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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 -An WX I Q W"m 'ANY t! 'V, pan, I.,; j �An toy- too" I Q W"m 'ANY t! 'V, I.,; j �An toy- �jw T_k �y ........... M405 Z�s VMS T_ _0 V-1 . . . . . . . . . . VIA W �j �d 0" A 4 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: V NMI On 31 % �'Tjl mw* -0 PON- P, Aw -00- A wh Aj "K Q, SN nil AS AQ v7 ism, KA I Of A 1 I yt lot U SAT ��:04 rK , A 1 SIT w"I" 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. . , �.,;. �` .., � , .: �� � ..} �'; i � + . �,� � � i .� _ /. . � :?:. �� � l � � - r __ a �� 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 _rj OCT 2,2 2M 'I, �,,J(Iooc .4 1 G. 0 0 0 L 2S 4 -:1, e Ac: I . 01 ao en J c%i --T-24 cli Pt t .1 5: ip N Qcl.- Lo 3 ul e Ac: v" - Hoonan &'McDowell, Inc. r-1110 �-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 --j -,A A2- .... ............................... .4 IG.8'2) . LA 0 Ci 2 S - co 01 on a, go g,w cu --T-24 z C- C> q-. V, co kRy E Up N 0 Ld 104 Tr- m r Lj N cz� ul I 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 L 2 S— 13 1 0 Eli % 31 01 t4 - gt-P 4 -to OF ui AQ�-� NEZD r Z 4*7--,-7 4 cu 2 4 cu LV ul 1 1 LIft 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,�-