable financial hardshio 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: NA LUA FORM t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 3 of 4 Commonwealth of Massachusetts City/Town of North Andover Form .9A - Application for Local Upgrade.Approval ^DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: NA 4. Connection to a public sewer is not feasible: None Available 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit ® Complete plans and specifications ® Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other (List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for sub ' ng false information, including, but not limited to, penalties or fine and/or imprisonment ford ate violations.° Georae Haseltine Print Name Bill Dufresne/Merrimack Engineering Name of Preparer 66 Park Street Preparer's address MA/01810 State/ZIP Code 9-22-11 Date 9-22-11 Date Andover City/Town (978) 475-3555 Telephone LUA FORM t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 4 of 4 t ` TOWN OF NORTH ANDOVER NORTh Office of COMMUNITY DEVELOPMENT AND SERVICES 3�`-'+���'•'' �O° HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 ' ° •--»-.. �� NORTH ANDOVER, MASSACHUSETTS 01845 �1ss�C tay 978.688.9540 — Phone Susan Y. Sawyer, REHS/RS 978.688.8476— FAX Public Health Director E-MAIL: healthdeptna.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM Date of Submission: 947-1.1 Site Location: 24MJ WEBSITE: http://www.townofnorthandover.com 7� SES' 28 Z911 TOWN 'OF NORTH ANDOVER HE Engineer: �� .11�i t� � t Q�AAAST EPART_ENT New Plans? Yesz$225/Plan Check # 009 (includes Is' submission and one re - review only) /9 Revised Plans?Yes 75/Plan Check #" " �O— Site Evaluation Forms Included? Yes No 0'70 Local Upgrade Form Included? Yes No v Telephone #:(qVj qjl�-- ?%55L2/ Fax #: E-mail: Homeowner Name: ncL� ,Ii�1 IS OFFICE USE ONLY When the sub mis ion is complete (including check): ➢ t� Date stamp plans and letter ➢ t,//" Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ Enter on Log Sheet and Database U) O ..CL 0) « E L- 0 0 � � � E � 2 CD / cu Q ƒ ) @ � v ( k > r -. O. f. to o = m < E s 0 0 ƒ 0(j) 4)or \E/ c E r — C, . E0 E akk § Lo- U. 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Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. A. Site Information 2009 Salem Street Realty Trust Owner Name 2009 Salem Street Street Address or Lot # North Andover MA 01845 City/Town George Haseltine Contact Person (if different from Owner) B. Test Results State Zip Code (603)785-8768 Telephone Number Date Time Test Passed: 0 Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Bill Dufresne Test Performed By: Randv Burlev Witnessed By: Comments: t5form12.doc• 06/03 Perc Test • Page 1 of 1 9-12-11. 11 am Date Time P-5 Observation Hole # 36" Depth of Perc 10:55 Start Pre -Soak 11:10 End Pre -Soak 11:10 Time at 12" 11:26 Time at 9" 11:46 Time at 6" 20 min Time (9"-6") 7 Rate (Min./Inch) Date Time Test Passed: 0 Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Bill Dufresne Test Performed By: Randv Burlev Witnessed By: Comments: t5form12.doc• 06/03 Perc Test • Page 1 of 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, September 30, 20112:42 PM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley' Cc: Sawyer, Susan Subject: FW: SEPTIC - 2009 Salem Street - Plan Review Application - Map 108.A - Lot #2 - Subdivision #3 Attachments: 20110928154957551. pdf Attached is a new septic plan review application from Bill Dufresne for 2009 Salem Street - Plan Review Application - Map 108.A - Lot #2 - Subdivision #3. Please note that this is a different 2009 Salem Street than the one before. The lot was divided. It is leaving in the mail today. Thank you!:) Best Regards, Pamela DelleChiaie -----Original Message ----- From: noreply@townofnorthandover.com fmailto:norebly@townofnorthandover.coml Sent: Wednesday, September 28, 20113:50 PM To: DelleChiaie, Pamela Subject: SEPTIC - 2009 Salem Street - Plan Review Application - Map 108.A - Lot #2 - Subdivision #3 This E-mail was sent from "RNPOA428C" (Aficio MP C5000). Scan Date: 09.28.201115:49:57 (-0400) Queries to: noreply@townofnorthandover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://AArww.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. TOWN OF NORTH ANDOVER ER Q� JAORT11 Office of COMMUNITY DEVELOPMENT AND SERVICESf', HEALTH DEPARTMENT 1600 OSGt?011 STREET; :BUILDING 20; Sill'I'E 2-36 NORTH ANDOVER, MASSACFIUSE`fTS 01845 Actius 9.18.688.354() — Photic Susan V. Sawq, REUSAIS 978.6$8.8476 FAX Public Healf) Diree(or E-MAfl-:.healthde t t�townofnorthaaidovei cojti WEBSITE: littp:/hvtvw.to�vi►ofi)orthandovet com SEPTIC PLAN SUBMITTAL FORM Date of Submission: Site Location:%,f) ` SEF 283011 TOWN OP NORTH ANDOVER Engineei•�Tr' �I1IAl7hIDEPARTMENT New Plans? Yes $225/Plan Check #_(includes 1st submission and one re- review only) Revised Plans?Yes $75/Plan Check # Site Evaluation Forms Included? Yes No Local Upgrade Form Included? 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Q Q. a) d0 o .r o ❑ M a cl r N axi L. ttf 0 N 0 0 OLO t/1 cn N 0 (fl sr3 o w 2 Q m (0 � •= C 41 o 3 0 0 L J' ,C N N .Q 0 N .m N X � � a� m •� a 0 E 0 o a) a N � Q. rn c ro 0 m 3 � Z O a � � o N c 3 .. o o El N O �p a >, N.N Cu LU m J_ - 'o 3 z o `° 0 N N ow�. o 10 O CL V1 ''^(D V+ vel C9 c O O '�^A .wJ y.. o �O ts O .(n 7 Z 4- >O 0 3 E VULL f E L O — croi .� Ivo Cp N ro U 'c UJ O (0 'O co Ao O r N N X Ulm C) cY M O � ro O c .` 3 tt • Q. .0 ro C µ' �O O a .0 4) U N E N �O GO - U*) > fl U W co + CD v -N 'LO O V +�+ 41 O C 'C W o C (u LO D u a) C) N O M S. C 3 O ro— N CL > C roto (o >,0 G N r U N RfN.r�? Voa.0 fu C: V 'Q)-oo LL 0 w N (D o c o Ro L E d G Z = P oa m cu 0 mm E o 0 roma) eE �- I. Z N O 4) RS t O •a Cl co G C C L6 m C 2 OL CL co aw :C Commonwealth of Massachusetts City/Town of North Andover Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local. Board of Health to determine the form they use. Important: When filling out A Site Information forms on the computer, usa 2009 Salem Street Realty Trust only the tab key Owner Name to move your 2009 Salem Street cursor - do not Street Address or. Lot # use the return key. North Andover MA 01845 Cify/rown State Zip Code ' « Geor a Haseltine (_603)785-8768 Contact Person (if different from Owner) Telephone Number B. Test Results 9-12-11 11 am Date Time Date Time Observation Hole # P-5 - - Depth of Perc 36" _ Start Pre -Soak 10:55 End Pre -Soak 11:10 Time at 12" 11:10 Time at 9" 11:26 Time at 6" 11:46 Time (9"-6") 20 min Rate (Min./Inch) 7 Test Passed: Test Passed: El Test Failed: ❑ Test Failed: El -Bill Dufresne Test Performed By: - Randv Burlev Witnessed By: Comments: l5f6rm12.doc• 06103 Perc Test Page 1. of 1 MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS 0 LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER. MASSACHUSETTS 01810 • TEL (978)475-3556,373-5721 • FAX (978)A75-1448 • E-MAIL: merrenq®aol.com 8 FANEUIL HALL MARKETPILAQE • THIRD FLOOR • BOSTON, MASSACHUSETTS 02109 • TEL (617) 973.6462 • FAX (617) 973.6406 RECEIVED OCT 2 0 2o11 TOWN OF NORTH ANDOVER HEALTH QEPARTMENT _f0 u- Vu PvtK G� � �i %�►�NI ��T r DATE: TO: FROM: RE: CC: 2A 1 N F 1 LT R AT O R® systems Inc. M E M O R A N D U M March 2, 2010 Massachusetts Septic Engineers Kyle Landis, Infiltrator Area Sales Representative NEW Innovative Chamber Announcement - The Quick4 Plus Standard LOW PROFILE (LP) Blake Johnston, Infiltrator Northeast Region Manager Infiltrator Systems Inc. is excited to share our most recent innovation in gravelless chamber technology with the Massachusetts Title 5 system design community- Infiltrator makes it our goal to provide the onsite wastewater community with a full range of products that meet most any system design requirement. With this in mind, we are introducing the NEW Quic1k4 Plus Low Profile (LP) chamber. The'Quick4 Plus Standard LP chamber is similar to its predecessor, the Mass DEP-approved Quick4 Standard chamber, in length (48 inches when engaged) and width (34 inches). The innovative facet of the design is in the height, which has been reduced from 12 inches to 8 inches. For a drainfield situated where a shallow groundwater table, impervious conditions, or other restrictions limit vertical separation distance, the reduced height of the Quick4 Plus Standard LP chamber increases separation distance. Additionally, this design feature provides more soil that can contribute to wastewater treatment between the infiltrative surface and limiting condition. The reduced vertical profile moves infiltration closer to the ground surface, thereby improving the potential for subsoil reaeration from the atmosphere. This promotes oxygen recharge to the biologically active vadose zone beneath the infiltrative surface and helps support aerobic decomposition of wastewater_ With an approved rating of 6-96 square foot per linear foot, the Quick4 Plus Standard LP chamber has the same footprint requirement as the current Quick4 Standard chamber, but allows for even greater design and installation flexibility. low We have included the MassDEP approval letter, product cut sheet, and typical AutoCAD designs. Should you have any additional questions, or would like for me to visit your office to discuss the uses of this new product, feel free to contact me at 866-511-6068. We appreciate you considering Infiltrator's chamber products- As always, we will continue to innovate and support our products to assist with all of your septic system design needs. 6 Business Park Road . P.O. BOX 76B . Old Saybrook, CT 00475 • Phone 880.677.7000 • Fax 880.577.7001 . www.infltmtorsystems.com Infiltrator Modified Approval of Alternative Systems for General Use Page 4 of 7 5. Effective leaching area is equal to 1.0 (3 +(2x invert Height)) for Systems with a width greater than 3 feet. The maximum trench width allowed to calculate effective leaching area is 3 feet. 8. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Table 2 above or additional reductions in soil absorption leaching area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 9. In accordance with 310 CMR 15.240 (6) absorption trenches should be used whenever possible. When the System is installed for new construction without aggregate in a bed or field configuration, as defined in 310 CMR 15.252, the System shall be designed using the effective leaching area for the bottom width presented in Table 3. No system shall be designed and constructed with a leaching area of less than 400 square feet of effective area determined in accordance with 310 CMR 15.252(2)(1). 'fable 3. Effective Leaching Area for Bed or Field Configuration Model Effective Leaching' Area S)~ /LP Equalizer 24 2.08 uick4 Equalizer 24 2.23 uick4 Equalizer 24 LP 6 -inch invert 2.22 uick4 Equalizer 24 LP 2 -inch invert 2.22 Equalizer 36 3.05 uick4 Equalizer 36 3:05 Standard Chamber 4.72 uick4 Standard 4.72 uick4 Plus Standard 4.72 uick4 Plus Standard LP 4.72 Infiltrator 3050 or StormTech SC -740 7.1 High Ca a ity Chamber 4.72 ick4 High Capacity 4.72 7. Effective Leaching area is equal to 1.67 tunes bottom width only_ 10. The System, when installed in a bed or field configuration without aggregate on remedial sites, shall utilize the effective leaching areas presented in Table 3 above or additional reductions in soil absorption system area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction DEVAL L. PATRICK Governor TIMOTHY P, MU1tRA.Y Lieutenant Governor COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENERGY & ENVIR.ONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 021.08 617-292.5500 IAN A. BOWLES Secretary LAURIE BUILT Commissioner mi ssioner MODIFIED ,APPROVAL OF ALTERNATIVE SYSTEMS FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: Infiltrator Systems, Inc. P.O. Box 768 6 Business Park Road Old Saybrook, CT 06475 Trade name of technology and model: High Capacity chamber, Quick4 Mgh Capacity chamber, Standard chamber, Quick4 Standard chamber, Quick4 Plus Standard, Quick4 Plus Standard LP (Low Profile), Infiltrator 3050 (Storm Tech SC -740), Equalizer 24 chamber, Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, and Quick4 Equalizer 24 LP (Low Profile) chamber (Hereinafter the "System"). Schematic drawings of the System and a design and installation manual are attached and made a part of this Certification Transmittal Number: X228042 Date of Issuance: February 21, 2003, Revised August 19, 2005, December 22, 2005, July 24, 2006, July 19, 2007, Modified February 4, 2009, Modified June 30, 2009 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Certification to: Infiltrator Systems, Inc., P,O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein_ Sale and use of the System are conditioned on and subject to compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000 - June 30, 2009 Glenn Haas, Acting Assistant Commissioner Date Bureau of Resource Protection This information is ararratoe in sllernate format. Cs" Donsid K GomrA. ADA Coordinator at 617-356-1057. TDDN;466-539-7622 or 1.617-474-6868• MassDEP on the World Wide Web: http:1twww.ma9s.gov/dep 0 Printed on Recycled Paper DelleChiaie, Pamela From: Randy Burley [rburley@millriverconsulting.com] Sent: Friday, October 14, 2011 1:17 PM To: 'Daniel Ottenheimer'; Grant, Michele; 'Isaac Rowe'; 'Marianne Peters'; DelleChiaie, Pamela; Subject: -St Plan Review (Upgrade for existing hous Attachments: Bill Dufresne Disapprova a er - 9.pdf Hello All, As you may be aware, this is the lot that new construction soil testing has been performed. This particular plan proposes an upgrade to the existing dwelling. The main point of confusion is the loading rate and/or actual model of Infiltrator that is being proposed. I have attached the latest approval off the DEP's website. Keep in mind in this approval letter, Table 2 is for a "trench" configuration and Table 3 is for a "bed or field" configuration, which is being proposed. Feel free to contact me with any questions. Sincerely, Randy Burley Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930 Ph 978-282-0014 Fx 978-282-1318 www.millriverconsulting.com rburley@millriverconsultinsz.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/ore/l)reidx.htm. Please consider the environment before printing this email. t c Commonwealth of Massachusetts Executive Office of Energy & Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 DEVAL L PATRICK RICHARD K. SULLIVAN JR. Governor Secretary TIMOTHY P. MURRAY KENNETH L. KIMMELL Lieutenant Governor Commissioner MODIFIED APPROVAL OF ALTERNATIVE SYSTEMS FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: Infiltrator Systems, Inc. P.O. Box 768 6 Business Park Road Old Saybrook, CT 06475 Trade name of technology and model: High Capacity chamber, Quick4 High Capacity chamber, Quick4 Plus High Capacity chamber (8 -inch invert), Quick4 Plus High Capacity chamber (13 -inch invert), Standard chamber, Quick4 Standard chamber, Quick4 Plus Standard chamber (5.3 -inch invert), Quick4 Plus Standard chamber (8.0 -inch invert), Quick4 Plus Standard LP (Low Profile) chamber (3.3 -inch invert), Quick4 Plus Standard LP (Low Profile) chamber (8 -inch invert), Infiltrator 3050 (Storm Tech SC - 740) chamber, Equalizer 24 chamber, Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, Quick4 Equalizer 24 LP (Low Profile) chamber (6 inch invert), and Quick4 Equalizer 24 LP (Low Profile) chamber (2 inch invert) (hereinafter the "System"). Schematic drawings of the System and a design and installation manual are a part of this Certification. Transmittal Number: X228042 Date of Issuance: February 21, 2003, Revised August 19, 2005, December 22, 2005, July 24, 2006, July 19, 2007, Modified February 4, 2009, Modified June 30, 2009, Modified September 18, 2009, Modified June 30, 2010, Modified March 30, 2011. Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Certification to: Infiltrator Systems, Inc., P.O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein. Sale and use of the System are conditioned on and subject to compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000. David Ferris, Director Wastewater Management Program Bureau of Resource Protection March 30, 2011 Date This information is available in alternate format. Call Michelle Waters-Ekanem, Diversity Director, at 617-292-5761. TDD# 1-866-539-7622 or 1-617-574-6868 MassDEP Website: www.mass.gov/dep Printed on Recycled Paper Infiltrator -chamber. Modified Approval of Alternative Systems for General Use Page 2 of 7 I. Purpose 1. The purpose of this Certification is to allow use of the System in Massachusetts, on a General Use basis. 2. With the necessary permits and approvals required by 310 CMR 15.000, this Certification authorizes the use of the System in Massachusetts. 3. The System may be installed on all facilities where a system in compliance with 310 CMR 15.000 exists on site or could be built and for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the local approving authority, or by DEP if DEP approval is required by 310 CMR 15.000. II. Design Standards 1. The models listed in Table 1 are covered under this Certification. Table 1. Chamber Dimensions Model Dimensions W, x L x H Inches Invert Height Inches Equalizer 24 15 x 100 x 11 6 Quick4 Equalizer 24 16 x 48 x 11 6 Quick4 Equalizer 24 LP 6 -inch invert 16 x 48 x 8 6 Quick4 Equalizer 24 LP 2 -inch invert 16 x 48 x 8 2 Equalizer 36 22 x 100 x 13.5 6 Quick4 Equalizer 36 22 x 48 x 12 6 Standard Chamber 34 x 75 x 12 6.5 Quick4 Standard 34 x 48 x 12 8 Quick4 Plus Standard 5.3 -inch invert 34 x 48 x 12 5.3 Quick4 Plus Standard 8 -inch invert 34 x 48 x 12 8 Quick4 Plus Standard LP 3.3 -inch invert 34 x 48 x 8 3.3 Quick4 Plus Standard LP 8 -inch invert 34 x 48 x 8 8 Infiltrator 3050 or StormTech SC -740 51 x 85.4 x 30 22.25 High Capacity Chamber 34 x 75 x 16 11 Quick4 High Capacity 34 x 48 x 16 11.5 Quick4 Plus High Capacity 8 -inch invert 34 x 48 x 14 8 Quick4 Plus High Capacity 13 -inch invert 34 x 48 x 14 13 I Includes Infiltrator MultiportTm invert adapter attached to the side of the end cap. 2 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All -in - One 8 Endcap. 3 Only systems installed with this invert height shall be allowed to use the effective leaching area associated with this model in Table 2 Infiltrator -chamber. Modified Approval of Alternative Systems for General Use Page 3 of 7 4 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All -in - One 12 Endcap. 2. The System is an open -bottom leaching unit molded from polyolefin resin. It can be installed without aggregate or distribution pipe as an absorption trench in accordance with the requirements in 310 CMR 15.251 or as a bed or field in accordance with the requirements in 310 CMR 15.252. The use of aggregate as specified in 310 CMR 15.247 is not necessary with the System when installed as a trench, bed or field. When designed with aggregate in accordance with 310 CMR 15.253, the System shall be designed in accordance with Section 11 item 11. 4. The minimum separation between any two trenches shall be as specified in 310 CMR 15.251. The requirement that the Chamber installed in trench configuration as specified in 310 CMR 15.253(6) be provided with inlets at intervals not to exceed 20 feet is not applicable to the System. In accordance with 310 CMR 15.240 (13) a minimum of one inspection inlet shall be installed per system. The inlet shall be capped with a screw type cap and accessible to within three inches of finish grade. 6. The total effective leaching area for any Chamber Model shall be calculated by multiplying the Effective Leaching Area per square foot of chamber times the total length of chamber from end cap to end cap including end caps. 7. For new construction, the applicant can size the System in a trench configuration without aggregate, using the effective leaching areas presented in Table 2. No System, however, shall be designed and constructed with a soil absorption system area of less than 400 square feet of effective area. Table 2. Effective Leaching Area for New Construction And Remedial Sites Model Effective Leaching Area SF/LF Effective Leaching' Area SF/LF Equalizer 24 3.76 NA Quick4 Equalizer 24 3.90 NA Quick4 Equalizer 24 LP 6 -inch invert 3.90 NA Quick4 Equalizer 24 LP 2 -inch invert 2.78 NA Equalizer 36 4.73 NA Quick4 Equalizer 36 4.73 NA Standard Chamber 6.53 NA Quick4 Standard 6.96 NA Quick4 Plus Standard 5.3 -inch invert 6.20 NA Infiltrator -chamber. Modified Approval of Alternative Systems for General Use Page 4 of 7 Quick4 Plus Standard 8 -inch invert 6.96 NA Quick4 Plus Standard LP 3.3 -inch invert 5.65 NA Quick4 Plus Standard LP 8 -inch invert 6.96 NA Infiltrator 3050 or StormTech SC -740 NA 6.71 High Capacity Chamber 7.79 NA Quick4 High Capacity 7.93 NA Quick4 Plus High Capacity 8 -inch invert 6.96 NA Quick4 Plus High Capacity 13 -inch invert 7.93 5. Effective April 21, 2006, 310 CMR 15.251(1)(b) maximum trench width is 3 feet. 6 Effective leaching area is equal to 1.67 (bottom width + (2x invert height)) for Systems 3 feet or less in width. '. Effective leaching area is equal to 1.0 (3 + (2x invert Height)) for Systems with a width greater than 3 feet. 8. The maximum trench width allowed to calculate effective leaching area is 3 feet. 8. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Table 2 above or additional reductions in soil absorption leaching area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 9. In accordance with 310 CMR 15.240 (6) absorption trenches should be used whenever possible. When the System is installed for new construction without aggregate in a bed or field configuration, as defined in 310 CMR 15.252, the System shall be designed using the effective leaching area for the bottom width presented in Table 3. No system shall be designed and constructed with a leaching area of less than 400 square feet of effective area determined in accordance with 310 CMR 15.252(2)(i). Table 3. Effective Leaching Area for Bed or Field Configuration Model Effective Leaching Area SF/LF Equalizer 24 2.09 Quick4 Equalizer 24 2.23 Quick4 Equalizer 24 LP 6 -inch invert 2.23 Quick4 Equalizer 24 LP 2 -inch invert 2.23 Equalizer 36 3.06 Quick4 Equalizer 36 3.06 Standard Chamber 4.73 Quick4 Standard 4.73 Infiltrator -chamber. Modified Approval of Alternative Systems for General Use Page 5 of 7 uick4 Plus Standard 5.3 -inch invert 4.73 Quick4 Plus Standard 8 -inch invert 4.73 uick4 Plus Standard LP 3.3 -inch invert 4.73 uick4 Plus Standard LP 8 -inch invert 4.73 Infiltrator 3050 or StormTech SC -740 7.10 High Capacity Chamber 4.73 uick4 High Capacity 4.73 uick4 Plus High Capacity 8 -inch invert 4.73 uick4 Plus High Ca acit 13 -inch invert 4.73 9. Effective Leaching area is equal to 1.67 times bottom width only. 10. The System, when installed in a bed or field configuration without aggregate on remedial sites, shall utilize the effective leaching areas presented in Table 3 above or additional reductions in soil absorption system area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 11. The System, when installed as specified in 310 CMR 15.253: Pits, Galleries, or Chambers, shall have an aggregate base and/or be surrounded by aggregate and shall be sized as specified in 310 CMR 15.253 (1) (a) and (b), effective leaching area is equal to 1.0 times a conventional aggregate system. Effective depth can be increased up to two feet inclusive of invert of the chamber. Bottom width can be increased by two to eight SF/LF with the corresponding addition of one to four feet of aggregate per side. 12. When the System is installed as specified in 310 CMR 15.255: Construction in Fill, the finished 15 foot horizontal separation distance, item (2), shall be measured from the from the top of the chamber. III. General Conditions 1. All provisions of 310 CMR 15.000 are applicable to the use of the System, except those that specifically have been varied by the terms of this Certification. 2. The facility served by the System, and the System itself, shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 3. In accordance with applicable law, the Department and the local approving authority may require the owner of the System to cease use of the System and/or to take any other action as it deems necessary to protect public health, safety, welfare or the environment. 4. The Department has not determined that the performance of the System will provide a level of protection to the environment that is at least equivalent to that of a sewer. Accordingly, no new System shall be constructed, and no System shall Infiltrator -chamber. Modified Approval of Alternative Systems for General Use Page 6 of 7 be upgraded or expanded, if it is feasible to connect the facility to a sanitary sewer, unless allowed pursuant to 310 CMR 15.004. Design, installation and use of the System shall be in strict conformance with the Company's DEP approved plans and specifications and 310 CMR 15.000, subject to this Certification. IV. Conditions Applicable to the System Owner 1. The System is approved for the treatment and disposal of sanitary sewage only. Any wastes that are non -sanitary sewage generated or used at the facility served by the System shall not be introduced into the on-site sewage disposal system and shall be lawfully disposed of. 2. For new construction, the owner initially shall size a soil absorption system in accordance with 310 CMR 15.242 to demonstrate that a conventional Title 5 soil adsorption system using aggregate, including a reserve area, can be installed on the site. The owner may then size the soil absorption system for the System. The total area required for the aggregate system, which may include the area designated for the System, and a reserve area shall be preserved and the owner shall ensure that no permanent structures or other structures are constructed on that area and that the area is not disturbed in any manner that will render it unusable for future installation of a conventional Title 5 soil absorption system. 3. The owner of the System shall at all times properly operate and maintain the on- site sewage disposal system. 4. The owner shall furnish the Department any information that the Department requests regarding the operation and performance of the System, within 21 days of the date of receipt of that request. 5. No owner shall authorize or allow the installation of the System other than by a person trained by the Company to install the System. V. Conditions Applicable to the Company The Company shall notify the Department's Director of Watershed Permitting at least 30 days in advance of any proposed transfer of ownership of the technology for which this Certification is issued. Said notification shall include the name and address of the proposed new owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership, responsibility, coverage and liability between them. All provisions of this Certification applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 2. The Company shall furnish the Department any information that the Department requests regarding the System, within 21 days of the date of receipt of that request. Prior to any sale of the System, the Company shall provide the purchaser with a copy of this Certification. In any contract for distribution or sale of the System, Infiltrator -chamber. Modified Approval of Alternative Systems for General Use Page 7 of 7 the Company shall require the distributor or seller to provide the purchaser of the System, prior to any sale of the System, with a copy of this Certification. 4. The Company shall prepare an installation manual specifically detailing procedures for installation of its System. The Company shall institute and maintain a training program in the proper installation of its System in accordance with the manual and provide a training course at least annually for prospective installers. The Company shall certify that installers have passed the Company's training qualifications, maintain a list of certified installers, submit a copy to the local approving authority, and update the list annually. Updated lists shall be forwarded to the local approving authority. 5. The Company shall not sell the System to installers unless they are trained to install these Systems by the Company. VI. Conditions Applicable to Installers of the System 1. Each Installer shall install the System in accordance with Company training on the installation of the System and the conditions of this Certification. 2. No Installer shall install the System unless the Installer has been trained by the Company on installation of the System. VII. Reporting All submittals of notices and documents to the Department required by this Certification shall be submitted to: Director Wastewater Management Program Department of Environmental Protection One Winter Street - 5th floor Boston, Massachusetts 02108 VIII. Rights of the Department The Department may suspend, modify or revoke this Certification for cause, including, but not limited to, non-compliance with the terms of this Certification, non-payment of an annual compliance assurance fee, for obtaining the Certification by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Certification, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to this Certification, the System, the owner, or operator of the System and the Company. .! P October 21, 2011 George Haseltine 66 Gilcrest Road Londonderry, NH 03053 North Andover Health Department Community Development Division Sent via Email and Regular Mail: george.haseltine@gmail.com Re: Subsurface Sewage Disposal System Plan for 2009 Salem Street (Man 108A, Lot 2) Dear Mr. Haseltine, The North Andover Board of Health has completed the review of the septic system design plans, for the above referenced property, submitted on your behalf by the Merrimack Engineering Services dated September 21, 2011, The design has been approved for use in the construction of a replacement, three bedroom, on-site septic system. This plan is good for 3 -years from the date of approval. During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid. The following local upgrades have been approved. 1. The vertical offset from SAS to the estimated water table from 4 feet to 3 feet This approval is also subject to the following conditions: 1. Please keep the attached DEP Form 9b for your records 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 ✓ O 2009 Salem Street October 20, 2011 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance.of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely, Sus n Y. SaZer,REHPublic Healt cc: Vladimir Nemchenok file encl: Form 9b Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Commonwealth of Massachusetts City/Town of a o Local Upgrade Approval Form 913 M DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. A. Facility Information Important: When filling out forms 1. Facility Name and Address on the computer, use only the tab George Haseltine Trustee, 2009 Salem Street Realty Trust key to move your Name cursor - do not 2009 Salem Street use the return key. Street Address City/Town State Zip Code 2. Owner Name and Address (if different from above): 66 Gilcrest Road Name Londonderry City/Town 03053 Zip Code 3. Type of Facility (check all that apply) ® Residential ❑ Institutional 4. Design flow per 310 CMR 15.203: 5. System Designer: 66 Park St Address B. Approval Street Address NH State 603 785-8768 Telephone Number ❑ Commercial ❑ School gpd Vladimir Nemchenok Name Andover City/Town 1. Local Upgrade Approval is granted for: ❑ Reduction in setback(s) — specify: ❑ Reduction in SAS area of up to 25%: SAS size, sq. ft. x PE RS MA, 01810 State, ZIP % reduction 2009 Salem St 9b 10 20 11.doc • rev. 7/06 Local Upgrade Approval* Page 1 of 2 y « Commonwealth of Massachusetts City/Town of F a Local Upgrade Approval Form 9B GM B. Approval (continued) x Reduction in separation between the SAS and high groundwater: S f d ; 1 epara Ion re ULA U" Percolation rate Depth to groundwater ❑ Relocation of water supply well (explain): ft. 7 min./inch 3 ft. ❑ Reduction of 12 -inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ❑ Use of a sieve analysis as a substitute for a perc test List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: North Andover Health Det Approving Authority Susan Sawyer —October 20, 2011 Print or Type Name and Title Date 2009 Salem St 9b 10 20 11.doc • rev. 7/06 Local Upgrade Approval* Page 2 of 2 o TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, RENS, RS Public Health Director 978.688.9540 — Phone 04i4ff A -1w &r//V1 978.688.8476 — FAX healthde t townofnorthaover. www.townofnorthandover. lcTAwt-ji N!'O-Z ANDOVER HEALTH 1 APPLICATION FOR SOIL TESTS DATE: e z Z yI z o) I / MAP & PARCEL: Li j 4 2— LOCATION OF SOIL TESTS: nf) C/ !�', A I e m 5� . P. 14 n c.10 fi e✓ A A -ec OWNER: SFid2!„�Co �L. lo J'" n Zl T6le— r5 (9 g R& � Se tk1, G !`1e T4 Contact #: 60 y �� 10 �APPLICANT: ADDRESS: &(o2 Cni1Oler C -r (Z4 L101 04d ENGINEER: t q 'Du' rQSPI e— 01E ®3053 Contact #: CY—�V S-02 67-0(o CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing. -IE Undeveloped Lot Testing Upgrade fo ' Addition: In the Lake Cochichewick Watershed? Yes No " THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.511x 11 "Plot plan & Location of Testing (please indicate test pit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent. _ 4z Lo Date back to Health Department: (stamp in): 6 w I +fid BENCHMARKeli \.,w,� BOTTOM WEST CORNER OF STEP ELEVA70N 127.94,` �Vdf)i _ ";s. , aAl" ' y _Ap " IS..e_ .p..>t. V;j t.1 I ,f "•� .n �® �9 1' 1 f /� a. roz. , � * ✓'� I \\ \\ ( r �l�\u 1,113 i \\ \\ \1,t1. r---- \I \ 1-61 \ \ +k "4. 1 I , / I .,x / / 1 I",�,.„ ,�,1 \ �'\ -\' \ \ Y100n �' BENCHMARK �1 1\ t� L 1 j CENTER CATCHBASIN = mr j 1 % I I •,.e J, ul I firs`%r r / li t 1 i l 11� \ n Oho I as +..AIM=98.27 �\ x,sym I / I II / \ I I .� °d / r°✓, i yY , °" \ ) t L, , d>n 1 I✓ �,sz 6/ \ 1 \ 1 I ✓ j 1 I c / S. j. t t i \ g .Ita. iozsd •..y% \ ' ,i / , `, 1 \ 1 , \ fn�5 17",, �.°i � .cE"�+` I,n ,ma f "t'itVtVAX_ t 12 ca FD z z � '� \�� / ✓ " ,,.\ \ 1 \ \ \ \\ ' - � ,a>e gym. Sl ._r'o I �zl \ r \ i .. a, °"� \ \ /�� \ t \ \ \ \ \ � �b,e,/ W�-g 4 •4w. \ � 1_`ioamm. wuna. i\i \ oAm- m •ice • a /„°�� \ \ 1/r,//� 1, 1 ,''� i6>s �✓ ice✓ :,.,.>: �„an — I I I I w.5. /,9w ati I I I I y ✓1 � � �Nro ✓ / l 1 1 12� THIS PLAN RMS TO THE REGULATIONS OOFOTHE REGISTRY ROFEDEEDS cD �I. 7/13/11 STEPHEN I R.L.S. DATE 112 SALEM WOODS NORTH ANDOVER MA DEVELOPER: 2009 SALEM STREET REALTY TRUST 66 GILCREST ROAD—LONDONDERRY, NH 03053 OWNER: 2009 SALEM STREET REALTY TRUST .66 GOREST ROAD—LONDONDERRY NH 03053 SCALE: 1"=40• 0 40 . 80 DATE: JULY 13, 2011 MERRIMACK ENGINEERING SERMCES 66 PARK STREET ANDOVER MASSACHUSETTS 01810 EXISTING CONDITIONS PLAN SHEET 3 OF 6 F r,t TOWN OF NORTH ANDOVER of µOR7y Office of COMMUNITY DEVELOPMENT AND SERVICES o �O HEALTH DEPARTMENT 41 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 -� NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS, RS 978.688.9540 - Phone Public Health Director 978.688.8476 - FAX I ,w,== APPLICATION FOR SOIL TESTS DATE: (P - 7i' 11 MAP & PARCEL: LOCATION OF SOIL TESTS: 7-00 9 �.A L --F- w .com OQN ^ 4011 TOWN OF NORTH ANDOVER --7HF,AUrH DEPARTMENT OWNER: 6) U Contact #: APPLICANT: 60 j% 0gA-'-r1' rg Contact #41zh) 7V7(i 0 -76 ADDRESS: �j D��1 ENGINEER: ted ,j, 6-1^' 1 Contact #: �r( 7g14 -7S "Z2 CERTIFIED SOIL EVALUATOR: Intended Use of La .: esidentia�l Subdivisio Single Family Home Commercial 0 ` I Is This: Repair Testin ndeveloped Lot Testing Upgrade for Addif n: In the Lake Cochichewick Watershed? Yes No - o Cl' i 14x45 THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x 11 "Plot plan & Location of Testin (please indicate test nit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for reaairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approv Date: /I_ Signature of Conserpation Agents L t �s Q Date back to Health Department: (stamp in): 1 �-�5 7�yCVr-""-- ✓ SEE PLAN BY CLINTON GOODWIN, SURVEYOR, DATED JULY 1975 FOR PROPERTY LINES OF THIS SITE. TOPOGRAPHY FROM AN ACTUAL FIELD SURVEY DATUM BASE U. S. G. S. M.S.L. (N. G. V. D.). WETLANDS FIELD DELINEATED BY WEST ENVIRONMENTAL CO. IN 2004, 122 MAST RD. -SUITE #6 LEE, NH, 03824 FIELD SURVEYED BY MERRIMACK ENGINEERING SERVICES INC. THIS S17E IS NOT LOCATED IN THE ESTABLISHED 100 YEAR FLOOD PLAIN PER FEMA COMMUNITY PANEL #250098 0012 C DATED JUNE 2, 1993. INSTALLATION PLANS FOR UNDERGROUND GAS, ELECTRICITY, TELEPHONE, AND CABLE TELEVISION UTILITIES SHALL BE PREPARED BY THE APPROPRIATE UTILITY COMPANY AND SUBMITTED TO THE NORTH ANDOVER DEPARTMENT OF PUBLIC WORKS PRIOR TO INSTALLATION. TOTAL PARCEL AREA= 441, 261 S.F. =10.129 AC. RIGHT-OF-WAY AREA=36,661 S.F. =0.842 AC. TOTAL LOT AREA 404,600 SF. =9.288 AC. 3. DEEDS FROM THE OWNER OF THE SUBDIVISION SHALL RESERVE THE FEE IN ALL STREETS OR WAYS SHOWN ON THE SUBDIVISION PLAN, SUCH FEE TO BE RETAINED BY THE DEVELOPER UNTIL CONVEYED TO THE TOWN. i. NO SOILS ARE INTENDED TO BE EXPORTED FROM SITE. APPROXIMATELY 2000 YDS. OF SOILS SHALL BE IMPORTED AND USED FOR BACKFILL AROUND THE PROPOSED DWELLINGS, THE.SEP77C SYSTEMS AND FOR 77 -IE DRIVEWAY SUBGRADE N li T{i o e -• '�� jUN-2N11 TOWN OF NORTH ANQOVER HEALTH DEPARTMENT PRELIMINARY SUBDIVISION PLAN W NOR'Tarff ANDO�R, MA. PREPARED FOR GEORGE HASEL TINE 66 GILCREAST ROAD LONDONDERRY, N. H. 03053 DA TE. APRIL 7, 2011 REV.: MAY 11, 2011 SCALE: 17-40' 0' 20' 40' 80' 120' MERRIMACK ENGINEERING SERVICES 66 PARK STREET ANDOVER MASSACHUSETTS 01810 PHONE.- (978) 475-3555 FAX: (978) 475-1448 EMAIL- mERREjvG@AOL COAf i06 38 k I i .78. 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J`' ?4,�.'-.. t ..•. j�3.3�J �� � $ �r 3''� � i,�" nY § '42: � / / ��� � t •rte z���'-�. � t 145 X 74.42 "Mi �ii'�?:;�7 ? i Ali. z fix§ DRPTION 145.01 } fix f �` .. i Ak �'=. §•fi 1 \✓ PROP SOIL�AB. *= -- SORPTION ��`•_-;.,=x�..,��;,�=- , S �,SYSTEki" � y' 139.97 OR X 145 r3 'TP lh2,v5 t< �• .. �— y-' •' 1 ! r{! • D� �• � !f is 1133.:fh � �, r �� 1 r +1.17 � •$,. �.�: = r 1 .. . ;?,'?� Jr 2-S �Qp J 1 %-C) `{ it �t i. �' �I �r � ( i l r ! '( � f' 13S'.4a:.1 S s C0 ROq \ r` r l FC ; X .6872 1 i X 148-64 • r :� ; ,, r �� X14?=ems o f/ I 1 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, June 14, 2011 1:29 PM To: 'Daniel O ime�';,--;sane eters, Marianne; 'Randy Burley' Cc: wyer, Susan Subject: Septic - 2009 Salem Street - Conservation Co ments Received - see below Importance: ig _- Follow Up Flag: Follow up Flag Status: Flagged Here are the comments from Heidi Gaffney in Conservation: "Test Pits 0* ... access to sites by driveway only. " Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 2 Office - 978-688-9540 R Fax - 978-688-8476 0 Email - pdellechiaieotownofnorthandover.com '1� Website bM://www.townoftiorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet, "--Anonymous From: Isaac Rowe[mailto:irowe@miliriverconsulting.com] Sent: Tuesday, June 14, 2011 12:21 PM To: DelleChiaie, Pamela Subject: RE: 2009 Salem Street - soil testing Has Bill been notified that this is tentative? If not, he should be ASAP because I am sure he has a contractor already scheduled for tomorrow morning. A determination from the Town (to schedule or not) should be made probably by 3pm at the latest. I have no problem calling Bill if you need me to. Let me know, thanks. Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone: (978) 282-0014 Fax: (978) 282-1318 iroweCcD,millriverconsulting.com www.millriverconsulting.com From: DelleChiaie, Pamela [mailto:pdellech@townofnorthandover.com] Sent: Tuesday, June 14, 201111:58 AM To: 'Isaac Rowe' Subject: RE: 2009 Salem Street - soil testing Please mark as tentative on your schedule until I receive the comments back from Conservation. Thanks. fiat Re"%4, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 2 Office - 978-688-9540 R Fax - 978-688-8476 M Email - ndellechiaie(@townofnorthandover.com -2� Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous From: Isaac Rowe [mailto:irowe@millriverconsulting.com] Sent: Tuesday, June 14, 2011 11:54 AM To: DelleChiaie, Pamela Subject: RE: 2009 Salem Street - soil testing Is there any site plan or sketch that can be emailed over? Did Marianne let you know about this being scheduled? It was on my calendar so I assumed NA was notified. Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street J ' Gloucester; MA 01930-2719 Phone: (978) 282-0014 Fax: (978) 282-1318 iroweCaD-millriverconsulting.com www.millriverconsulting.com From: DelleChiaie, Pamela[mailto:pdellech@townofnorthandover.com] Sent: Tuesday, June 14, 201111:43 AM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley' Cc: 'Bill Dufresne (wrdufresne@comcast.net)' Subject: FW: 2009 Salem Street - soil testing Importance: High Hello Isaac, Just waiting until Conservation can view the site. Will let you know when I receive the feedback. Thank you. fiat Rigaaala, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA 01845 `aZ Office - 978-688-9540 2 Fax - 978-688-8476 2 Email - pdellechiaie@townofnorthandover.com '16 Website http://www.townoftiorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. —Anonymous From: Gaffney, Heidi Sent: Tuesday, June 14, 2011 11:40 AM To: DelleChiaie, Pamela Cc: Hughes, Jennifer Subject: RE: 2009 Salem Street - soil testing I will go today... Heidi Gaffney Conservation Field Inspector Town of Nortli Andover 1600 Osgood Street North Andover, MA 01845 978-688-9530 plione 978-688-9542 fax From: DelleChiaie, Pamela Sent: Tuesday, June 14, 2011 11:39 AM To: Hughes, Jennifer; Gaffney, Heidi Subject: FW: 2009 Salem Street - soil testing Hi, Any updates on this one yet? Consultant was asking, as he is going to seethe soil evaluator tomorrow. This one is a large area, so if you have not gotten to it yet, don't worry about it. Fiat Raganda, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover W. 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 liil� Office - 978-688-9540 Fax -978-688-8476 (] Email - pdellechiaiePtownofnorthandover.com Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous From: Isaac Rowe (mailto:irowe@millriverconsulting.com] Sent: Tuesday, June 14, 2011 11:25 AM To: DelleChiaie, Pamela Cc: 'Susan Sawyer (ssawyer@townofnorthandover.com)' Subject: 2009 Salem Street - soil testing Pam, Do you have the soil testing application1or the above referenced property? I am testing with Bill Dufresne tomorrow and did not see the application in our emails. It is for new construction. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street DelleChiaie, Pamela From: Marianne Peters[mpeters@millriverconsulting.com] Sent: Tuesday, August 30, 2011 11:30 AM To: DelleChiaie, Pamela; Sawyer, Susan; Grant, Michele Cc: 'Randy Burley'; wrdufresne@comcast.net Subject: Soil eval for 2009 Salem Street scheduled for 9/8 @ 9:30 Attachments: 20110815083907497.pdf Soil evaluation for 2009 Salem Street is scheduled for Sept 8th at 9:30 with Bill Dufresne. From: DelleChiaie, Pamela [mailto:pdellech@townofnorthandover.coml Sent: Tuesday, August 30, 20119:50 AM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley' Cc: Sawyer, Susan Subject: FW: Soil Test Application - 2009 Salem Street, North Andover Hello, Please go ahead and schedule this soil testing with Bill Dufresne for 2009 Salem Street. Received back from Conservation today. No comments. VW Req=4, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 9 Office - 978-688-9540 Fax - 978-688-8476 O Email - pdellechiaiePtownofnorthandover.com Website htW:/Avww.townofnorthandover.com/Pages/`index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "— Anonymous From: DelleChiaie, Pamela Sent: Friday, August 26, 2011 12:55 PM To: Gaffney, Heidi; Hughes, Jennifer Cc: 'Bill Dufresne (wrdufresnec@comcast.net)' Subject: FW: Soil Test Application - 2009 Salem Street, North Andover Hello, I was wondering if either of you had a chance to get out to this site, and if you had any comments? Bill Dufrense was asking about it. Thank you. seat RV40 a, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA oi84s 2 Office - 978-688-954o R Fax - 978-688-8476 Email - Rdellechiaiecetownofnorthandover.com -1 Website bnp:/Avww.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous Frahm: DelleChiaie, Pamela Sent: Monday, August 15, 2011 10:03 AM To: Gaffney, Heidi; Hughes, Jennifer Subject: Soil Test Application - 2009 Salem Street, North Andover Here is the right soil test application. O Please let me know your comments when you have a chance and I will forward on for scheduling. I will leave a hard copy for Hei&s reference. Thank you. Sint Reganda, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 2 Office - 978-688-9540 D Fax - 978-688-8476 IZI Email - pdellechiaieotownofnorthandover.com '?� Website hn://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet. "--Anonymous Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: Citta://www.sec.state.ma.us/ore/preidx.htm. 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Received back from Conservation today. No comments. feat Rcgaad4, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 e2 Office - 978-688-9540 R Fax - 978-688-8476 0 Email - pdellechiaie(&townofnorthandover.com '25 Website http://www.townofnorthandover.com/Pages/index "We can never seethe path of our life if we are too busy focusing on the pebbles under our feet. "~—Anonymous From: DelleChiaie, Pamela Sent: Friday, August 26, 2011 12:55 PM To: Gaffney, Heidi; Hughes, Jennifer Cc: 'Bill Dufresne (wrdufresneCdcomcast.net)' Subject: FW: Soil Test Application - 2009 Salem Street, North Andover Hello, I was wondering if either of you had a chance to get out to this site, and if you had any comments? Bill Dufrense was asking about it. Thank you. Vent Rjaada, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 R Office - 978-688-9540 2 Fax - 978-688-8476 O Email - pdellechiaie@townofnorthandover.com '16 Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet "~ Anonymous From: DelleChiaie, Pamela Sent: Monday, August 15, 2011 10:03 AM To: Gaffney, Heidi; Hughes, Jennifer Subject: Soil Test Application - 2009 Salem Street, North Andover Here is the right soil test application. O Please let me know your comments when you have a chance and I will forward on for scheduling. I will leave a hard copy for Heidi's reference. Thank you. Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA o1845 DelleChiaie, Pamela From: Marianne Peters [mpeters@millriverconsulting.com] Sent: Thursday, September 08, 2011 10:12 AM To: DelleChiaie, Pamela; Sawyer, Susan; Grant, Michele Cc: ` 'Randy Burley'; wrdufresne@comcast.net Subject: Soil Eval for 2009 Salem St with Bill Dufresne moved to Monday/Sept 12th Due to the rain, soil evaluation for 2009 Salem Street has now been rescheduled to Monday, Sept 12, same time, 9:30. Thanks! '_ Riever consu Itin Civil Enginn,-.ring i Envirunraf!rttSl PemriiUing Municipal Environmental tdettlth Crtn%ulting Marianne Peters Office Manager 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 Fax: 978-282-1318 www.millriverconsultiniz.com mpeters Camillriverconsulting.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email.