HomeMy WebLinkAboutMiscellaneous - 29 BARCO LANE 4/30/2018 (3)0
Lot & Street n,,,. Map/Parcel
CONSTRUCTION APPROVAL
Has plan review fee been paid: YES
Plan Approval: Date:_�5 le- r10
Designer:.AX�,-��5/0.56bc?h �,J 4f
Conditions:
NO Permit#
Approved by: AA';�Vu
Plan Date:-- 311,5-16,
Water Supply: Town Well
Well Permit: Driller:
Well Tests: Chemical Date Approved
I
Bacteria I Date Approved
Bacteria 11 Date Approved
Plumbing Sign -Off:
Comments:
Form "U" Approval
Date Issued
Conditions:
Final Approval:
Wiring Sign -off:
Approval to Issue: YES
By:
NO
All Permits Paid?
NO
Well Construction Approval?
S
Y S
NO
Septic System Construction Approval?
ES-
NO
Certification?
, &--YE S
N 0
Other?
N 0
Any Variance Needed?
YES
JO
FINAL BOARD EALTH APPROVAL:
DATE:
APPROVED BY: �11 K0 YI) '111f /7
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SEPTIC SYSTEM INSTALLATION
CONDITIONS:
Construction Inspection:
Needed:
ilt PNn Satisfa
YES
Approval of Backfill:
Final Grading Approval
Date:
Date:
By:
By:
Final Construction Approval:
5 �, /.-;
Certificate of Compliance: Approval:_ Date:
Is the installer licensed?
NO
Type of Construction:
NEW
(1-R �EPA I R
New Construction: Certified Plot Plan Review
YES
IZ71-Ml;i—
Floor Plan Review
YES
("NO -�>
Conditions of Approval from Form U
YES
CNR�F-
Issuance of DWC permit:
NO
DWC Permit Paid?
NO
DWC Permit # Installer:
Begin Inspection:
YES
NO
Excavation Inspection:
Needed:
Construction Inspection:
Needed:
ilt PNn Satisfa
YES
Approval of Backfill:
Final Grading Approval
Date:
Date:
By:
By:
Final Construction Approval:
5 �, /.-;
Certificate of Compliance: Approval:_ Date:
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TOWN OF NORTH ANDOVFR
HEALTH DEPARTMENT
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 0 1845
Sandra Starr
Public Health Director
April 1, 2002
Ben Osgood, Jr.
New England Engineering Services, Inc.
60 Beechwood Drive
North Andover, MA 0 1845
Re: 29 Barco Lane
Dear Mr. Osgood:
T&Iephone (978) 688-9540
FAX (978) 688-9542
This is to notify you that the proposed plans dated January 28, 2002 and revised 3/15/02 for the upgrade
of the septic system at 29 Barco Lane, North Andover have been approved.
If you have any questions, please call the office at 978-688-9540.
Sincerely,
Sandra Starr, F -S., C.110.
Public Health Director
Cc: BOH
�-Aomeowner
File
a
Sandra Starr
Public Health Director
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 0 1845
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
9/20/2002
This is to certify that the individual components
entire (X ) subsurface disposal system
constructed ( ), repaired ( ), or upgraded (X
by
Michael Reilly
at
29 Barco Lane
North Andover, MA
Telephone (978) 688-9540
FAX (978) 688-9542
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5), North
Andover Board of Health septic system regulations, and the design plan approval # 1181
dated March 28, 2002.
The Issuance of this certificate shall not be construed as a guarantee that the system win
function satisfactorily.
Board of Health Inspector
m
909
'TOWN OFNORrfH ANDOVER SDVAGEDISPOSAL SYSTE�I,j
I_N-,STALLA-rioN CERTIFICATION
The und-ersismed here:,v cer-,'fv that the �zc%vagc Disposal System i . cof�su-,Ictro
recaired:
by LLk_eL_. 1 L L
A
located at 2- q (z c c CL 'A C—
was installed in 6onfcrmance with the North Andover Boa. rd of HeziEh a-:,prove� plan..
S v s t e m D c s I g n P c "Mi t dated With an approved desi-n
flow of caflonsperday The ma-teni-ais,usc-a; were incontormarct "'Ith those
specmed oh the apVro�71-d plan; th'e sysiern was inst3fled in' accordar.cl-11%,ith the prcvisions
of 31 10 CVM t 5.000, Title 5 and local res-ilaElons, and the final Qradipft a, -,re --s
su6stantially %Nith the approved plan. Ail work, 'Is accuraic.'y reDresenced �)r the As -built
%Vhjch has been submitted to the Board cz- Health.
Bedinspectiondatle- co
Enp-ineer
FInaJ inspecu*cn �date� h_91 '-- 7
Engirecr Represeniat:%:e
lInstaller:
Cesium Eng-incer:
jo
OF
RMHARD
C.
TANGARD
NAL
Date
Date-.
INI
Town of North Andover, Massachusetts Form No. 3
BOARD OF HEALTH
,AORTpi
VJ //-a
0
DISPOSAL WORKS CONSTRUCTION PERMIT
Applicant f f
-----NAME . V ADDRESS TELEPHONE
Site Location —,a q 4,-4-,
Permission is hereby granted to Construct ( ) or Repair (2,- �an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.- �Z'F/
Tel, �4
130,8ND OF HEALTH
D.W.C. No.
MEMENEW—M-1
BOARD OF HEALTH -
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: _e42-oiz
CURRENT INSTALLER'S LICENSE#
LOCATION: �)
LICENSED INSTALLER:
SIGNATURE TELEPHONE#
CHECK ONE:
REPAIR:_,_� NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
160.00 Fee Attached?
Project Manager Ob.
. Administrative Use Only
Yes No
Yes No
Foundation As -Built? Yes
No
Floor Plans? Yes No t_,�
Approval Date:_��
INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction of the septic system for the
r -N
property a _C_ —relative to the application
of F_.QLQAVNi_ dated 2
for plans by and
dated_]_-��� with revisions dated
1 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 Health Regulations may
result in a $50.00 fine being levied against my company.
a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done
first. Installer must request the inspection but does not have to be present.
b) Final inspection - Engineer must first do their inspection for elevations, ties, etc. As -built or
verbal OK from engineer must be submitted to Board of Health, after which installer calls for
inspection time. Installer must be present for this inspection. With pump system all electrical
work must be ready and able to cause pump to work and alarm to function.
c) Final Grade - Installer must request inspection when all grading is complete. Does not have to be
on site.
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
- - Y ^ - 4
Disposal Works Construction
#
Date: S -
Town of North Andover, Massachusetts Form No.2
VtORTN BOARD OF HEALTH
'DESIGN APPROVAL FOR
CHU SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant Test No.,
Site Location 9-- - &A"
Reference Plans and Specs
Permission is granted for an individual soil absorption sewage disposal system to be installed
in Accordance with regulations of Board of Health.
Fee Z�a 0
CHAIRMAN, BOARD OF HEALTH
Site System Permit No. 11fi
k
Town of North Andover, Massachusetts Form No. 1
tkORTH BOARD OF HEALTH
11,ED 6 .6 - - t �a2td 44r.,:27d
0
APPLICATION FOR SITE TESTING/INSPECTION
Applicant Pe�f-e- r Y- 9 -70-4�s �z
NAME ADDRESS TELEPHONE
Site Locat
C
17 & Qv- " 11,
Engineer .5 vic-e5, In,c, 6 o'
Test/Inspection Date and Time
Fee 061
ood -7
No ,,9y7dev-r TELI
CHAIRMAN, BOARD OF HEALTH
Test No. / 0 '-5? 7
S.S. Permit No—ffS�/ _D.W.C. No. C.C. Date—Plbg. Permit No
.-�' d5 °�%o_ '.�', -�.. t:;,`s:;. '�`„:'� ., 3..hT ,_ 'P�'c '•! y: � r � s ,. ���...:k'f5�a: ...e.,��. tt..} �`" ._.. c.�� .r' n. . , �.,;.
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I J C
Town of North Andover, Massachusetts Form No. 1
ORTH BOARDIOFHEALTH
6 0 r4
4
0 -/ __' � : � � �� I .
APPLICATION FOR SITE TESTING/INSPECTION
Applicant
NAME ADDRESS TELEPHONE
Site Location
7A
Engineer 7
NAME ADDRESS TELEPHONE
Test/I nspection Date and Time
Fee—,.,
CHAI RMAN, BOARD OF HEALTH
T �4 / I :?
est I o.-7
S.S. Permit No. // y/ D . W.C. No. C.C. Date—Plbg. Permit No.
NEW ENGLAND ENGINEERING SERVICES
INC
Sandra Starr, Administrator
North Andover Health Department
Town Hall Annex
27 Charles Street
North Andover, MA 0 1845
Re: 29 Barco Lane, North Andover, Septic system design
Dear Sandra:
TOWN 0' 'O'TH ANQOV�P/
BOARD OF HEALTH
EW27M
Enclosed 5 sets of revised septic system design plans for the above referenced property.
The following changes have been made to address the comments in the letter from John
Noonan.
1. The temporary turn around is shown on the plan. The deed does not sppcify that an
easement exists so a prescriptive easement would exist only in the area where there is
existing pavement.
2. The soil logs were reviewed with Sandra Starr and no discrepancies were found.
3. The design data has been revised.
4. The 14 foot head is comprised of elevation head which is 7.5 feet and velocity head
which is 6.5 feet at a flow of 80 gallons per minute.
5. The barrier is specified as an EPDM membrane. This is an acceptable engineering
alternative. Alternatives are allowed (see DEP letter attached).
If you have any questions regarding the information submitted, please do -not hesitate to
contact this office.
Sincerely,
!3-, /" 0
, � C- , "�L
Benjamin C. Osgood, Jr., EIT
President
60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099
NEW ENGLAND ENGINEERING SERVICES
INC
T0'JVN01N)00RTHANQ0V,---P/
BOA F HFALTH
RE
14AR 2 7 2002
March 27, 2002
Sandra Starr, Administrator
North Andover Health Department
Town Hall Annex
27 Charles Street
North Andover, MA 0 1845
Re: 29 Barco Lane, North Andover, Septic system design
Dear Sandra:
Enclosed 5 sets of revised septic system design plans for the above referenced property.
The following changes have been made to address the comments in the letter from John
Noonan.
I . The temporary turn around is shown on the plan. The deed does not specify that an
easement exists so a prescriptive easement would exist only in the area where there is
existing pavement.
2. The soil logs were reviewed with Sandra Starr and no discrepancies were found.
3. The design data has been revised.
4. The 14 foot head is comprised of elevation head which is 7.5 feet and velocity head
which is 6.5 feet at a flow of 80 gallons per minute.
5. The barrier is specified as an EPDM membrane. This is an acceptable engineering
alternative. Alternatives are allowed (see DEP letter attached).
If you have any questions regarding the information submitted, please do not hesitate to
contact this office.
Sincerely,
13-- 40
Benjamin C. Osgood, Jr., EIT
President
60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 01845
Sandra Starr
Public Health Director
April 1, 2002
Ben Osgood, Jr.
New England Engineering Services, Inc.
60 Beechwood Drive
North Andover, MA 0 1845
Re: 29 Barco Lane
Dear Mr. Osgood:
Te'lephone (978) 688-9540
FAX (978) 688-9542
This is to notify you that the proposed plans dated January 28, 2002 and revised 3/15/02 for the upgrade
of the septic system at 29 Barco Lane, North Andover have been approved.
If you have any questions, please call the office at 978-688-9540.
Sincerely,
Sandra Starr, R -S., C.H.O.
Public Health Director
Cc: BOH
Homeowner
File
NOONAN & Mc DOWELL, INC.
25 Bridge Street, Suite 6, Billerica, MA 01821-1023
Voice (978) 667-9736 Fax (978) 671-9565
Email: iun@netway.com
February 15, 2002
Town of North Andover
Office of the Health Department rrw -0 —R!
OF N
Community Development and Services Division TGj t PIOP'Ro
27 Charles Street
North Andover, MA 0 1845
RE: Subsurface Sewage Disposal System
Plan Review, 1770/056A
29 Barco Lane
Assessors Map 104B, Lot 145
Dear Members of the Board,
Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated February 11, 2002
by New England Engineering Services, Inc. It is our opinion that the proposed design will meet
the requirements of Title 5 and the North Andover Board of Health "By -Laws" if the following is
addressed:
1) Show temporary turn around at street frontage.
2) Check soil log for test hole #I it does not agree with Board of Health log.
3) Revise design data table to indicate 4' wide trenches.
4) Where is 14 ft. head derived from. — , 19
5) Use clay orconcrete
POLIOVIRUS VACCINE INACTIVATE
Respectfidly,
'�o
4
John L. Noonan, P.L mK1
G:office/boh/1770056A
Land Surveyors Civil Engineers Environmental Planners
NOONAN & Mc DOWELL, INC.
1
25 Bridge Street, Suite 6, Billerica, MA 01821-1023
Voice (978) 667-9736 Fax (978) 671-9565
Email: m-n@netway.com
February 15, 2002
Town of North Andover �i�bFj --i
Office of the Health Department
t" 0 L5 I
AR6 OF
opg6
Community Development and Services Division
27 Charles Street
North Andover, MA 0 1845
RE: Subsurface Sewage Disposal System
Plan Review, 1770/056A
29 Barco Lane
Assessors Map 104B, Lot 145
Dear Members of the Board,
Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated February 11, 2002
by New England Engineering Services, Inc. It is our opinion that the proposed design will meet
the requirements of Title 5 and the North Andover Board of Health "By -Laws" if the following is
addressed:
1) Show temporary turn around at street frontage.
2) Check soil log for test hole 41 it does not agree with Board of Health log.
3) Revise design data table to indicate 4' wide trenches.
4) Where is 14 ft. head derived from.
5) Use clay or concrete for impermeable barrier
Respectfully,
John L. Noonan, P.L.S.-P.E.
G:office/boh/1770056A
Land Surveyors Civil Engineers Environmental Planners
FORM 11 - SOIL EVALUATOR FORM
Page I of 3
No. -6 Date:
__.. Z li— - -
Commonwealth of Massachusetts
Massachusetts
Soil SuitabiW Assessment for On-site Sewage Moos&
Performed By: .......... 77-:�Qt<74��� ..... . C ....... -7�� Date:
Witnessed By: . ..... ...... ........................ . ......
L=4fion Addrus or �P_D (>wtxr*s Narm.
Addros, and
Tckphorke I
A/0
jew construction El Repair EJ -770
Office Review
Published Soil Survey Available: No El Yes IN
Year Published ............. .. Publication Scale ....... ........... . Soil Map Unit <"';P
Drainage Class .................. Soil Limitations �R�_ � . ..... ... .. ... ...
Surficial Geologic Report Available: No 5� Yes 0
Year Published Publication Scale
GeologicMaterial Qvlap Unit) ... ................................................................ ........................................
Landform...................................................................................... ........................
Flood Insurance Rate Map:
Above 500 year flood boundary No E]Yes
Within 500 year flood boundary No E]Yes EI
OF
Within 100 year flood boundary No E]Yes F� F-IOP"FID U
Wetland Area:
National Wetland Inventory Map (map unit) ....................... .... .....
Wetlands Conservancy Program Map (map unit) ........... . . . . . . ...
Current Water Resource Conditions (USGS): Month 4ePICW0� ......._'77.
Range :Above Normal EINormal ElBelcw Normal
Other References Reviewed:
WDEP APPROVED FOWN1 - 12/07/95
Location Address or Lot No. _;�? '0
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
On-site Review
Dee . p Hole Number Date:..///`��*�`/"`�/�'��/ Time- Weath
Location jidentify on site plan)
Slope M
Land Use ... ... T . �4� Surface Stones
Vegetation .
Landform
'e—
Position on landscape (sketch on the back) .... . .
Distances from:
Open Water Body 144c::2 feet Drainage way/ feet
Possible Wet Area feet Property Lin
e .... feet
Drinking Water Well feet Other
DEEP OBSERVATION' HOLE LOG*
Depth from
Surface (Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mortling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
601
_5*Z
Y
YF
65;_
171-h*z R-5 P
MINIMLIM
nF 2 HOLES
RE(2UIHLU A I EVERY
PROPOSED DISPOSAL
AREA
Parent Material (geologic)
Depth to Groundwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water:
DEP APPROVED FORM - 12/07/95
DepthtoBedrock:
Weeping from Pit Face:
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No.
'Ale
On-site Review
Deep Hole Number D a t e:.. T i me:. Weather
Location (identify on site plan) . ......... ......
Land Use
Surface Stones 77-1
Slope M
Vegetation
Landform zzel"'-��
Position on landscape (sketch on the back) .. ....
Distances from: feet Drainage way./..... feet
Open Water Bod,, ==3 e.P
Possible Wei: Area feet Property Line ?�7.. feet
Drinking Water Well feet Other . ......
DEEP OBSERVATION HOLE LOG*
Depth frorn
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
"04
7 ZY4
7
4Z -
I— 1?ev
'z4
Z 9
M I rill MUNI Vr Z rIULrQ nr-%.A�M�W
Paren t Material (geologic) DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water:_
DEP AYPROVED FO"I - 12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. ;�� - Al�p.
Determination -Lor Seasonal High Water Table
Method Used:
El Depth observed standing in observation hole .... .... . inches
El Depth weeping from side of observation hole ..... inches
Depth to soil mottles inches lrl� e
7 It
El Ground water adjustment ................... feet ;4
Index Well Number ........ Reading Date .................. Index well level
Adjustment factor ................... Adjusted ground water level .... .. .. ......................... ... . ... _ ...
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in aJI areas
observed throughout the area proposed for the soil absorption system?
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on (date) I have passed the soil evaluator examination
approved by th( n Environmental Protection and that the above analysis
was performed by me consistent with the required training, expertise and experience
described in 310 CIVIR 15.017.
Signature ate
WDEP APPROVED FORM - 12/07/95
BOARD OF HEALTH.
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR SOIL TESTS, OCT 2 2
DATE: 10 -) 1-1 F�
.1zi lot MAP & PARCEL: 6
LOCATION OF SOIL TESTS:
OWNER: r— -7 -7 �2 2
TEL. NO.: i
ADDRESS: ZIC
ENGINEER:
71,,, 6- TEL. NO.:
!��(&;aFg - 6 66, 1
CERTIFIED SOIL EVALUATOR: 1�2 C -LO 6-C1Z,0 j"/L
C f '::k J
Intended Use of Land: Residential Subdivision Single Family Home 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
— perco aLion Lests required for each disposal area. Fee of $200.00 per lot for jgpq�jrs or
upgrades. (If time is not critical, fee for repairs is $75.00)
GENERAL INFORMATION
I .
2.
3.
4.
5.
6.
7.
d,6` -1A
"J'0'
Itla- 1 161)
' P rl�
10 1
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 soU evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval:
Date Received: /C'
Check Amount: Check Date: )h I --IT'41,171)
CIO
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OCT 2,2 2M
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�-Vftd!2 IFIVIS �101M , /I
[E)le Edit Tools Data Maintain Process View fieport W LMndows Help
Billing Groups
Er. -I RE 3
Project: 1770 lqfk�o! Health Department 27 Charles Street, No. Andover,
Billing Group ID: FFA ] T:fl
Billing Type: Fixed Fee
Billing Fee: Card ID: FLo—NA
Miln Billinq Info -Qontract Info Classification
GLAccounts Billing Messages lerts taiing Activities
ssign To
Proposal Number:
Contract Number:
TA r --A
epartment:
Contract Date: 12002
Work Start Date: =L/G/2
Expected Finish Date: IM8102
[Juse Government Invoice Style
Description:
Engineering services required for plan review
Engineer, NEES, Inc. #978-686-1768
Assissors MAp 1048, Lot 145
Applicant: Peter Wegen
29 Barco Lane
Project Request Record
Town of North Andover
Date:
Client Id: ToNA Card Id: ToNA Client/Company Name: lloarA of Health'
Card Type -Client -
Contact Name: Ms. Sandra Starr Phone: 978-688-,9540
Title: Director Fax: 978-688-9542
i Address: 27 Charles Street Emad- sg-tarr@townofnorthandover.com.
Notes:
Town: North Andover
State: MA Zip Code: 01845
Other contacts. if. applicab taller
Name:' Phone: Y,75 -
Title: Fax:
Address: Email:
Notes:
Town:
State: -------�Zip Code:
Proiect:
Project Id: 1770 Project Title: Town of North Andover, Board of Health
(JOB NO) (PROJECT NAME & STREET ADDRESS)
Manager: NOW Billing Group: A_j3illing CodJ: Fixed =Fee
&7f, 601 Age-- L- - I
Contract Info. Project Description for each billing group
BG/ ---.Applicant
Assessors Mgp A14- f5 Lot Street Z -
Type of service
Office/fomis/jbrqutona
FOF,%1 I I -SOIL EVALUATOR FOR N I
Page 2 or 3
Location Address or Lot No. —2 P ';WZr_ e: C) ,I ov
On-site Review
Deep Hole Number Date:_� —'/—w /0 Time: —Weather e-'
Location (identify on site plan)
Land Use Slope Surface Stones
Vef9etation
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet Property Line feet
Drinking Water WeR /7 5 e feet "Other
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
JUSDA)
Soil Color
tMunsell)
Soil
Mottling
Other
IStrumum. Stones. flouldars. Consistency. %
Graven
1 jL
1/31,
7
4z, - 3-0
Z
A UM
OF 2 kD1 1-1, JR&C)i
IMM Z I I.V05Y
3,07SPI WIM
Mirpric A I A
BE X
Parent Materia(l[Reologic) ,,o t 7 08PLhW8 I cd: >
De2thto Groundwater- Standing Water in the Hole: /1"u -t Weeping born Pit Face: A, a- c
EsTirnated Seasonal High Grmx-vd Water -
DEF APPROMM FORM - 12WIPS
FORM I I -SOIL EVALUATOR FOR N I
Page 2 or 3
Location Address or Lot i4o. Z V 6 ij --v
fv , 01 , V 171 v L
. On-site Review -
Deep Hole Number ------- Ll. Date:_fL/F'/0/ Time: ."Weather C--'� 3 3
Location Gde n*tif V on site plan)
Land Use Slope M - Surface Stones /J Q f�) C
Vefgetation -5
Landform
Position on landscape (sketch on the back)
Distances from:
0 Ofeet Drainage way f et.
pen Water Body
Possible Wet Area feet Property Line feet I
Drinking Water Well /'00 -t_, feel 'Other
-7
.4v t - 4- / "v
& - e I _L6z_ 2EE!�j Ar e- -
DEEP OBSERVATION HOLE LOd'a 'we,
Depth Iforn
Surlace (inches)
Soil korizon
Soil Texture
4USDA)
Soil Color
tMunsell)
Soff
110lattling
Other
IStructme. Stones. Boulders. Consistency. %
Graven
+
3
1-d
6-
MINJmUM
OF Z_RM E -s RFOUIRM
ALI I-VI-RY
PRnPnr1rM
I'SlizorwAl Al2L
A
Parent Material (geologic)
DepthloGroundwaier, Standing Water inthe Hole: v v- v --- -
Daptftp rlcl: '57e�p
Weeping from ft Face: — 0 �,- e --
Estirnated Seasonal High rwound water.
DEF APPRONIM FoRM - UW193
, F �. a:
FOXNI 12. - PERCOLATI
7 7 C2'4�— O -N TEST
46
Location. Address or Lot No. Z.,,9 I_ -/I
COMMONWEALTH OF MASSACHUSETTS
/V,
Massachusetts
Minimum of I percolation test must be perfo . rmed in both the primary area AND
reserve area.
f�� E3
Site Passed Y -Site Failed
... . ........ .. . .
Performed By: a j ci V . .... .................. : ............ _ .................... . . ... .. . ...... .
Witnessed By: /V 0 0 /V 01 4j
Comments:
ENV
DEP AMOVED FOIN IM,15
Percolation Test*
Date:
4//7- Ila Time:,
Observation Hole
Depth of Perc
Start Pre-soak
0" 7 -
End Pre-soak
/0 3)
Time at 12"
'9
Time at 9, -
Time at 6"
-------------
4 5
Time (9"-6n)
Rate Min./inch
Minimum of I percolation test must be perfo . rmed in both the primary area AND
reserve area.
f�� E3
Site Passed Y -Site Failed
... . ........ .. . .
Performed By: a j ci V . .... .................. : ............ _ .................... . . ... .. . ...... .
Witnessed By: /V 0 0 /V 01 4j
Comments:
ENV
DEP AMOVED FOIN IM,15
FORM I I -SOIL EVALUATOR FORM
Page 2 of 3
.7 7 0 5-ic
Location Address or Lot v4o. Z k,;,, e— a
/V r-2 0
. On-site Review -
Deep Hole Number Date: Time: 0 0 We a t h e r
Location fiden'tify on site plan)
Land Use Slope Surface Stones 1J Q
V6getation 0 .
Landform T777—
Position on landscape (sketch on the back)
Distances from:
>1 po IVQ
Open Water Body — feet Drainage way feet
Possible Wet Aren /00
feet Property Line fee
Drinking Water Well -1*00- +- feet Other - -----
271 ro-v /Y1 I-.
2 4.- ^oV
e Mr�t-7 F?:rve
./I- Ov0000v.-17,ro� DEEP OBSERVATION HOLE LOd
Depth from
Surface (inches)
Soil Horizon
Soil Texiure
JUSDA)
Soil Color
Munsell)
sod
Mottling
Other
(Structure. Stones. Boulders. Consistency. %
Groven
A
3
/v��d e 0 V77 :7—
HOILS REQUIRED
AT EVERY
PRU)POSED
LjjNrLr-%At ARPA
P&r*nt Material lgeoJogic)
Depth to Groundwater St8reding Water initwe Hole: /v C/ -v t.-:' Weeping from Pit Face: e--
EsTsmated Seasonal H4h rwound Water:
DEF APPRON7M FORM. LIMMS
, I-- / -- r)
FORm n s01L EVALUATOR FORM
Page 2 or 3
07 5--Z
Location Address or Lot No. 2Y 1.94W -r -o
4w- P0
On-site Review -
Deep Hole Number nstip. 1 1/7 1/0
Location (identify on site plan)
Land Use SlopeM - Surface Stones
ViEfgetation 5
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Bo*dy > /0,0 feet Drainage way. -�/o 0 feet
Possible Wet Area 7 100 feet Property Line 7- -E-f feet
Drinking Water Well t? 5 '�. feet *Other - ----- --- -
I- .IV .0 011-4 4- DEEP OBSERVATION HOLE LOG
Depth from
Surface tinches)
Soil Horizon
Soil Texture
JUSDA)
Soil Color
tMunsell)
Soil
Mottling
Other
(Structure. Stones. ilouldars. Consistency. %
Graven
0
-Al
f L
)Q
3— 3 -2
Ft
4 3-0
-/,o 00 r- 0,7 0 L t 1p
5'0
Z,-) 45
—
/0 A,4 wc - 17
Zv
7, �5 YR
15YX7 e -
YOM= lovi-Ay
PRC)Pf)r1Fr)
nj
Parent Material (geoiogic) e! 7 r Depthtoll > )00
Depth to Groundwater. Standing Water in the Hole: A/0 --v 'L Weepina frorn Pit Face: 0v Ov t:.
Estimated Seasonal High GMX-jd Water.
DEP APPR01*7M FORM - Uffl7jV5
FORM 12. - PERCOLATIO.N TEST
177 (2/4-9
Location. Address or Lot N - , 'T
0. 2. 40"C 9 1"1
COMMONWEALTH OF MASSACHUSETTS
. /'/- Massachusetts
Percolation Test 0
Date:
Vz- Ila j Time%
LO b :se :ry a t :io n fHo I e
Depth of Perc
Start Pre-soak
Ir
— ---------
01 Zl*
End Pre-soak
3)
Time at 12"
9
Time at 91 -
Time at 6 -
Time (9"-6")
Rate Min./inch
V
Minimum of I
reserve area,.
percolation test must be performed in both the primary area AND
Site Passed Site
Failed D
PerformedBy:
................................................ : ............ . ........................
Witnessed By:
1, Ao-001Vo�-A,'
Comments:
Eff
DEP AMOVED FORM IMVS
FORM 11 - SOIL EVALUATOR FORM
Page I of 3
No. Date:
Commonwealth of Massachusetts
,"I/0. , Massachusetts
Soil Suitability Assessment fibi: On-site Sewage Disposal
Perfonned By: .. ........ C ....... Date: V/00/
Witnessed By: ...... . ..... ............. I .......... I ...........
Lo-ation Address or �P—D Oww's Name.
Lot Address. and
/Val.
Telephone 9 ove
jew construction El Repair .770 450/- //115
Office Review
Published Soil Survey Available: No El Yes 14
Year Published ............. . Publication Scale � . . ................... Soil Map Unit
Drainage Class ................ Soil Limitations
Surficial Geologic Report Available: No 1� Yes
Year Published Publication Scale
GeologicMaterial (Map Unit) ................................ .... I .............................. ... - ..................... I ...... ......
Landform..................................... ....................................... ........ .............................................
Flood Insurance Rate Map:
Above 500 year flood boundary No 0Yes
Within 500 year flood boundary No 0Yes 1-1
Within 100 year flood boundary No E]Yes D
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month
Range :Above Normal RNormal OB,elcwNormal
Other References Reviewed:
11
DEP APPROVED FORM - 12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No.
On-site Review
Dee p Hole Number .. / - te:..///`��`*`/`*`/�95�'/ Time: Weathe
Da
Location (identify on site plan)
L a n d U s e Slope .147' Surface Stones
Vegetation
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage Way/ feet
Possible Wet Area feet Property Line feet
Drinking Water Well /2'.P.157 f eet Other . ......
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency,
Gravel)
601
YZ
i%W7 2—
Yf—
-:5
X
lo
'!�v '/ 171W
0
d
. rA I NjrVjUrvj Ur 4 MULro nv-,-iuinvw ^ - 6�
Parent Material (geologic) A�<Ave-14eK — DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water: 19F)�
QDEP A.PPROVED FORM - 12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot i�o. '47
On-site Review
e>
Deep Hole Number Date:..-.1//r//e0-/ Time:.. Weather
Location (identify on site plan) . ......
Land Use Slope M ;�-7 Surface Stones
Vegetation —<�vo-' ... ...
oil W.I., ... I - - . - : ,, ".. - ...r...... .. � - - . - - - - :2
Position on landscape (sketch on the back)
Distances from: '3e74!7 feet Drainage way f eet
Open Water Bo -d-,, --m
Possible Wet Area feet Property Line feet
Drinking Water Well 110�5 feet Other
DEEP OBSERVATION'HOLE LOG*
Depth from
Surface (Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
oca
17
7
J3
ew
— I MINIMUM OF 2 HOI-Lb KLUUIHtU A I LVtNT rnuruaru U10rV0MLIAn[;M
Paren t Material Jgeologic) 6�� DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water:
DEP ATPROVED FORNI - 12/07/95
11
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No..�n? C;Poe'07 --��z
Determination for Seasonal High Water Table
Method Used:
Depth observed standing in observation hole inches
Depth weeping from side of observation hole ... .... .. . inches
Depth to soil mottles inches
El Ground water adjustment ................... feet
Index Well Number ........ Reading Date ............ ..... Index well level .
Adjustment factor . .................. Adjusted ground water level
Depth of Naturally Occurrina Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system?
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on (date) I have passed the soil evaluator examination
approved by the Department of Environmental Protection and that the above analysis
was performed by me consistent with the required training, expertise and experience
described in 310 CIVIR 15.017.
S i g n a t u r e Date
aDEP APPROVED FORM - 12/07/95
0
NEW ENGLAND ENGINEERING SERVICES
INC
January 30, 2002
Sandra Starr, Administrator
North Andover Health Department
Town Hall Annex
27 Charles Street
North Andover, MA 0 1845
Re: 29 Barco Lane, North Andover, Septic system design
Dear Sandra:
Enclosed are the following documents regarding the above referenced property.
1. 5 sets of design plans.
2. Soil evaluator sheets.
3. Application for approval.
4. Check to cover the review fee.
If you have any questions regarding the information submitted, please do not hesitate to
contact this office.
Sincerely,
& c
Benjamin C. Os EIT
President
00 - F
60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099
BOARD OF HEALTH
NORTH ANDOVEF, MA 01845
978-688-9540
APPLICATION FOR SOIL TESTS OCT 2 2 2001
DATE: j.01 z i 10 MAP & PARCEL: ' 10 L-1 F> )IS -
LOCATION OF SOIL TESTS: 2,c( &caco �_czotv_
OWNER: V_ u) E&C-0— -TEL.NO.:. '1-78-_2R��"LJZ
ADDRESS: Zt E>a(zcc,
ENGINEER: �)c,,,, TEL.NO.: c1_Z8-6EX-,-i76P_�
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This:
Repair Testing: Undeveloped lot testing:
In the Lake Cochichewick Watershed? Yes
No x
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
1. Only Certified Soil Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
3. At least two deep holes and two percolation tests are required for each septic system disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the
BOH representative.
5. Full payment will be required for all additional tests within two weeks of testing.
6. Within 45 days of testing, a scaled plan (no smaller than 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 sod evaluation forins shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval:
Date Received: _ff0bj?P- 9 tO / Check Amount: Check Date: b L'� lb I -ewe
C"_qzy-&
Fo r in I Da' 7
OCT 2,2 2M
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104
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DATE: 01 z
LOCATION OF SOIL TE
OWNER: —2c, �-c 0- �'
ADDRESS: Z I"- E>c,
BOARD OF HEALT14
345
STS
t't)'4� A�t4
6 P4 -
OCT 2 2 2001
'� ;? �� C-'�; Ll z
ENGINEER: E-Adi -7 7 8 176 !P)
CERTIFIED SOIL EVALUATOR: 04p -
ck
Intended Use of Land: Residential Subdivision Single Family Home 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
j1pgrades. (If time is not critical, fee for repairs is $75-00)
GENERAL INFORMATION
L 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 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
kl� Check Amount: Check Date:
BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR SOIL TESTS OCT 2 2 2001
DATE: MAP& PARCEL:
LOCATION OF SOIL TESTS:
OWNER: —2c �-C- tz- ccfFe- -TEL.NO.: 1-76'7;�C,5-LJ2
ADDRESS: Z"t
ENGINEER:
�c4uu a�Flz TEL. NO.:
7 8
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Home 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 I "A 00') 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 Cominission Approval: _Qm
r
Date Received: . Lo kg 1z � Check Amount: Check Date: 6 k?) lb I
�7
7
P7
CIO'
OCT 212 2001
IA A
A
72'.
Ci
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Eli
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31
01
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11 c
Town of North Andover
Office of the Health Department
Community Dev%elopment andServilices Division
Williarn J. Scott, Division Director
27 Charles Street
North Andover, Massachusetts 01845
Sandra Starr
Health Director
North Andover, MA 01845
Re: Application for <a
Telephone (978) 688-9540
Fax (978) 688-9542
Dear:
Your application for c4a 6 at 30 r (!Z—) has been reviewed by the Health Department. The
application was been denied on
/j/ 2001 for the following reasons:
1. 0 Missing information
2. ok"""
Passing Title 5 inspection of septic system required I Q )5n neck)
3. 0 Location of structure not acceptable
To address the problem(s):
If #1 is checked, please supply:
a. Floor plan of existing and proposed addition
b. Certified plot plan showing house, septic system and proposed project in scale
If #2 is cj3—ecked:
a. I Have the septic system inspected by a certified Title 5 inspector to determine the size of the system
and whether it is operating properly: OR
b. Tie-in to municipal sewer
If #3 is checked:
a. Relocate the project
Please feel free to call the Health Office at 978-688-9540 with any questions you may have.
Sincerely,
Reviewer
Cc: Building Department
File
BOARD OFA-PPEALS 6SP-9541 BUILDING 689-9W CONSERVNTIOT 688-9530 NTURSE 68,R-9543 PLAYINTING 6B-9535
I
JOE LE
FORM - U - LOT RELEASE FORM
IP1-1 �f (_ 0 "-,�
10�L,(,c A
3QK(�
,<-UCTIONN: This form is used to vanify that all -necessary approval / permits from
j and Departments having junisdiction have been obta'
s ined. Th*s does not relieve the
,,plicant and or landowner from compliance with any applicable requirements.
I .... a 0 0 a 0 a 9 a 0 i E a E ff a a E a a 0 0 0 a a a a N a a a a 0 0 a 9 x 0 a WN 2 N a R a 0 x a 0 5 a a N 0 a N a M a a a 0 x a 0 a a a a N a
APPLICANT Pnife__r q# _C_cAr,,o I U-) eqe r PHONE
ASSESSORS MAP NUMBER LOTNUMBER
SUBDIVISION
LOT NUMBER
STR.EET_ 8 a rc,0 a n P_ STREET NUMBER L
on* W on mean . nouns amsessonanummommax N man a
OFFICIAL USE ONLY
gas Naga an-wrism on no
RECOMNIENDATIONS OF TOWN AGENTS
DATE APPROVED
X CONSER'VA_'TION ADMINATRATOR
DATE REJECTED Lk4
DATE APPROVED
TOWN PLANNER
CONOAENTS
FOOD INSPECTOR - 11�ALTH
SEPTIC INSPECTOR - HEALTH
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
PUBLIC WORKS - SEWER / WATER CONNECTIONS
DRIVEWAY PERAOT
FUZE DEPARTNfENT
CON94ENTS
RECEIVED BY BUILDING INSPECTOR
DATE APPROVED
DATE -REJECTED
Iv—
WELL DATABASE
ADDRESS:. �, (1 8 AAt� � n,7
AGE OF WELL. 1\4' WELL DRILLER:
-j--
WELL PERIYET,u- 'WELL LOCA'7ON:
--W= PER.&[IT DATE: DEPTH OF ViELL.--
"TYPE OF W=-- a.. DRILLED b. DUG C. UNKNNOWN
TYPE O.F WATER BEARING ROCK�
WATER ANALYSIS DATE-- PH iVfANGJSE: Y
HIGH IROY. Y N OTMM CONTAMW-ANT y N
A,v,�-