HomeMy WebLinkAboutMiscellaneous - 263 CANDLESTICK ROAD 4/30/2018 (2)C)
Lot & Stree Map/Parcel
CONSTRUCTION APPROVAL
Has plan review fee been paid: (�YEDS
Plan Approval: Date:
Designer:
Conditions:
Water Supply: Town Well
Well Permit: Driller:
Well Tests: Chemical
Bacteria I
Bacteria 11
Plumbing Sign -Off:
Comments:
NO Permit#-&?-,—?
Approved by:
Plan Date:
Date Approved
Approved
Sign -off:
Form "U" Approval: Approval to Issue: YES NO
Date Issued By:
Conditions:
Final Approval:
All Permits Paid? 0 NO
Well Construction Approval? YES NO
Septic System Construction Approval? CY-TE-$) NO
Certification? �Irs NO
Other? YES NO
Any Variance Needed? YES NO
FINAL BOARD OF HEALTH APPROVAL:
DATE:
APPROVED BY:
SEPTIC SYSTEM INSTALLATION
CONDITIONS:
Is the installer licensed? <:jED N
Type of Construction: NEW EPAIR
New Construction: Certified Plot Plan Review YES NO
Floor Plan Review YES NO
Conditions of Approval from Form U YES NO
Issuance of DWC permit: NO
DWC Permit Paid? NO
DWC Permit # Installer:
Z
Begin Inspection: NO
Excavation Inspection:
Needed:
Passed: IIIADIOZ- By:
Construction Inspection:
Needed:
As BuiltPlan Satisf ctoryl
YES: "V �-, � t 1 -2, 74 6-***�
Approval of Backfill: Date: By:
Final Grading Approval: Date: 0-7, By:
Final Construction Approval: Date: By:
Certificate of Compliance: Approval: Date:b\
Town of North Andover, Massachusetts Form N773
,40RT#1 BOARD OF HEALTH
0 -11
4491
d d DISPOSAL WORKS CONSTRUCTION PERMIT
U
Applicant
Site Locat
Permission is hereby granted to Construct or Repair an . I nclividual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. I /'/ Y K -
CHAIRMAN, OARDOFHEALTH
Fee-�Z/�dl D.W.C. No.
AS -BUILT CHECKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIM[ENSIONS OF SYSTEM,
INCLUDING RESERVE
TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
ORIGINAL STAW & SIGNATURE
INTERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
LOCATION & ELEVATIONS OF BENCHMARK USED
Town of North Andover, Massachusetts Form No.1
01 14ORTH BOARD OF HEALTH
0
'"W4141
APPLICATION FOR SITE TESTING/INSPECTION
'�S CHUS
Applicant J cb o Ve roaz>cc,
NAME ADDRESS TELEPHONE
40
Site Location ro
Engine
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time-
CH- I RMAN, BOARD OF HEALTH
Fee— Test No.-
S.S. Permit No.-D.W.C. No.-C.C. Date-Plbg. Permit No.
Town of North Andover, Massachusetts Form No.1
v%ORTH BOARD OF HEALTH
';U V&
j
0*
_4V_
0
APPLICATION FOR SITE TESTING/INSPECTION
CHU5
Applicant 'J'J' Ve
NAME ADDRESS TELEPHONE
Site Location 4P�ICLY
E n g i n e e rLv/—z—/ 4,
Test/I nspection Date and Time—fi��/
CnAIRMAN, BOARD OF HEALTH
Fee Test No.
S.S. Permit No.—D.W.C. No.—C.C. Date—Plbg. Permit No.
BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR SOIL TESTS
DATE: MAP & PARCEL:
LZJ2
LOCATION OF SOIL TESTS: I,&-
&! - - . A401. &P,
OWNER:JWQ'� Dir -JA VL1r9jMz!v TEL. NO.:
ADDRESS:
ENGINEER: TEL. NO.:
CERTIFIED SOIL EVALUATOR: V
--- A 1j,
Intended Useof Land: Residential Subdivision me Commercial'
Is This:
Repair Testing: 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 o
gpgrades. (If tirne.is not critical, fee for repairs is $75.00)
GENERAL INFORMATION
I . Only Certified Soff 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 I "-100') shall be submitted to the Board
of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval:
Date Received: Check Amount: Check Date:
Town of North Andover, Massachusetts Form No.2
VtORTh BOARD OF HEALTH
P44)
60
DESIGN APPROVAL FOR
SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicanj�dLQ ]CLIA1 V&ZX,4j::j�� Test No
Site Location 4Z-42 !! � �6 7 -'-/ CK —ZA
Reference Plans and Specs
NGINEER
DESIGN
DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
Fee — 1;&c/ -Z
CHAIRMAN, BOARD OF HEALTH
Site System Permit No.
C-1
7-10 f\l.
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62 0 H., I/ V; _1N
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SOTTOM DE-T�-'' :zT- 3 t
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T N 1. E
SEPTIC PLAN SUBMITTAL FORM
LOCATION: Z- 4- -7--" /?-P.
NEW PLANS: YES $160.00/Plan
REVISED PLANS: ('VES,/) $ 60.00/Plan__5��'e& 7
SITE EVALUATION INCLUDED: YES
DATE: ((v
DESIGN ENGINEER:
DATE TO CONSULTANT:
When the submission is all in place, route to the Health Secretary.
TC..�445NORPT7AQU,
BOARD OF HEALTH
OCT I I
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Public Health Director
Bill Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 0 1810
Re: 263 Candlestick Lane, North Andover
Dear Mr. Dufresne:
Telephone (978) 688-9540
Fax (978) 688-9542
October 7, 2002
Please be advised that the proposed plan dated 9/23/2002 for the repair of the septic system at
263 Candlestick Lane has technical deficiencies that must be addressed before the plan can be
approved. They are as follows:
• Locations of the percolation tests are missing from the plan. (3 10 CMR 15.220(4)(i))
• No elevations for percolation tests and none current. (N.A. 8.02n)
• Missing note on variance requests. (3 10 CMR 15.220(4)(p))
• No Local Upgrade Approval Form (310 CMR 15.403(1)) .
• Need original P.E. stamp, signature and date. (3 10 CMR 15.220(l) & (2))
• Locate existing septic system on site plan. (310 CMR 15.354)
• Please indicate that there is a minimum of 3" of air space above tees/baffles in the septic
tank. (310 CMR 15.227(4))
• With a 2 MPI percolation rate, the separation to groundwater shall be a minimum of 5'
unless a variance is granted by the Board of Health. (3 10 CMR 15.212(a) & (b))
• If a variance is requested, it must be listed on the plan.
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: File
BOARD OFAPPEALS 688-9541 BUILDENG688-9545 CONSERVATION11698-9530 HEALTH688-9540 PLANTNNIG688-9535
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: Y,6(1114,5 co
Plan Date:
RevisionDate:
Name of Designer: 7 X),--IEVS�
Date of Review:
Property Address: — e /6aJbz"q-5 71cic- - Map: Lot:
BOH Reviewer: 7;W- - Type of Plan (new or upgrade):
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
K Problem N/A
Street number and map/lot - 220(4)(u)
Maximum scale of I "=40'for plot plan - 220(4)
Maximum scale of 12'=20' -for vrofile and component details - 220(4)
Legal boundaries of the facility being served - 220(4)(a)
t7" Names of abutters from recent tax map - NA 8.02j
Number of bedrooms, design calcs., - NA 8.02i
Name & address of record owner & applicant - NA 8.02k
Name & address of designer - NA 8.021
Holder and location of all easements - 220(4)(b)
Date plan drawn & any revision date - NA 8.02m
V 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 8.03 a -c
Elevation of proposed driveway - NA 8.02t
=----Location and elevation of foundation drain - NA 8.02y
Location and dimensions of the system incl. reserve (new const.) - 220(4)(e)
Limits of excavation of leach area on site plan - NA 8.02z
Locus plan - 220(4)(t)
North arrow - 220(4)(g)
Existing and proposed contours - 220(4)(g)
Locations and logs of deep holes - 220(4)(h)
Locations and logs of percolation t6sis- -',220(4)(i)
Date(s) of soil testing - 220(4)(h) & (i)
Existing grade elevation of each deep hole - 220(4)(h)
ekle-�ation of percolation tests — N.A. 8.02n
Name of approvi authority representative - 220(4)(h) & (i)
Ing
Name of soil evaluator - 220(4)0)
Soil logs and perc test logs match BOH records
Locations of waterlines, drains, and subsurface utilities - 220(4)(m)
Observed and adjusted g.w. elevation in the vicinity of the system - 220(4)(n)
Complete profile of the system to scale - 220(4)(o), NA 8.02c
Cross section of leaching facility - NA 8.02w
Location of benclunark(s) within 50-75 feet of facility - 220(4)(q)
Note listing all variance requests with proper citations - 220(4)(p)
Local'upgrade approval requestfonn submitted - 403(7)
Original R.S./P.E. stamp, signature & date - 220(l) & (2)
If PE., discipline specified within stamp. MGL C. 112 s. 81M
sfc. supplies (w/in 400%. pub. wells (w/in 250% pvt. wells (w/in 150) - 220(4)(
Location of watercourses, wetlands, wells, etc. w/in 150' of system — NA 8.02r
Wetland disclaimer — NA 8.02s
1,7 Land surveyor plan reference required (property line setbacks) - 220(3)
Plan contains designer's certification statement
Use approvals / standards checked for I/A system - DEP docs.,
Perc rate >30 NTI - not allowed for new, LUA for upgrade - 245(1)&('3)
Perc rate > 60 MPI - must use modified tight tank or 11A technology - 245(4)
Proposed system qualifies as "shared" system - 002 (definitions)
Flow is over 2,000 gpd - No R.S. allowed - 220(l)
Design flow was set in accordance with code - 203
Existing sy�tem location and note on proper abandonment - 354
Leaching facilityat least V above Base Flood elevation — NA 9.05
All pip ing Sch 40 minimum — NA 10.01
Basement floor minimum V above groundwater elevation — NA 5.04
Foundation drain present with elevation — NA 8.02y
On-site Soil and Groundwater Review
OK Problem N/A
Proper deep observation hole logs on plan - 220(4)(h)
All deep holes and—lmwQwshown, including aborted tests — NA 8.02n
Soil evaluation forms submitted within 60 days of field work - 0 18(2)
Proper percolation test log - 220(4)(i)
Ample d ep observation holes in primary disposal area (minimum 2) - 102(2)
Ample deep observation holes in secondary disposal area (minimum 2) - 102(2)
Ample perc testing (one in each disposal area, 3 in prim. > 2,000 gpd) - 104(4)
Deep hole testing conducted within two years — NA 7.05
Hole Identification Numbers:
ground elevation el.
97,1
-9,& Y
acceptable soil el.
Leach facilitv invert el.
ground water el.
refusal el.
S73.
TZ,77
bottom of leach facility el.
i3l
1-3, 7
thickness of acceptable soil
before & after soil R&R
separation to groundwater
separation to refusal
soil class
perc rate
2!V
I
2
loading rate
septic tank below g.w. ta�le (yes or no)
pump tank below gw. table (yes or no)
H in fill -255(l)
Setback Distances (Given in feet) 15.21 1
OK Problem N/A
1/ Is the lot in the Lake Cochiewick Watershed? NA 6.00 & 5.02
Septic Tank Leach Facility
Property line 10 10
V/ Cellar wall 10 20
1--� Inground pool 10 20
Slab foundation 10 10
L—"Beck, on footings, etc. 5 10
Waterline 10 10
_jf�' Private drinking well 75 100
I/"'- Irrigation well 75 100
Wetlands 75 100
Public well 400 400
k-,//' Wetlands bordering surface 150 150
water Supply or trib.
(in Watershed)
Trib. To Surface Water supply 325 325
Reservoirs 400 400
Tributaries to reservoirs 200 200
Drains (wat. supply/trib.) 50 100
Drains (intercept g.w.)
Foundation drains 10 20
Drains (Other) 5 10
Drywells 20 25
Downhill slope 15'to 3:1 slope
w/o barrier
I
3
Building Sewe
OK Problem N/A
Grease trap required for certain uses (check 230 for details)
Pipe diameter listed (4" minimum) - 222(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)@
'leanouts precede all changes in alignment and grade - 222(8)
Cle�nout provided every 100 feet - 222(8)
Manho\le, at any 90 degree alignment change - 222(8)
Invert ele'vation at building:
Invert elevation at septic tank:
Length of run:
Slope: _ (minimum of 0.01 - 0.02 desired) - 222(6)
10' offset to private well or suction line - 222(2)
Septic Tank
4
OK Problem N/A
Tank is accessible - 228(3)
Tank can accommodate both primary & reserve — NA 9.04
200% of flow (required & provided given. 1500 min.) - 220(4)(f) & 223)(1)(a)
2-3" drop from inlet to outlet - 227(5)
Minimum of 4'liquid depth - 223(2)
37 -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)
Inlet tee extends 10" below flow line (minimum) - 227(6)
Ou�let 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)
AZ
228(2)
3-20" manholes - 228(2)
—Le!!�-
1 childproof, 24" niser/manhole to final grade if <1000gpd- 228(2)
Inlet and outlet ttes on center line - 227(l)
Soil compaction below tank specified (if soil is non-native) - 221(2)
6" of <=3/4"stone beneath tank specified - 221(2) & 22 8Q)
L--
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(l)(c)
Buoyancy calcs. required if tank at or below water table - 221(8)
Tank is watertight - 221 (1)
9" of cover over tank (minimum) - 2280)
H- 10 loading (min.) - 14-20 if traffic - 226(3)
Top of tank <=36" below grade - 221(7)
All pumping to tank (if applies) in accordance with - 229
Tank is set to keep old system in service during install if possible
4
Tight Tan (Check here if not present:
OK Problem N/A
500% of deisgn flow or 2000 gallons provided — 260(2)(a)
3- 20" manholes — 228(2)
Soil compaction below tank specified (if soil non-native) — 221(2)
6" of <=3/4" stone beneath tank specified — 221(2) & 228(l)
Buoyancy calcs. Required if tank at or below water table — 221(8)
Tank is watertight — 22 1 (1)
9" of cover over tank specified (minimum) — 228(l)
H- 10 loading (min.) — H-20 if traffic — 226(3)
Top of tank <= 36" below grade — 221(7)
All pumping to tank (if applies) in accordance with — 229
AN alarm set at 3/5 tank capacity — 260(2)(c)
Min. 1-24" frame w/cover at finished grade — 228(2)(f)
Year round access for pumping — 228(2)(g)
Distribution Box (Check here if not present:
OK Problem N/A
Inlet elevation:
Outlet elevation: V �f
0. 17' drop from inlet to outlet m�inimum)-232(3)(b)
6" sump (minimum) - 232(3)(e)
All outlets at same elevation - 232(3)(b)
Outlet pipes laid level for first 2 ft. - 232(3)(c)
Pipe Sch 40 - NA 10.01
Number of outlets: 46 Number of laterals:
Size of outlets:
Inlet baffle/tee min. V over outlet invert for all d -boxes - 232(3)(a),
Soil compaction below distribution box specified (if soil is non-native) - 221(2)
6" of stone beneath distribution box specified - 221(2)
Box is watertight - 221 (1)
Top of box <=36" below grade - 221(7)
Buoyancy calculations required if box is at or below water table - 221(8)
Pump Chamber (Check here if not present:
OK Problem N/A
Volume specified: 220(4)(r)
Pump on elevation- 220(4)(r)
Pump off elevation: 220(4)(r)
Alarm on elevation: 220(4)(r)
Number of cycles per day - 220(4)(r) (also 254(l)(d) if gravity from d -box)
Minimum 2" delivery line to d -box if gravity - 254(l)( c)
Pressure dosed 11 if flow >= 2,000 gpd - 254Q)(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)
rel
Capacity of pump(s) - . gpM @ 'TDH - 220(4)(r)
Pump can pass 1 1/4 "solids (minimum) - 231(7)
Pump controls specified - 220(4)(r)
Alarm equipment specified - 231(2)
Alarm is in building and powered on separate circuit from pump - 21) 1(9)
Pump sequence correct (off -lead on -lag on-alan-n on) - 231(8)
performance curves included - 220(4)(r)
Marra'al,operating switch - NA 12.01
Check valve, bleeder hole - NA 12.01
I childprod,,�4" riser/manhole to final grade - 2'31(5),
Soil compactio'n,beneath pump chamber specified (if soil is non-native) - 221(2)
6"of <=3/4"stone beneath chmbr. specified - 221(2) & 228(l),
Buoyancy calculations if chamber is at or below water table - 221(8)@
9" of cover over chamber (minimum) - 228(l)
H- 10 loading (rnin.) - 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
50% larger if garbage disposal - 240(4)
Trenches to be used whenever possible - 240(6)
No vehicle access or imperv. area above l.f unless unavoidable - 240(7)
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)
L__ Vent is placed beyond traffic or impervious area - 24 1 (1)(c)
All lines connected to vent if bed or trenches - 241(l)(d)
9" cover over peastone - 240(9)
_L,-- Reserve area provided (new construction) - 248(l)
Reserve 4' from primary leach area — NA 9.04
4'(5'if perc rate <=2 NIPI) separation to g.w. - 212(a) & (b)
4'(down to Twith variance or I/A - upgrades only) of natural soil under Lf.
GW separation is adjusted to highest existing grade if facility cuts into a hillside
Pipe slope minimum of 0.005 - 251(9)
Require 6'removal. and replacement if in fill - 255(5)
Top of le'ach facility <= 36" below grade - 221(7)
Final grade over I.f. minimum 0.02 ft/ft -240(l 0)
Surface & subsurface drainage away from 11 - 240(l 1) & 245(5)
Nfinimurn design flow 440 gpd without deed restriction — NA 13.01
3:1 slope where grading required - 255(2)
Toe of fill slope stops Yfroin property line or swale installed - 255(2)
Impermeable barrier if < 3:1 slope or < 15 feet to —3: 1 slope - 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)
Petc test(s) done in most restrictive layer - 104(2)
P -test 4� bolo* leaching elevation — NA 7.06
erc
_jZ 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 - 23 1 (1)
LeachinLy Trenches (Check here if not present: ><
OK Problem N/A
Number of trenches:
Minimum of 2 trenches - NA 9.01(2)
Depth of trenches (max eff. 2'): -247(l)
Width of trenches (2'min., 4'max.): - 251 (1)(b)
Length of trenches (100' max.): - 25 1 (1)(a)
Trenches are vented (when > 50') - 251 (11)
Trenches follow contour lines - 251(2)
'Trench spacing 3 times effective width or depth - 251 (1)(d)
In fi I-orreserve between trenches, 10' min. - NA 14.01& 14.03
Available'leach ' area given (Min. 500 s.f NA 9.01(2)
Bottom = x W x s. f.
Sidewall = L `—.x D x # x2= s. f
Effective leach area given
Loading factor:
Effective area = total area s.f x LTAR g/day
Effective 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 washed stone - 247(l)
11�
Leaching Pits (Check here if not present: _ I- -� )
OK Problem N/A
# of Pits/pit systems:
(dosing chamber if > 1, 23 1 (1))
Dimensions of each pit or system: L W D
Depth of Pits (max eff. 2): 253(l)(a)
Available leach area given
\Bottom = L x W x # of systems s.f
§idewall = L + W xD x 2 x # of systems s.f
Total area = bottom + sidewall s.f
Effe\ctive leach area given
Loa`d�rng factor:
Effective area = total area s.f x LTAR ____,g/day
Effective a�ea is >= design flow of facility being served
Minimum of 2,pits at least 13'XI 6' – NA 9.01(3)
Distribution for gMIe.ries/chmbrs. in trench config. - pipe every 20' - 253 (6)
Distribution for galleries/chmbrs. in bed config.-ea.pipe serves <= 40 s.f -253(6)
Spacing - 2 times the effective width or depth (the greater) - 253(l)(c)
2"of 1/8"- 1 /2" 2x washed peastone.- 247(2)
3/4" to 1 1/2" double washed stone - 247(l)
Each pit has at least one 20" access cover. 24" CI to grade over 2,000 gpd.
-253(3)
Surrounding aggregate thickness between F(min.) and 4'(max.) - 253(l)(b)
Vents, if necessary, extend under covers of pit(s) - 241 (e)
Leach Fields (Check here if not present:
OK Problem N/A
Number of fields: �need dosing chamber if > 1, 231 (1))
Length (100'max.): 252 (2)(b)
Width: A Q
Wj
8/28/98
Total area: L els x W ze�' -- S. f
Minimum 900 square feet - NA 9.01(l)
Distribution lines connected with solid pipe — NA 15.01
Effective leach area given
Loading factor: -7
Effective area = total area, W& s.fxLTAR -7q gNav
Effective area is >= design flow of facility being served
Minimum of two distribution lines - 252(2)(a)
6'line separation (max.) - 252(2)(d)
4' maximum separation from edge of field to line - 252(2)(e)
10'minimum separation between adjacent leach fields - 252(2)(f)
Between 6" and 12" of 3/4 - 1 1/2" stone beneath field - 252(2)(g) & 247(2)
2"of 1/8"-1/2" 2x washed peastone.- 247(2)
Oct -09-02 09:59A
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charle.,, StTm, t
North Andover, Massachusetts 01845
Sandra Starr
Pub6c Heattli.
P.01
1AFT00
4
Telephone ('978) 688-9-540
Fax (978) 688-9542
Bill Dufresne October 7, 2002
Merrimack Engineering
66 Park Street
Andover, MA 0 18 10
Re: 263 Cundlestick Lane, North Andover
Dear Mr. Dufresne-,
Please be advised that the proposed plan dated W2312002 forthe repair or the septic system at
263 Candlestick Lane has technical deficiencies that must be addressed before the plan can bk�
approved, They are as follows:
/Locations of the percolation tests are missing frorn the plan. (310 CMR I 5.220(4)(i))
um',' ,0' No elevations for percolation tests and none current, (N.A. 8.02n)
Missing notc on variance requests, (310 CMR 15.220(4)(p))O
e' No Local Upgrade Approval Form. (3 10 CMR 15-403(1)) 0
vo- Need original RF, stanip, signature and date. (3 10 CMR 15.220(l) & (2))�
Locate existing wptic system on site plan, (3 10 CMR 15.354)
Please indicate, that there is a minimum of 3" of air spa'ce above tees/baffles in the septic
tank, (3 10 CMR 15.227(4)) '--� I
With a 2 MPI percolation rate, the separation to groundwater shall be, a miniTnum of 55'
unless a variance is granted by the Board of Health, (310 ClAR 15,212(a) & (b))
AJA, 9 If a vaiiance is requested, it must be listed on the plan.
Please remember that all re-subrnittals require a $60 fee. Feel free to call if you have questions
about the content ofthis letter.
Sincerely,
Sandra Starr,
I Jealth Dircetor
Cc. File
F)R
,1/ 7 5--
/V14
W)A)(-d0F,AJ'PJA1,8688-9541 RUUMNG688MO COSSERVATRYN6RR-TSIO HUALT11688-9.14U PLANNIN0688-95.35
INSTALLER PROJECT MANAGEMENT OBLIGATI I ONS
As the North Andover licensed installer for the construction of the septic system for the
property at axi &- relative to the application
o
of Rf_� M dated I 1- 1-0 : for plans by and
dated with revisions dated 10-15-Oc-)
I understand the following obligations for management of this project:
I . As the installer I am obligated to 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 two shall be applicable.
2. 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 H I ealth 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.
3. As the installer I understand that persons or companies not associated with my company may
not perform the work required by my company 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 in the Town of North Andover plus
significant fines to all persons involved.
4. 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.
d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other
components.
5. 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:-..) I - '7-0,;
Disposal Works Construction Permit #
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AS BUILT PLAN
OF
SUBSU.RFACE DIS.POSAL SYSTEM
LOCAT-ED IN -re UIA r2
AOP0Ve0-
AS PREPARED FOR
DATE: 11-20-02- so 15
SCALE: I
MERRIMACK ENGINEERING SERVICES,, INC.
PROFESStONAL ENGINEERS 0 LAND SURVEYORS o PLANNERS
pAltK STjW a ANDOVEk MAUACHUSETTS 01610 or JEL (617) 475-35W. 3M$721
BOARD OF HEALTH -
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE:— CURRENT INSTALLER'S LICENSE#
LOCATION: 7(,2S r_,A/yPtu!5TrcK_ Vo4o
LICENSED INSTALLER: PA
SIGNATURE:
TELEPHONE#
CHECK ONE:
REPAIR:. NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
160.00 Fee Attached?
Project Manager Ob.
Foundation As -Built?
Floor Plans9
Administrative Use Only
Yes_k
No
Yes
No
Yes
No
Yes
No
Approval Date:
System Owner
Type: Emergency
Cesspool: No
Date of Pumping;
System Pumped By:
Contents transferred to:
Contents Disposed at:
Commonwealth of Massachusetss
: Massachusetts
System Pumving Record
System Location
� ; v H -- )*
-1 . , . k
16, #v V
Is
Form 4 -- System Pumping Record
1 ha, PAutine.
Yes
Septic tank:
Yes
Quantity Pumped:
Gallons
Wind Nver Envimnmental, LLC
permit #:
g- - 0 -Z
Date: Pumper Signature:
lCondition of System/Other Comments
Dep AA" ved From - 12107195
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845 CHU
Sandra Starr
Public Health Director
Bill Dufresne
Merrimack Engineering
66 Park Street
Andover, NIA 0 18 10
L,ke: 263 Candlestick Lane, North Andover
Dear Mr. Dufresne:
Telephone (978) 688-9540
Fax (978) 688-9542
October 7, 2002
Please be advised that the proposed plan dated 9/23/2002 for the repair of the septic system at
263 Candlestick Lane has technical deficiencies that must be addressed before the plan can be
approved. They are as follows:
• Locations of the percolation tests are missing from the plan. (3 10 CNM 15.220(4)(i))
• No elevations for percolation tests and none current. (N.A. 8.02n)
• Missing note on variance requests. (3 10 CNM 15.220(4)(p))
• No Local Upgrade Approval Form. (3 10 CXM 15.403(1)) .
• Need original P.E. stamp, signature and date. (3 10 CXM 15.220(l) & (2))
• Locate existing septic system on site plan. (31OCNMI5.354)
• Please indicate that there is a minimum of 3" of air space above tees/baffles in the septic
tank. (3 10 CMR 15.227(4))
• With a 2 NIPI percolation rate, the separation to groundwater shall be a minimum of 5'
unless a variance is granted by the Board of Health. (3 10 CMR 15.212(a) & (b))
• If a variance is requested, it must be listed on the plan.
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: File
BOARD OF APPEALS 688-9541 BULDING688-9545 CONTSERVATION688-9530 HEALTH688-9540 PLANNING 688-9535
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Public Health Director
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
11/4w
This is to certify that
the individual subsurface disposal system
constructed () or repaired (X)
by
Mike Reilly
at
263 Candlestick Road
Telephone (978) 688-9540
Fax (978) 68&9542
has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the
North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will function
satisfactorily.
'Bn'an f LaGrasse
Board of Health Inspector
BOARD OF APPEALS 689-9541 BUILDING 688-9545 CONSERVATION 689-9530 BEALTT1688-9540 PLANNING 688-9535
AS -BUILT CHECKLIST
LOTNUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WITHIN I 50'OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
ORIGINAL STAMP & SIGNATURE
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
LOCATION & ELEVATIONS OF BENCHMARK USED
4- �.�
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System constructed;
��r'e�aired;
by
located at U,'72 CA62� PLK
was installed in conformance with the North Andover Board of Health approved plan,
System Desi gn Permit dated ' with an approved design
flow of A�k 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 3 10 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: - I I— I
Final inspection date:
- C 2".. t'g � � - -
Engineer Represintative
e' - c2" -_ . .
Engineer Represenlative
Installer: Lic.#: — Date: J X_"A020;:�
Design Engineer- Date: \t-c� \-O�,
OF
DANIEL
KORAVOS
CIVIL
No.37752
BOARD OF HEALTH
4c%
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR SOIL TESTS
DATE: MAP & PARCEL:
LOCATION OF SOIL TESTS: 1,
*WNER: 190 '
U1,JA TEL. NO.:
ADDRESS: 5!�r
ENGINEER:. TEL. NO.:
CERTIFIED SOIL EVALUATOR: 01-Jt4?,r14-AY'-
Intended Use.of Land: Residential Subdivision me Commercial'
Is This:
Repair Testing: 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 o
upgrades. (If time.is not critical, fee for repairs is $75.00)
GENERAL -INFORMATION
I . 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 F�400') shall be submitted to the Board
of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing sod evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval:
Date Received: Check Amount: lChe Date:
OTC
M.
27 Charles Street
North Andover, MA 01845
Telephone#(978) 688-9540
Fax#(978) 68&-9542
do
IM
Tb:'—Ox� From:
Fax: Pages:
Date:
Phone: , 12 �/L- 5
Re:
CC:
D Urgent 0 For Review 0 Please Comment 0 Please Reply 0 Please Recycle
0 Comments:
---Pzz- --�7�z- /-,
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Public Health Director
Bill Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 0 18 10
Re: 263 Candlestick T
I -ane, North Andover
Dear Mr. Dufresne:
Telephone (978) 688-9540
Fax (978) 688-9542
October 25, 2002
Please be advised that the proposed plan dated 9/23/2002 and revised 10/15/2002
for the repair of the septic system at 263 CandlestickT a, ne has been- approved.
.LI
Should you have any questions, please do not hesitate to caU the Health office.
Sfficerely,
Sandra Starr
Health Director
Cc: FUe
BOARDOFAPPEALS688-9541 BIJILDING688-9545 CONSERVATION688-9530 HE.Ai,,rH688-9540 PLANINNITNTG688-9535
Town of North Andover '
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Public Health Director
Bill Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 0 18 10
Re: 263 Candlestick Lane, North Andover
Dear Mr. Dufresne:
Telephone (978) 688-9540
Fax (978) 688-9542
October 25, 2002
Please be advised that the proposed plan dated 9/23/2002 and revised 10/15/2002
for the repair of the septic system at 26-3 Candlestick Lane has been approved.
Should you have any questions, please do not hesitate to call the Health office.
Sincerely,
Sandra Starr,
Health Director
Cc: File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH688-9540 PLANNING 688-9S35
SEPTIC PLAN SUBMITTAL FORM
LOCATION: I-&* e&qAj�?
NEW PLANS: $160.00/Plan V-'
REVISED PLANS: YES $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: rxfW NO
DATE:
DESIGN ENGINEER:
DATE TO CONSULTANT:
When the submission is all in place. route to the Health Secretary.
BOARD OF HEALTH
�SEP Mom
Location: Owner's Name: Vg
Map/Parcel Address:
Installer. #J.. 44A41
Tel #.---6 Vr_1 New (siso)__ Repair
Date: 1-11-0V Wetland I
S:Z�Zone EL , Soil Symbol-4—Soil irfhme_C&M�U Soil Class y
Deep Observation Hole Locr
e's
E, ei-Ation Depth Soil Horizon Soil Texture Soil Color
I - Soil blOttling. % Gravel, Stones, etc:
L
I 1710L
fy kit;
Parent MateriW_41lA-__Depth to Bedrockdf�J_Standin.w Water in the Hole- %veepLn!! fmm pit Face
Date
Percolation Tests
Observation Hole
Depth of Perc
Start Pre -soak -
Time at 12"
Time at 9"
Time at 611_
Time (9"- 61,
-Rate Min/Inrh I
Performed B%. Witnessed Br.
OP -1
0%0
to
1-3
Parent Material
M+U841
to Bedrock
—to —7-7
Water in the Eole:�_�Wnpin.-
_Ubtandin:
fr-m Pit Fat� _ESHMV. —
&�A*Avfi rdwow
L
I 1710L
fy kit;
Parent MateriW_41lA-__Depth to Bedrockdf�J_Standin.w Water in the Hole- %veepLn!! fmm pit Face
Date
Percolation Tests
Observation Hole
Depth of Perc
Start Pre -soak -
Time at 12"
Time at 9"
Time at 611_
Time (9"- 61,
-Rate Min/Inrh I
Performed B%. Witnessed Br.