HomeMy WebLinkAboutMiscellaneous - 295 FOREST STREET 4/30/2018TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
7/19/01
This is to certify that
the individual subsurface disposal system
constructed ( X ) or repaired ( )
by
William Sawyer
at
295 (Lot B) Forest Street
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.
Board of Health Inspector
".9
-,;egq '
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System (Y51constructed;
( ) repaired;
by
located at Ze 7- a eu 7- -S
was installed in conformance with the North I r B d of Health approved plan,
,//Np oye oar
System Design Permit #IW, dated / /-0 e) . with an approved design
flow of ��O 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: 11'13,qh.�d
Final inspection date:.
ffnjm�eelRepresentative
Engineer 9epreszntaiiv_e
Installer: A401 Lic.4:/
Date:
Design Engineer-.�'. (Ijlf �Z�e� D ate: 7
MW -i CF: ' �3_rt A" :)O",:R/
I 8Qr'R:: C = iqt��Lt A
7
3 2001
AS -BUILT CHECKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS 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 -W*TIM 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
�1-14-00 10:01 A"CiDveir-
� - - — — ,.t-mfvt fr%T FOR SEPTIC SYSTE'N45
INtitot:t- I IVI'M .-A -
A. ROMM Of Bad
1. F
.X=vation to "!��vnticn are beneath 13 haizw
2, WM fzmcn';',
3. Edge
wified disw= &GM founIM,
-----------
'L fled
w..n height and width as 911-
3. wan Mjpirnwn 10' W, 19MMUIS AMM—j
4. Wall fnem SP="'""�--
commem:
I- Pipe diuncM , Mulus"
2.
!ntet to tank ccrmmt0d
5. slope Minifftum 0.01 U9 I/*.*- per loom
W-var-- f-:,= �M"-
6. PiPc PrOPffly - Smcnf �d& ',n Wsiaht URt
7. NP9 441;;; in alffanent UW Fade
chanip
t n, in;mLm Offl9t to WSW line
508 68s 9542
--_I, o4- ZZ -AT
+tl
Yes 140
P. 02
y
T ^WA
-1.-10-0 0 minimum
7—.
3. 93= baMe presc!a an cw=L
4. MWAOW W 5"-
-I- -.- 0.0"Tow mtd caCh tM
VA
12" undW ifkvUt
Outlet teg UtinimUM
,9. Outlet line Mfienrea
10. Ailr q*w -f" 2007 w9�0
— itiit to - -
3-,-4'v�
V -
base wM tr Of Y*" crushed
SMD uffmm bwAft
is
14. TiW vsmtiot
P. 02
y
j?Rp-,-14-00 10:01 Npirth Andover Com. Dev- 508 6BS 9542
-X)NV, KD -r 15 40re<-T
o'
—'rI \.Ct C-) V — I -
Yes NU
E. ftmp Chxffdm
I jF%ffi"*rUft from tanir, compact base with 6- of stOne undanea*-"
I Min6um 2!- pipe to d4m if gmvitY NYMM
1 20- access mafihOl*
4. Tank Wei
amr— wi+ nhwi sos6fication
I Uwahale to arm& %
9' Ch;�i vIL14Od bkedcr We premu
9. Al2M in building an Upwift cirmit
10. Alarm fiAWOUS
S- out ..I --
kL sch Traxna
1. i4inminuffu 2
—�16^ftwjwsArt AOYW with Otan. (NUX fenSth 1001
I Ar.db of wmches amm with Plan - MinimLffn 2; mwdmum
fled
4� Vent WNW if<50 fc*t Or Wa6
5. Dig== Wwem weneftes MMMUM
- -- --&— in,
6. Minimum dLqmc;t berwaEu- , . -
S. --. - —*-:—
T. ?�* '$Jim
,ftrPnMeg below ouft invm minimum oC6-,
P. 03
I .
04)OK ICVCI
2_
Minimun 0. 1 r p drop &am. inset to oucieL
3.
Minimum 67'FAnP
4.
QuIlOt Pi PCs Wtow %4udL%
4"Ar9#TMf'bmenth box
'T
All "es Cern;;.d with hy&aulic CWDCOt
Sche&le 40 Pipe
Commaws.
G- Soil A-boomrVolicaft
1.
All SMe double-WaSbCd -1/4"
.............
w;.;mum 6- awe wwewh pipe
4.
Eissibuem linft COPPOd Or cOmuxftd togemer
S.
Colding meeft 3:1 3X"
6.
MftftUM or V- at UIR W�
of wwatr, if nak then SWIRIe
7.
- edae
- J, I
%, /� A ti
-7
I' A A 11/1 In -A PW I I Is j , NF-
1 11 - .
IVI IL -Y- %fll V�4LA-A
kL sch Traxna
1. i4inminuffu 2
—�16^ftwjwsArt AOYW with Otan. (NUX fenSth 1001
I Ar.db of wmches amm with Plan - MinimLffn 2; mwdmum
fled
4� Vent WNW if<50 fc*t Or Wa6
5. Dig== Wwem weneftes MMMUM
- -- --&— in,
6. Minimum dLqmc;t berwaEu- , . -
S. --. - —*-:—
T. ?�* '$Jim
,ftrPnMeg below ouft invm minimum oC6-,
P. 03
Jun -14-00 10:02 Nov.-th Andover Com. Dev. 508 6sa 9642 P.04
1 --4- a
Yes NO
9. pipft so an stable bm.
('ewnments:
L'G"If &- OWL%&
Iona+ MF field 100'
I. wm Slone minimum 0.005 of 5 " Pef too,
I S�P&�Oft bdWeeft VPC 6* M24MUM
4. pipes we ecced at end - . �- .-A'
zdjWMc'LIcIW* IV
bazz
e."*m6nn &nrn edge of field to 1591A line
wnhoum me distnbu6on lines
9, MWdMMPM"t*20Mpi
y 1~hinffF,--t
1_ jWUjhMUM WeL pipe 4-
2. Pitsoftmaetc
3. Sidawall bKvieft I mm40 wl%m
- -1 -- -- --.A. -;* .
4. ACCM MWUPJ46* — — P-' "I.
nf-- ---*-A -414 hVA"y olic cpMeffit
K Lv� �.-- - --- ..' - - -- -
N
inoqtm" m inimum 0.02
-MM
A a ,.q. "ponew ewaved by at least r %oil
I. covee 861 fi= of Imes Ina d=,6"
4. Gnding Sigpes away fivm dwelling
5. No vial ovcr TYWM Ma "say rm"
LU
z
0
.0
z
E
I
0
LL
LU
-j
0
F-
0
-j
<
LU
L)
ro
in
(v
CA
ro
0.
Ln
Ln
LU
ce CL
LLJ
ce
0
0 <
> m
C:
0
LL
<
w
0
0
U
<
-C ce
ce
tE
0 o
z cn
0
0 0
u
0
0
<
0
0
0
zi
(z
tA
kA
.21
0
ta.
<
INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction of the septic system for the property
relative to the application of
dated f—tS2,000 for plans by and datedg?,j;Z/9, Zg?q with
revisions dated �2 -Z2 _V2�
I understand and agree to 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 in�taller I am required to have the necessary work completed prior to the applicable
inspections as indicated below. I understand that requesting an inspection, without completion
of the items in accordance with Title 5 and the Board of Health Regulations may result in a
$50.00 fine being levied against 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, des, etc. As -built or verbal OK from
engineer must be submitted to BOR 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 understan 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 ftirther 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 License�jeptic Installer
Date:
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: 2_0M C-u=iNTLNST.,kLLER'SLICE,-�SEr--
LOCATION:
LICENSED DiSTALLER:
SIGNATURE: _TELEFHONE9
CHECK ONE:
NEW CONSTRUCTION: Zl_�
IFNEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
I
A�rninistrntive Use Only
S75.00 Fe-- Attached? Yes NNO
Foundation As-Bu�'t? Yes No
Floor Plans? Yes ING
Approval
D ate: _L15�1 1_ez
0
I
Town of North Andover, Massachusetts Form No. 1
,,%ORTH BOARD OF HEALTH I . 4
19
0
FOR SITE TESTING/INSPECTION
APPLICATION
Applicant 'S'L, '7
ADDRESS TELEPHONE
NAME
!F3
Site Location �-O--r
Engineer 1� " 15 rM *'J I TELEPHONE
NAME DDRESS
Test/l nspection Date and Time
CHAIRMAN, BOARD OF HEALTH pv
Fee Test No.
S.S. Permit No. /&2 D.W.C. No.j��C.C. Date -81bg. Permit No.—
4
No.
FORMli - s61L EVALUATOR FORM
Page 1 of 3
Date: -71-��-117
Commonwealth of Massachusetts
, Massachusetts
Issessment for On-site Sewage Disposal
Oct i-� ef Se r's e, Date:
Performed By: ........ ....................... 4A..� . ......... 'T
.......... P!t� k. ,�. .
Witnessed By: ...... J3-j^-eLz% .. . .......... rj
L=tion Add=S Or /--o'T Owner's Nam, R, -Tacle-e—
L'ot # ML j06 )qk� Address. and 9T-�
Telephone I t 6- M 4
J;
NewConstruction JZ Repair
Office Review
Published Soil Survey Available: No Yes
Year Published J ?,91 Publication. Scale
loci/ ....................................
Drainage Class ........ ......... Soil Limitations
Surficial Geologic R eport Available: No 2 Yes
Year Published Publication Scale
Geologic Material (Map Unit) .....................................................................
Landform............................................................................. ...............................................
Flood Insurance Rate Map:
Above 500 year flood boundary No []Yes 21,
Within 500 year flood boundary No E]Yes 0
Within 100 year flood boundary No El Yes 0
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month
Range :Above Normal ONormal E1Belc--.vNormal El
Other Refere nces Reviewed:
iaDEP APPROVED FORM - 12/07/95
Soil Map Unit
13
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. 4,7- 13 T r -
On -site Review
Deep Hole Number � -/a -j Date: /# 7/ " Time: 11"A0 Weather elea- r -
Location (identify on site plan) ....... /,,�o . ujdey-s
Slope Surface Stones
Land Use
e..........
Vegetation . ........
Landform 7-? #R.03.c
Position on landscape (sketch on the back)
Distances from:
.Open Water Body /00 * feet Drainage way feet
Possible Wet Area f eet Property -Line feet
Drinking Water Well )190 . feet Other
iiDEP APPROVED FOPM - 12107195
DEEP OBSERVATION
HOLE
'_OG
Soil Texture
(USDA)
Soil Soil
M u n7Csoe'101)r Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
le
re, 67—S
Depth from
Surface (inches)
Soil Horizon
F,2
YIR
tj- Y
k
t§/d
"sloe
k s.5 b ly
r-ew ir62irs- ro.�6 se;? or
.
am tie ly
M,
d -S-Y A C
6
C_
2,57Y
�A
Standing
High Ground Water:
Water in the Hole:
DepthtoBedrock:_
Weeping from Pit Face:
--MINIMU
Parent Material (geologic)
Depth to Grou ndwater:
Estimated Seasonal
iiDEP APPROVED FOPM - 12107195
FORM 11 SOIL EVALUATOR FORM
Page 2 of 3
/3 r_0 —r -e t
Location Address or Lot No. _I __
On-sitte Review
Deep Hole Number _Y Date: 1AA11?
Location (identify on site plan)
Land Use ... ICAM�.A.-_. Slope M)
Vegetation A!k
me: Weather 6/0 LAI V
..................
C�4 ide r
Surface Stones
..........
Landform
Position on landscape (sketch on the back)
Distances from:
Open Water Body f eet Drainage way feet
Possible Wet Area /40 f 'feet Property -Line f eet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE -. OG_
Soil Texture Soil Color Soil
Depth from Soil Hionzon (U 0 Mottling
Surface Onches) I I
# C
A.,
0yo
Other
(Structure. Stones. Boulders, C:onsistency, O/C
Gravel)
fe", ir -
ii -e
7
.. ............... ...... ........... ....... AKLA
DeptMoBedrock:
Parent Material (geologic) Weeping f rom Pit Face:
Depth to Grou ndwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water:
aDEp AppROVED Fo"t - 12107195
L37 yr\
F _YA
M, 16 Yk
6119
hk
# C
A.,
0yo
Other
(Structure. Stones. Boulders, C:onsistency, O/C
Gravel)
fe", ir -
ii -e
7
.. ............... ...... ........... ....... AKLA
DeptMoBedrock:
Parent Material (geologic) Weeping f rom Pit Face:
Depth to Grou ndwater: Standing Water in the Hole:
Estimated Seasonal High Ground Water:
aDEp AppROVED Fo"t - 12107195
FORM 12 - PERCOLATION TEST
Location Address or LoT No. )6T B 5T,
COMMONWEALTH OF MASSACHUSETTS
, Massachusetts
Percolation Test*
Date:
Observation Hole #
Lf - /;z
Depth of Perc
Start Pre-soak
End Pre-soak
Time at 12"
Time at
J'2 Id
/11 3S_
Time at 6"
42 3
Time (9"-6")
_T
Rate Min./inch
Minimum of 1 percolation test must bo performadi ir, both the primary area AND
reserve area.
Site Passed �EL Site Failed M
Performed By: Pek ksei-x
Witnessed By: -3 ^6 Li --r J-eff
?'7
Comments:
DEP APPROVED FORM - 12/07/95
Location Address or Lot No.
t
Method Used:
FORM 11 - SOIL LVALUATOIZ FoIzAl
Page 3 of 3
D Depth observed standing in observation hole .. .... inches
El Depth weeping from side of observation hole inches
S 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 )ccurring lervious 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? Ye- S
if not, what is the depth of naturally occurring pervious material?
Certification
I c . ertify that- on /0 0/ 9 (date) I have passed the soil evaluator examination
approved by the DepartFnent of Environmental Protection and that the above analysis
was performed by me consistent with the required training, expertise and experience
described in 310 CMR .15.017.
` Date 3b -V lye
Signature —
DEP APPROVED FORM - 12107195
zt
"Mom
0
LAIT
ou
d dSC:EO 86-OZ-AON
t -L4
LAIT
ou
d dSC:EO 86-OZ-AON
OVA
SO'd ETEO-99V-Sos Sld/3d ap�q-An_L
I
Town of North Andover, Massachusetts Form No. 2
BOARD OF HEALTH
4P
DESIGN APPROVAL FOR
C U SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applican
Site Loca
Referenc,
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health. I
Fee 10�55-1
CHAIRMAN, BOARD OF HEALTH
Site System Permit No. 1462
SEPTIC PLAN SUBMITTAL FORM
LOGATION:
NEW PLANS: YES
REVISED PLANS:
(:;:is:
SITE EVALUATION FORMS INCLUDED:
DATE: Z' 4
$125.00/Plan
$60.00/ Plan
YES
DESIGNENGINEER:
,77-TIV
DATE TO CONSULTANT:
When the submission is all in place, route to the Health Secretary. FEB 2
SEPTIC PLAN SUBMITTAL FORM
LOCATION:
NEW PLANS
REVISED PLANS
(ZaD
YES
r -
pro
��-5�7-
$125.00/Pla.n
$ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: NO
DATE:---�:
DESIGN ENGINEER:
DATE TO CONSULTANT.--�-����
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering -
When the submission is all in place, route to the Health Secretary.
---DOVER/
T Okh" N 0 F iTOTTF A I f H
0 )F
MAR 7 4 1999
k
Nov -20-98 03:34P Paul D. Turbide, PE/PLS 508-465-0313 P.01
'Facsimile Cover Shoot
To: SANDRA STARR
Company: NORTH ANDOVER BOH
Phone: 978-688-9540
Fax: 978-688-9642
From: Carlton A. Brown
Company: Port Engineering Associates, Inc.
Phone: (978) 4654594
Fax: (978) 4654313
Date November 20,1998
Pages Including This
Cover Page: 5
Comments:
Enclosed are the results of perc tests on:
Ralph Joyce Lot B Forest (Nhp 8 1) and
Walter Joyce 595A Boxford Street
Comments on Forest Street: Only Lot B was perced, Curt Young was out flagging
wetlands at 10 am when I first arrived. It is probable that a system on this lot will require
a variance for 100' from wetlands. A John Deere 41 OD backhoe was used, and was
unable to pick the boulders from the bottom of the pits (I believe that an excavator could
go down n=b deeper. Evidence of this is that only 30 feet or so away was an eight to ten
foot old foundation hole with the same type of material). Thus on Test Pit 1, there was
not 4 feet of permeable material observed. A system designed on today's test must be
conditioned on having an excavator go out next spring to verify a 4 foot permWe layer
and to look for mottles (none were observed in the shallow Test Pit 1). Also only one
perc test was performed, so another perc will also have to be done in the spring.
Thanks,
Carlton
CHRISTIANSEN & SERGI, INC.
PROFESSIONAL ENGINEERS AND LAND SURVEYORS
160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830-6318 (978) 373-0310 FAX: (978) 372-3960
April 27, 1999
Ms. Sandy Starr, R.S.
Health Administrator
North Andover Board of Health
27 Charles St.
N. Andover, MA. 01845
Re: ssds revisions lots A & B Forest St. for Ralph R. Joyce
Dear Ms. Starr:
We are in receipt of your letter dated April 16, 1999. In response to the issues
raised in said letter:
1. Trenches were considered but rejected due to area limitations for the
following reasons:
a.) The break out requirements would require the trenches to start
approximately 301 from the southern lot line. The width of system including
reserve would be an additional 321. With the required 101 separation for the
system on lot A, the total distance from the lot line would be approx. 721 to the
first trench on lot A. This would not leave enough area to the 1001 wetland
setback for the system on lot B.
b.) Nearly twice as much of the lot on the south side of the proposed
house on lot B would need to be cut and filled.
c.) The higher water table in test pit 98-12-2 would require a pump
to be used in the primary system initially rather than added later should the
primary system fail.
2. The leach area on Lot B has been raised .881 to have maximum 3' of cover
3. Access covers are brought to within 6" of finish grade.
4. Benchmark is located in ridge on southeast side of leach areas.
5. Pipe connecting end of leach pipes has been specified.
6. Section A -A note has been changed.
Lot A Only:
7. Easement agreement will be filed before request for certificate of
compliance.
8. Slope of sewer line from building is 0.01
9. Profile is revised.
10. grading at septic tank has been revised
Should you have any further questions in the above matter, we are available at
your convenience and can be reached by phone at, 978-373-0310.
oSin re y
f
Phili Christiansen, P.E.
PGC/w
cc: file 98074
Feb -29-00 03:33P Paul D. Tur�bide, PE/PLS 978-465-0313
February 29, 2000
Sandra Starr
North Andover Board of Health Administrator
Office of Community Development and Services
30 School St.
North Andover, MA 01845
RE: Title V third review for Lot A and Lot B, Forest Street, Map 106A Lot 81,82,83
Dear Sandra,
Because the proposed leaching beds for both lots are so close together, and the design
for both lots is shown on the plan and on the profile on both sets of designs, I have
chosen to address both lots in one letter.
P. 02
To the best of my determination, the plans dated February 17, 2000 have the following
revisions with regards to the plans that I approved in my report dated May 6, 1999:
• The building on Lot B was moved.
• A pump and pump chamber was added to Lot A
• The leaching bed elevations were lowered.
(I note that the lowering of the leaching bed elevations is satisfactory because it still
leaves a 4 -foot separation between the bottom of the leaching beds and the ESRW
determined for the high point of the leaching bed.)
Lot A
I have the following concerns for Lot A-.
o The leaching field must have a vent because of the proposed pump.
a The pump specification notes that normally are a part of a pump system are
missing on the plan (probably by mistake). Items usually addressed are:
Pump can pass 1 1/4 - solids, pump controls, alarm, manual operating switch,
bleeder hole, etc -
c3 The volume of effluent to be pumped and the number of cycles per day are
missing. 310CMR2204R
u The "on" bulb switch for the pump is shown to be located only 3 inches
above the "off' bulb switch. It appears that this figure should be more like
PRT LOt B 18 inches if 440 gallons is to be pumped in one dose.
OIL I I find that the revisions to the design dated February 17, 2000 adequately address the
'"GINEIRING regulations -
Civil FnginecrK & If you have any questions or comments please feel free to contact me.
Land Surveyors
One Harris Street Sincerely
Newburyport, NLA
01950
(978) 465-8594 Carlton A. Brown, PE/PLS
Foresta I 06a -86c
Town of North Andover
OFnCE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 0 1845
WILLL,kM J. SCOTr
Director
(978) 688-9531
March 6, 2000
Christiansen & Sergi
160 Summer Street
Haverhill, MA 0 1830
RE: Lots A & B Forest Street (Map 106A, 181, 82, 83)
Dear Mr. Christiansen:
'20 ,
Fax (978) 688-9542
This is to inform you of the approval status for the proposed septic systems on these two
lots.
Lot A still has the following technical deficiencies:
• The leach field is missing a vent (needed because of the proposed pump system).
• Pump specifications are missing.
• Volume of effluent to be pumped and the number of cycles per day area missing (3 10 CMR
15.22(04)R.
• The "on" switch for the pump is shown to be located only 3 " above the "off' switch which
appears to be incorrect if 440 gallons are to be pumped in one dose.
The plans dated February 17, 2000 are approved for a dwelling with a maximum of nine
rooms.
Please call the office at 978-688-9540 if you have any questions.
Sincerely,
-d
Sandra Starr, R.S., C.H.O.
Health Director
Cc: Ralph Joyce
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
ILI
66 LITTLETON ROAD, WESTFORD, MA 01886
Report Number 57484.2
Client:
im.
Ralph Joyce
121 Collins Landing
Weare NH 03281
Sampled by: Client Date Received: 7/16/01
Certificate of Analysis
(978) 692-8395 FAX (978) 692-0023 1 -800 -649 -TEST
Report Date: 7/18/01
Sample Information:
Lot B (295) Forest St.
N.Andover,MA
Date Sampled: 7/16/01
Test Parameter
EPA Limit
Results
Units
Total Coliform (P)
0
0
perl00m1
Fecal Coliform (P)
Absent
Absent
perl00mI
Exo1i
Absent
Absent
perl00mI
This water sample as submitted, meets all State, Local and Federal (EPA) requirements for Coliform Bacteria.
Massachusetts Certification # MA048 Michael P.. Carlson, for
New Hampshire Certification # 2739 Thorstensen Laboratory Inc.
TOWN OF NOR 1-H ANDOVER/
BOARD OF HEALTH
20
LJ UU ELLQ 2 0 :M
V/20/2000 _9:51 d299702
'HnP, P95E 01
7,TFNSFm LAB -*tjr- cl
ft V —IrLE7cri X=-, - W Z, 1AA 9 1 jj
RqmxtWumkr: C48781
Mew:
Thunder Wells
?�O-au 13"1
Mtrf=44 NH 03054
SAUVIC Ukn * Lab So&
/-to T 3 cz _92 -IJ -0 Fo zrs
j.WD440.,TFqT
Rewrt Daw lutv 2(l, Iwo
ME&I Woof SorNleft
LIA 8 (M) FgrC$r $Vest
N. Andover, MA
ck; W19100
TV ST PARAMETER
Cdoncaw
EPA MAX
Of Analytiji
"SULTS
TOW C4UOTM (p)
1 0
.
Aftenic (P)
0.0
0
co -005
c4kiwz
No Limit
913
cw%lor (8)
1-3
-<0.02
I= (3)
0.1
j 10.9 -<
Lead i P)
0.015
C0.001
masbeikum
No Limi
1.5
Mangancie (S)
0.05
0.01
peowium
Not Spec.
A-2
soduwa
1s
53.4
Alkillictity (1,;)
Not".
113.5
,401 Spec,
<0.03
Chloride f 5)
250
17.7
(Wormt
Not Spw.
e.0.02
Color (S)
is
x ISO X
canducti-q*
Not Spec.
I"'
4.0
2.6
No Limit
31
(P)
10
0.22
PH (S)
Qdcr (S)
3
2
Sulpharcs (S-.-
250
61
Tudn,'Jov
NIV �kwc.
140)(.
sadanut
pol"Aft
Mg
'Awed. x--va-wo Exc*#& BPI, STD, MVrC-*Too Nurno. To Co=t
*-Buckuwnd Buicria Now&
"-EPA AdPvwTy Lignit.' -r,-cocdskd%*soYy I Im
(P)-Prirnsry F -FA 8ftndAtcI, (5)w6ccoudary EPA Sundard (may affm otathafin
of Uriawas Woct. i C. cob proput
tMTS
PiT I 11101mi
MBIL
MVIL
149/L
ma/L
m#jL
rAIVL
ITIVI
MWL
_X/L
M91L
mg/L
1715-11
nwl
CPU
u"towelm
ms%
OWL
MS -1
w*f,
Su
TON
M81.
NT'-;
Ais -ster mmle. a subrArted, is cowidered Sa& w drh& accardh* w YPA
gwdelizwt. R3%ever, anc or moze pamnvurs exceo& EpA aztcAftd" stond&rd
as denoted by Ott 0 figm
M"Mahusem Race COMJ&4 zwMEW �Flrxoa, W
Testing Uhorowy 0 MAO0 Thorwmen Laboratory Inc.
2 1
4
CX -L 5 F,
0
BOARD OF HEALTH a -7 r- 'S-t�
SACHUS NORTH ANDOVER, MASS.
APPLICATION FOR WELL AND PUMP PERMIT
Permit # Date Z7
A permit is requested to: drill a well install a pump
LOCATION: Lot # Z,0 Z:
Owner /_/�i�Vdaress Tel
Well Contrctr.4 Add. Tel
Pump Contrctr/Py ��Add. Tel -5--29 6- TO 7
WELLS (To be completed at time of pump test.)
Type of well
Diameter of well
Use
Size of casing
Depth of bed rock Depth casing into bedrock
Seal been tested? Yes
Depth of well
Depth to water
No (_) Date of test
Water -bearing rock
Delivers
GPM for
Drawdown feet after pumping hours at
(how long?)
GPM
Date of completion
Signature of well contractor
PUMPS (To be filled in before installation.)
Name & size of pump
Size of tank
Type
Pump delivers GPM
Pipe used in well: Cast iron (_) Galvanized (_) Plastic (_)
Sleeve used to protect pipe? Yes (_) No (_) Type well seal
Date
Signature of pump installer
Date water analysis report submitted to Board of Health
Plumbing inspector Wiring inspector
Board of Health
IT9
FIM&L"llrof -vvWwvuvvvvvvuuuuuu
fit, f,
t
06/20/2000 11:05 6034653512 SKILLINGS AND SONS PAGE 03
BOARD OF III' AL'1'1-1
orth"AI'IdOvc r
Town of P 1W
DaLe
ermit
APPLICATIO14 F011 Wt: -LL & PUMP ation I -S
Applic
2. 1 cation -is hereby made for permit to drill'a well
p
ade to install (-) a Pump system" ..Lot
ocation: Address Tel.
,wner -Address
Tel. JJ�ZJM�
tell Contractor ,�Address 0e,
Address Ord Tel.
Pump Contractor -41,
)ELL CONTRACTOR (To be completl6d at "111c of test)
Well used for
,ype of Well -
Size of Casing
)i3meter of Well
Daptil casing into Bed
Depth of Bed Rock
gas Seal Tested? Yes U No Datc..of 'resting
14ell Ended in WI'. -_t_ Material ------------ -
Delivrrs Cals.per Min. for 4 hou
Denth to Water
'd own 1pumpIng
Dra,;j feet after --hours
Date of'CompleLion
ur ractor
PUMP INSTALLER (To b�-- f-dicd i.n- before
'Pump Type
S'Xze & Name Pump
Wa . Ler Pump Delivers- GPM Size of
Pipe Material Used in Well: Cast iron Plastic
t4ell Pit or Pitless.AdapLdr
was sleeve use.d t o -protect Oipe? ycs NO(-) or NamC Well Seal
Date-
DPtle Water analysi'!�'-rep6r-t- bubmitted to Board of 11dal'th
Dj,e release given tL) owner of record & 11,16g, InsP
_. IlealLh InsPeCLOT
06/20/2000 11:05 6034653512 SKILLINGS AND SONS PAGE 04
BOARD 017
Ma 5 s - ad
To . wn of Porth AndOvcri Date
-rmit j,Uj,jp E RH IT
APPLI CATI IN F )Ik W ELL & App'licatiOn
t 0 �aw C �11
3 PL . i. . cation is hereby made for petmiL
3de t 0 nstall pump system 1,ot It . ......
LAC" .1111
Dcation: AddresS--.—r-
A d r C s s 7
.jner Tel.
ddress e
0, 11
ontraCtOr 40.0.r
ell C 00,
01-Z Te I
Address
ump Contractor
ELL CONTRACTOR (To be completed ziL Lime Of pkiinp L C S L
used for
ype of Well
size of Casing
)iameter Of Well -------
)L-pth of Bed Rock DepLh COsing i"Lo Bed gock
Jas Seal Tested? Yes No DaLe. . of Testing
well Z'ndcd it, Material
)epth --o-
Delivrrs Gals.Per Hin. for 4 hou
)enth to Water
Drd�jdown feet after -pumping C�
7 'r,
Date of' Completion
Si ure e ractor
j Is Li 1. In ti on)
PUMP INSTALLER (To b-�-- f-i.11cd in- before
Si z e & Name Fump PuInp Type Used
Water PuMp Delivers GPM Size of 'Ta III(—
Pipe Material Used in Well: CIst Iron G.11v;I1Ii7Cd
Well Pit or Pitless Adapter
Was sleeve use . d to -protect pipe? Ycs NO(_) 'Fypc or Namc Well Seal
Date
IV *IV** *1�**** %V IV IV IV IV* IV *IV *IV IV IV I'di IVI if if sc IT
D,tle Water analysi*t'.reP6r-t- �ubmitted to Board of 116alth
Da -e release given bD owner of record & 111c1g.- InSP
healtii Inspector
i jj��
m p i i
0
0 ca
ca
cn
rA
cn
am
Ia.
CD
aq
C3
rn
0
0
0
z
rn
>
-t/ ivi�i6hjbf WateCResources
Department of Environment 'I ffa6Agee6n
WELL COMPLETION REPORT
WELL LOCATION GEd
,ORAPHIC DESCRIPTION
Address S E JW of
4��D N (0
yr_-� - - (circle)
City/Town
Well owner (road)
Address r N S 6W of
(mi. in tenths) Ickrale) 4
WELL USE
Public D Industrial El
WELL DATA
Total well depth
Domestic
Depth to bedrock ft.
MonitoringK Other_
=rocll:u�nc !dated material:
Wjjjtje��r-bearing rock/u n
Method drilled
�;qsol
Descrip tion
Date drilled
Water -bearing zone I s:
1) From ?��TO
CASING
type
2) From—To
Length4:20 ft. Dia(I.D.) in.
3) Fromi 0
Length into bedrock ft.
Gravel pack well: dia
Protective well seal:
dia
Screen:
Grout Other
Slot#— length from —to
STATIC WATER LEVEL (all wells)
ft. Date
static water level below land surface
WELL TEST (production wells)
�Dra%4downt?!btC �—afte r,pu mp'i rig- hrn=:L-- min. at�::��gprn
How measured A40n4;;—:2 Recovery Zuj!�-9 ft. after A6 hr. —min.
LOG of FORMATIONS
COMMENTS/,/,,4
4
M a Is
�te !ia
Al
Driller
/0
Firm
Address
CityfTown
S ervising Driller Reg.#
up
If -III 11 drill.r
Aq n' h i rK s IF sing regist e ell
Please print firmly
A _--p - BOARD.OF HEALTH COPi -.;,/-
i
.37
0 0 1, pti
ijklu�� to ;nt
ra PI_.
&I �ab Iq
1_1 44,
fASEMENT AND AGREEM_F�NT FOR
SUESURFAC'E' _C.P�_NITARVI DISPOSAL S".75TEM
Lot and
North Andove_r,
TI -TIS -EASEMIENT AITID AGREEEMIE17T maie this 7th dav of February
by and bet,,,7eer Ralph R. Joyce c-ic- 95 Main St., North Andover, MA
(herei.rafter callet _�rantor', and RalphR. Jovce
c 1: 95 Main St. , N. AndovEa:�as sacIrluset ts , (here in a f� te-_- ca I led
" Gra ntee " ) I
WTH=E.�_S, -he G-antor i- '--ne cw-ner cf the z:rocerty kncTv-n a s
Lotg A &,
7 (:: t
Tz Own c n a plar. e!-�t-itled, " Plan of Land and Coamon Drive Special
Permit" located in North Andover, YA
des]-aned Z'or
Yass, p��LparecI by
Christiansen & Serfi, 150 Summer St.,,Haverhill, 71
-lass. cated Sept 9, 1999
,,aid -plan I-eing
and revise.d to
--eccr'ed- at tl,e. Esse_x 14ort-h Distric� Rec4--try of Deeds as P'an
13674
rCue _L
Grantee is t1ae c-wner o_ -F the prorcertv known as
" L �1_ _L
c- -ii A shcvn on t1-- aforement'oned Plan No. 13674
--;zr-ae Or'3ros.=s to cr- se�ct`c sVsI_e!r
--- .-,- - - I- - - n. s Id C __ a
I C_ r-, 7 sa4l Lot -;A " Wh lc`� s -e,
vs m wi I I enta
o-': Piping, d-is-t-ri-13uticn box, septJLc --ank, e-_F]-7I1,:ent connection
I -, n. = II, - - -
1-1-s azcur-�enances thereto and/or sewer pipes ahi-ch sha"I
-a -L* n -L - hereinafter
-e connectled to a ser4es c-, leach q p4pes, (which - -
as -he 'Iseptic system", T,7t'.Lcn sp�:)Zlc
zjnlal: te refe-_-re��
shall I he I�Dca�ed o n L -o B T(
MAR - 2
A
-J R
IM
tee to effect such
WHEREAS, in order for the Gran --
construction, it will -he necessary to enter upon the Gre'ntcr's
NOW, THE7EFCRE, for and in ccnsiderat-icn of the s,,:-7, of Cnc-
and 00/1-00 ($1.00) Dollar and other qood and valuable
cons ideration , the receipt and suff _-I'ciencv c -F wh-'ch is 'nerehnr
ackncwledgeld, Grantor dces herebv grant, ccnvev and release unto
the Grantee, its succes-sors, leaall representatives ard assigns,
a r -'c' -t and easer,-,enz to en-er upon certain property
Z'
4 e C
k,no-.,-n as Lc�_ F'B , to construct, 'Iayr, opmera�:e, maintain, -.1-so t'
repair, remove and replace a sewer pipe and leaching pi��es an'
tc 1 -MV, ope-ratie, mail.-ntain, inspect, recair, remcv-i- and replace
a ny p a r ;�r the whole o. -L' the septic sy-stem. a�� described -In plan,. -
d S -a d e i, n e d f 0
S r,
& 13 '_,CE57_,57_ , Ncrth Andover,
:'Ots /_O
a ss, e 9 a - e .-; �_7/-/;f , �5 r/4
-5 RIff
Mass. d_AtedM4904 and"approvedi by --he Ncrth ;�"ndover
Eoard of Health or, 13
I I tocether wit'.h. a ricrht
I.-Ig-ress and ecress -for any and all said 3Durposes, includinq
the removal of g:�owina crcos, trees, or shrubs, therefrom, and
the right to b_rincr -upon said Easement- sach equipment as may be
n�,,�cessary to "o anY and ail acts deemed necessary to maintain,
operate, i:isnect, repair, exca,,7ate and replace s.ewe-7-- and
I
leach._,'�ng "�,nes cr anv other element of t1 ,e septi4c system in or
over that corticn of the said orccert, whIch is owned by the
to -e-urn the orem-4-ces to its present
'.Zrantor Gran—e agrees
ra c
s -C _- t e f '0 C','; 11. C - C n S L _Lon ofic the prcject and following each
P,Ji .7", 1
subsecuent entrance upon the property 'or the purpose of
J
maintaining the sys-Lem. Grantee agrees to maJ_ntain_t�e sewer
pipe and leaching pipes and all other elements cf the septic
sYster,-,, including necessary repairs and replacements. This easaTient is
limited, however, to only those portions of Lot B as are shown on Plan #13674
as the "Septic System Easement".
Saic� elements of the 3eptic system shall he the property
of the Grantee and shall not become a fixture t'Cl G-rantor/s
r
.�_ro_cerzy and shall forbid the introducticn of hazard-4ous or t cx
materials whfl_ch may interfere with the prccer oper-al--ion of the
Sept-ic system
I'_ny action by the Grantee pursuant to this Ease7ment and
Agreemenz s1aall not be deemed a -tres-ass and the Grantor does
.tl -
heraby in,:ie.mnify and hold harmless the Grantee for anv and all -
damages incurred by said Grantee as a result this Easement
and tkg_-eement other tlhan willful Or intenti-onal acts of the
.L
Grantee, i7 -s agents, emoloyees or assigns.
. The Grantor, his hel-rs, successors/ transferees and
assions shall be 'Prohl"Cited
f -On Placing, construczing or
Maintaining any drive�-;ays, f-ix-r-ures, structuras, trees or
Ii-ruzoery C
easement area, and shall be prchibited from
or maintaining any underground utilities
Cr F=nceS Or, �-r
nroperty zha� WCU -ave the ef'-fect of imceding
1 d
access from Lot A to Te
uD t B pur-poses Of -taining,
main-
inspectinc, operati,-j,�-,, repairing, and replacing the septic
S1IISZ=_.I. it is the intention of the parties that the Easement
area s-lall te Icamed and seeded,,, and snall re -ma -in a l_e,,,.m; area.
MI.-, _� -0 P
?I 1D ,
LIP., % '� I , -..�
ThLs Easement shall terminate at such time as the Grantee
r3xtends and comoletes a connection to a public Sewer pt
to include services to Grantor's properzy and
the crope--ties sho,,%-n on the ref erenced Plan No.
it is ex��ressly providJed zhat this E_=sement is appur'!_-enant
i -,o Lots:- A- and B a�nd shall run with the land.
To have and zo hold the aforementioned descri_'-�ed Easemenz�
i:o the pzooer use and benefiz of the Grantee, its successors:'
iegal representatives and ass-ig-s.
E.�:ecuted on the day a. -d date ff-irst ah-ove -,,;ritten.
GFUUNTOR:
Ralph R. Joyce
95 14ain St., N.
G F,.Z%-' I T z E
Ri�lph R. 7oyce
95 Main St., N.-APq0ier_.
COMMONWEALTH OF MASSACHUSETrS
Essex, ss
Then personally appeared the above-named
foregoing iristrLfaent-to-,be-his-fr-ee-a(-zt
Joyce
f
my Z!�ssion
ff em IR* Y-1 -
j C?C I
the
') 4 j cc --.v
toos
(woo
C/)
m
m
m
m
m
m
C/)
m
C/)
0
m
CO)
CD
a z
CD 0
Cl)
CL
CD
CL
a)
Cl)
CO)
CO)
CD
0
C:r :E 5
-C 9L CD
0 Q
CD
CL
CD
CA
10
CD
a
CD
7
CD
a. -
CO)
CD
CO)
z
CD
CD
Go cr
rn cn o -0 Co
=It Cl)
cn moo a
cm) m
CLO
CD -*=
rm =r -C
w 10 —
M 0 = �* CO
=r CL _0 Ca.
M m
-0 rn CD =r 0)
m :r a CD CO) CA
-M CD 0
N =r CD CD
CD
0 C2
o =
to ft�c
0 C2
0 La. c 2
o CD
=r
CL
um 0
CD CD
CD C-3-0
co 0 CD
CL
n,,
0
or
12-0,
cn
0
cn ;,- 0 �Q
C, SP!z
03,
w
n
CD T
cl:
0
=r
CD!R Cl)
0 O�j
zJb
CD
St =r �g AMX
CD
Cos aLwi 0
NY
-3
CD
O�q
sb
CD:
CL
lu 0
Amft
24: ca 0 .
CA : —P -,j Amp
pt : -1
tz:
0:
CD:
0 -A
W
cn cn w
0
0
,- i COD
rD
RL C:
0
0
r-
S-
aq I'd
x n�- g,
0
i IL
10
ia.
cp
0
10
a
0
al
0
z
> cs;s
pa
cp
0
>
9v
(
onq
0
9
0
41�
CD
ol
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
I
****************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT PHONE
LOCATION: Assess&s Map Number_a���- PARCEL/4��1`5�71ZOb 717
SUBDIVISION LOT (S)
cl� -7
STREET o r< 5 �r,- ST. NUMBER_6,_/
**********************OFFICIAL USE
RECOMMENDATIONS OF TOWN AGENTS: pew 40 vy-V
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
COMMENTS
FOOD INS
UA I t: KtJtl- I MU
DATE APPROVED
DATE REJECTED
�-C IN§f�eTOR-HEALTH DATE APPROVED
DATE REJECTED --
COMMENTS
PUBLIC WORKS - S1
9
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR
Revised 9\97 j m
DATE
. .14
91Z
110101
"O'l
LO
I I
:T,
to
C -D
ul
V)
OiL
C6
to
Cx Li -A
It
>
0-0
-7 CD
-ell
V)
<
4,
f
LO
C'4 F.
LLJ
I it
it
'14
CD
f7
t4l
ME
LL -
it
it
I LFi-
L 0
0
so,
V,
Go
I -IJ
Ln
In
(-4
CD
70
Ln
-C)
0
to *
fA
LQ I
a
lop—
lk
RM
c