HomeMy WebLinkAboutMiscellaneous - 295 REA STREET 4/30/2018 (2)r, . I
North Andover Board of Assessors Public Access 'k Page 1 of 1
http://csc-ma.us/PROPAPP/display.do?linkld=l 702187&town=NandoverPubAcc 10/31/2011
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PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: October 9, 2012
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Complete Repair and Construction of an
On -Site Sewage Disposal System
By:
Todd Bateson
At:
Map 38 Lot 34
295 Rea Street
North Andover, MA 01845
The Issuance of this certificate shall not be construed as a guarantee that the system will ftmction satisfactorily.
P7�
n
Susa : Y. Sawyer, REHS/RS
Public Health Director
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com
TOWN OF NORTH ANDOVER AORT11
Office of COMMUNITY DEVELOPNIENTAND SERVICES
HEALTH DEPARTMENT
'AWNW.
;41�4 . *
41704 4M OSGOOD STREET *�. I. �--. , - *
.' 4"D
NORTHANDOVER, MASSACHUSETTS 0 1845 S CHU
978.688.9540 - Phone
Susan Y. Sawyer, REHS/RS 978.688.8476 - FAX
Public Health Director E-MAIL heal thdept�Lltownofnorthandover.com
WEBSITE: htti):,,'.'wNN-w.to,,vilofnorthandover.com
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System constructed; repaired;
by_ O�rjop)
(Print Name)
located at 2 q� WA f) A?
(Installation Address)
was installed in conformance with the North Andover Board of Health approved plan, originally
dated and last Revised on /2, _,with adesign flow of
_gallonsperday. The materials used were inconformance 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 -b t ich bee submitted to
the Board of Health. 7,71) L- the As -b t w icohbee
Bed inspection date:
Engi eer e nt (Signature)
Final inspection date: And - Print Na e
Engine R r (Signature)
wY4
And - Print Name
Installer:
(Signature) Date:—
'knd - Print Name
Engineer:
Jb hr, a ,
(Signature)
And - Print Name
Date:
September 27, 2012
Town of North Andover
Health Dept — c/o Sue Sawyer
1600 Osgood Street
North Andover, NLA. 0 1845
Re: 295 Rea Street (Tax Map 38 Parcel 34)
Septic As -Built
Susan;
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
0 COT
, " 0 2 2t)12
TOWN or Noa,.tl ANDov,,_F�
_.L6ALTH
Enclosed are two (2) copies of the Septic As -Built plan for the above property for your records. If you need
me to come into the office to sign the installers certificate just let me know.
Very Truly Yours,
Jack Sullivan, P.E.
22 Mount Vernon Road — Boxford, Massachusetts 01921 — (978) 352-7871 -Phone — 978352 -7871 -Fax
North Andover Health Department
(ommunity Development Division
QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 295 Rea Street
LOT:
INSTALLER: Bateson Bros
DESIGNER: Sullivan Engineer
PLAN DATE: 2-1-12
BOH APPROVAL DATE ON PLANA -26-12
INSPECTIONS
TANK INSPECTION: 8-27-12
DATE OF BED BOTTOM INSPECTION: 8-27-12
DATE OF FINAL CONSTRUCTION INSPECTION:
DATE OF FINAL GRADE INSPECTION:
SITE CONDITIONS
Comments:
SEPTIC TANK
MAP:
El Contractor reports any changes to design plan
El Existing septic tank properly abandoned
Internal plumbing all to one building sewer
Topography not appreciably altered
D Building sewer in continuous grade, on
compacted firm base
Cleanouts, per plan
X Bottom of tank hole has 6" stone base
X Weep hole plugged
X 1500 gallon tank has been installed
— loading
X Monolithic tank construction
El Water tightness of tank has been achieved by
testing
D Inlet tee installed, centered under access port
El Outlet tee installed, centered under access port
(gas baffle/effluent filter)
El inch cover to within 6" of final grade
installed over one access port
Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
Bottom of tank hole has 6" stone base
Weep hole plugged
gallon Pump Chamber installed
El loading
Monolithic tank construction
Inlet tee installed, centered under access port
F] Pump(s) installed on stable base
F1 Alarm float working
Pump On/Off floats working
Separate on/off floats
Drain hole in pressure line
cover at final grade installed over pump
access port
Water tightness of tank has been achieved by
F testing
Hydraulic cement around inlet & outlet
Comments:
CONTROLPANEL
Alarm & Pump are on separate circuits
Alarm sounds when float is tripped
Location of control panel: basement
El Alarm signal located inside: basement
Comments:
DISTRIBUTION -BOX
D installed on stable stone base
0 H-20 D -Box
Inlet tee (if pumped or >0.08'/foot)
Hydraulic cement around inlet & outlets
0 Observed even distribution
0 Speed levelers, provided (not required)
Comments:
SOIL ABSORPTION SYSTEM (General)
X Bottom of SAS excavated down to C soil layer,
as provided on plan
X Size of SAS excavated as per plan
X Title 5 sand installed, if specified on plan
El 40 Mil HDPE barrier installed
El Laterals installed and ends connected to
header (and vented if impervious material
above)
Elevations of laterals and chambers installed as on
approved plan
F1 Retaining wall (boulder / concrete / timber/ block)
Final cover as per plan
Comments: Remove larger rocks. 35'L x 27'W x 36"D 11 Feet from house
SOIL ABSORPTION SYSTEM (Gravel -less Chambers)
El Brand and Model of Chamber: Standard Quick
4 Infiltrator Chambers
El Number of chambers per row:
El Number of rows (trenches):
Comments: Total Chambers =
BM =
HR=
HI =
SYSTEM ELEVATIONS
ROD AS -BLT INVERT DESIGN INVERT
ELEVATION ELEV ELEV
Benchmark
Building Sewer OUT
Septic Tank IN
Septic Tank OUT
Pump Chamber IN
Pump Chamber OUT
Distribution Box IN
Distribution Box OUT
Lateral 1 TOP
Lateral 1 INVERT
Lateral 2 TOP
Lateral 2 INVERT
Lateral 3 TOP
Lateral 3 INVERT
Lateral 4 TOP
Lateral 4 INVERT
Lateral 5 TOP
Lateral 5 INVERT
Lateral 6 TOP
Lateral 6 INVERT
Top of Chamber
F 7Bo—ttom of Bed/Chamber
CRITICAL SETBACK DISTANCES
Mark those distances checked in the field against the design plan and regulatory
setback
1 Suction line 222(2)
2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02).
3 As defined in 3 10 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA
wetland bylaws
Tank
SAS Sewer
Property line
10
10
Cellar wall
10
20
Inground pool
10
20
Slab foundation
10
10
Deck, on footings, etc
5
10 --
Waterline
10
10 101
Private drinking well
75
1001 50
Irrigation well
75
100
Surface Water
25
50
Bordering Vegetated Wetland
Salt Marsh, Inland / Coastal Bank3
75
100
Wetlands bordering surface
water supply or trib. (in Watershed)
150
150
Trib. to surface water supply
325
325
Public well
400
400
Interim Wellhead Prot. Area
Reservoirs
400
400
Drains (wat. supply/trib.)
50
100
Drains (intercept g.w.)
25
50
Drains (Other) Foundation
10(5)
20(10)
Drywells
20
25
1 Suction line 222(2)
2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02).
3 As defined in 3 10 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA
wetland bylaws
M V - 0% - --A!- eaffrW60%
III
Important
When Ming out
forms on the
compoer, Use
only the tab key
to move your
cursor - do not
use the return
key.
&,---h
Aimlication Whereby made for a permit to:
L] Construct a new on-site sewage disposal system*
repair or replace an existing on-site Sewage disposall systern*
Repair or replace an existing system component — What?
A. Facility Information
C� 9
'S f4"t 'Sl -
Address or Lot #
Ala, Xk6 V IF_ k'14-
CHyfrown
2.- *TYPE OF WTIC SYSTEM
Q Pump O -Gravity (choose one)
***If pump system, attach copy of electrical permit to,application***
S1- 7— /�—
TODAY'S DATE
$ 250.00 — Full Repair
$125.00 - Component
[] Conventional System (pipe and stone system)
MInfiltrator or Blodiffuser (Gravel -Less) (Attach a copy of your certification to Install this type of system.
Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement)
Pressure Dosed (1343ox Present) S.A..S..
2.
Name
rf 7� 1r, "I
3. Installer Information
Name
Address
CitylTown AS
1-11-4 -- eq i, S-' 10
state Zip Code
Telephone Number
2��128, INC,
01810 -j
state, Zip Code
- 9w
Telephone Number (Cell Phone # ffpossibliplease)
4. Designer Information
i V4AI
Name Name of Company
Zi7yffown
state . Zip C6de
- 319— --S5;1 —"-79f-1 1
Telephone Number (Best # to Reach) .
Application for DbPOsaf SystOrn Construction Permit - Pwie I of 2
ORTit
Applicatfoh.for Septic Disposal Svsterr
Monstruction -Permit' TOWN OF,
0 'RTH
ANDOVER. MA 01845
PAGE 2 OF 2
A. Fadility.Information continued....
6. Type -of Buildin
_q: 29-e idential Dwelling or OCornmercial
B. Agreement
- ?--I —I �_ -
TODAYS DATE
$.250.00 � Full Repair
$125.00 - Component
The undersigned agrees to ensure the construction and maintenance of the afore -described
on-site sewage disposal system In accordance with the provisions of Title 5 of the
Environmental Code, as well as the Local Subsurhice Disposal Regulations for the Town of
North Ando and not to place the system M* operation until a Certificate of Compliance has
ver,
been Isnq by this Board of Health.
CI — I
Nam
Date
Application Ap Y: (Board of Health Representative)
'Ra—me Date
Application Dis;a ved. for the following reasons:
For Offfifee Use Only:
1. FeeAtucheO
Yes
2- P--OiectAfgn-agetObBgadonFormAtt,,c.hcd? Yis
31: EUM I SVS P Ifso) Attac cony
pelynit kes
4. FoundadonAs-Built?
(new construction-ronly),- Yes
(Same scale as appro vedplan)
.5 FloorPlms? (new construction only).
No
No
No
No
No
40c�atldn for,01#0al Systdth �06 Page 2 Of 2
n*uctioh Permit
mENT OBLIGATIONS
SEPT IC SySTEMINSTALLER PROJECT MANAGE
As the No . rth Andover licensed installer for.�hd.constructi . on forthe septic sys I temfor.theproperty at
d , 69 of sePtic sYstem)
Relative to the.application Of
gto6staller's name)
Dated
k I My 5 uate)
Forplansby C, L/±A_J
(Engineer)
Aiid dated
kunginal cale)
writ'k revisions dated
(Last revised date)
I understand the following obligations for management of -this project:
1. A . s the installer, I arnobligated to obtain. all permits and Board offlealth approved plans pAo--r to
,perforning any:work on a site. I must have the Mrovedplans and the permit . on site when MY work
b'cing done.
2. As the . Mis'taller,.I.nabst call -for. any and all -inspection& If homeowner, contractor, project manager, of * any
other person not associated with my company schedules -an inspection and the system is not ready, then
item three- shall. be. applicable.
work -completed pfior.to theapplicable inspections as
As the. installdri I atu -required to. have the necessary
T ggdamrid. that red . u6 . stin Z An ihspecti he items in, accord
indicated below6 n, without cbmtilefioll: of. t
'Vind . 20, =.st me At,
d/oi
my compM.
is the ere is aretaining wA which
this do' .1anks-ith
1666M bf.-B.— -Generany, flistooT* ..'sped. n.
sh�uia,bedo�eArst. The linstallefffiustroquostthe inspection but does. hot have to be pteknt.
er irispoction for clevations,ti-es, etc.
f6tisthlig; .1tispecti Engine' must first . do, their-
-b. Finaj. don
As-�diilrt of verb . 9 OK (or e-mail . to:h . e thdeptO; ofhorthagdLyer.gpm) from the engineer must
afie '.�vL mstaller
be subriiitted-to -tile Board -of Health, r calls f6r.an inspection time. Installe.r must
be With a pui#p system,� all electrical w�ii-mijst be ready and able to
present for this. inspection
causepump to work and.�akrtn to fimc.tion..
c. FinatQtade —.Installer must requestinspe.ctioavvhe'n''4,grading-i� complete.� Installer -does not
have -to be onrsite.
4. As -the installer,'I understand that only I =y perform the work (other than jimple excavation) and I.ath required
iden , d inthe: attathedapplkation: f6r installation.: J ffirther
to completethe-ins.tallat.i.on of the system. tifie
reasons for denial- of the - g1stem. and/_6r'.'r` c tioti -6r su��ensiofi of -my lidente-to 6perate in. the Tbwn.of
NorthAndoyer siki�Pica-nt fines to all 12'ersdris-m—volved4te also §s1le'. . .. ...
5.. As the.instiller,1 understand thatJ during tho-pe'd6imance of th'e -following cons'trUction
steps:
a. Detezmj�aadonehartheprqper elevation of the ercar2don has been reached. -
b. Inspection of the'saad and stove -to heused
c. Mialinspecdoir by Board ofHealth staffor consultant
d Instahadon. of ft* D -Box, pYpps., stone PUMP.
ven chamber, retah2hig waff aad other
components...
6. As theinstallm luriderstand that I:am solely resnonsible for the installation of the systern as Der the
me!pf -this obliZation
Undersigned Licensed Septic. Installer
(r-oday"s D ate) .
TOWN OF NORTH ANDOVER T
T
Office of COMMUNITY DEVELOPMENT AND SERVICES Z
HEALTH DEPARTMENT
4, 1
1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 "Mm.
NORTH ANDOVER, MASSACHUSETTS 01845 C
978.688.9540 Phone
Susan Y. Sawyer, REHS/RS 978.688.8476— FAX
Public Health Director E-MAIL: healthdeDta.townofnorthandover.com
WEBSITE: hl!p://www.townofnorthandover.com
SEPTIC PLAN SUBMITTAL FORM
Date of Submission:— '� I S� �) ?— I
Site Location: 2qY &,A Lf-fk�rr
jbpo g p4 VA("J'�j<
Engineer 1 0 z
F0, Islulz
New Plans? Yes_x$225/Plan Check #_ (includes I" submission and one re-
review only)
(4� Revised Plans?Yes $75/Plan Check #
Site Evaluation Forms Included? Yes__^_ No
Local Upgrade Form Included? Yes No
Telephone#: 7?8' Fax 4:
E-mail: J_ACKIU�L_�? t--1_9M6A1T /_J/fT
Homeowner dol 47 -
Name:
�," 11'r
OFFICE USE ONLY
When the sub * sion is complete (including check):
> T Date stamp plans and letter
> t1l" Complete and attach Receipt
> Copy File; Forward to Consultant
> Enter on Log Sheet and Database
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
Commonwealth of ssach
City/Town of
Form 9A - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming
septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CIVIR
15.404(l), is not feasible.
System upgrades that cannot be performed in accordance with 310 CIVIR 15.404 and 15.405, or in full
compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CIVIR 15.410
through 15.415.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of
a new design flow to a cesspool or privy, or the addition of a new design flow above the, e tin -a proved
capacity of an on-site system constructed in accordance with either tIf–WSWEe,�t—
�9
tj�,JT-kS -R
PMR�'Tl.000.
A. Facility Information Inv
I FEB I � "'I"
1. Facility Name -and Address:
TOWN OF NORTH A14DOVER I
HEALTH DEPA5TIMEEtN��Tj
Name z 7r 14�4 fTf4qT
Street Address
/1/, '�rvvmpL /rA 016Y
Cityrrown State -2ip Code
2. Owner Name and Address (if different from above):
Name StreetAddress
Cityrrown State
Zip Code
3. Type of Facility (check all that apply):
De Residential [] Institutional
Telephone Number
Fl Commercial 0 School
4. Describe Facility:
3 ffWow-, - YJWQF jz�q/994Y AWFU�rI6
5. Type of Existing System:
Fj Privy F1 Cesspool(s) X Conventional 0 Other (describe below):
6. Type of soil absorption system (Yenches, chambers, leach field, pits, etc):
zbx__�) V40 )�Fo
t5form9a.doc - rev. 7/06 Application for Local Upgrade Approval- Page 1 of 4
Commonwealth of Massachusetts
City/Town of
Form 9A - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
A. Facility Information (continued)
7. Design Flow per 310 CMR 15.203:
Design flow of existing system:
Design flow of proposed upgraded system
Design flow of facility:
B. Proposed Upgrade of System
330
gpd -2 3
gpd 33o
gpd
1. Proposed upgrade is (check one):
AVoluntary El Required by order, letter, etc. (attach copy)
El Required following inspection pursuant to 310 CMR 15.301:
2. Describe the proposed upgrade to the system:
/L)&J"/ 06 64�t6w 4�a-- J,
A-vd �ISW JO It Al �6
3. Local Upgrade Approval is requested for (check all that apply):
Ix Reduction in setback(s) — describe reductions-
yo,A Reduction in SAS area of up to 25%: SAS size, sq. ft.
Reduction in separation between the SAS and high groundwater:
Senaration ri"n+i^� — I
Percolation rate
Depth to groundwater
t5form9a.doc - rev. 7/06
min./inch
ft.
IN
date of inspection
A
% reduction
Application for Local Upgrade Approval, Page 2 of 4
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
VQ
Commonwealth of , ssach
City/Town of V
Form 9A - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming
septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CIVIR
15.404(l), is not feasible.
System upgrades that cannot be performed in accordance with 310 CIVIR 15.404 and 15.405, or in full
compliance with the requirements of 310 CIVIR 15.000, require a variance pursuant to 310 CMR 15.410
through 15.415.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of
a new design flow to a cesspool or privy, or the addition of a new desi n flow above,lthe,. xistin proved
capacity of an on-site system constructed in accordance with either t 0 R 1 .000.
A. Facility Information
I FEB 1 "Ql`
1. Facility Name -and Address:
Name Z7- y AQW, A4TF
Street Address
/V1 IrA
City/Town State
2. Owner Name and Address (if different from above):
Name
Cityfrown
Zip Code
3. Type of Facility (check all that apply):
De Residential 0 Institutional
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Street Address
State
Telephone Number
0 Commercial El School
4. Describe Facility: r
3 effl4ovn — flyVIC�Zf
5. Type of Existing System:
0 Privy El Cesspool(s)
6. Type of soil absorption system
zsot�_, �) ir��
01
-2ip Code
)� Conventional 0 Other (describe below):
chambers, leach field, pits, etc):
t5form9a.doc - rev. 7/06 Application for Local Upgrade Approval* Page 1 of 4
�LN Commonwealth of Massachusetts
City/Town of
Form 9A - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
B. Proposed Upgrade of System (continued)
R Relocation of water supply well (explain):
Ej Reduction of 12 -inch separation between inlet and outlet tees and high groundwater
Use of only one deep hole in proposed disposal area
Use of a sieve analysis as a substitute for a perc test
Other requirements of 310 CIVIR 15.000 that cannot be met — describe and specify sections of the
Code:
If the proposed upgrade involves a reduction in the required separation between the bottom of the soil
absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the
high groundwater elevation pursuant to 310 CIVIR 15.405(l)(h)(1). The soil evaluator must be a
member or agent of the local approving authoilty,
High groundwater evaluation detgrmined by-
-y"W-V'a
Evaluator's Name (type or print) siptXl�_" Date of evaluation
C. Explanation
Explain why full compliance, as defined in 310 CIVIR 15.404(l), is not feasible. (Each section must be
completed)
1. An upgraded system in full comRliance with 310 CIVIR 15.00.0 is not feasible:
An upgraded system in full compliance wou-I'd require a pump chamber, retaining walls,
additional septic sand, and possible wetland setback relief since site is in a Riverfront
Area. These additional elements are costly and not economically feasible for the owner.
2. An alternative system _ppproved pqrsuant. to 310 CIVIR 15.283 to 15.288 is not feasible:
An alternative system is not feasible due to the installation cost and annual O&M fee.
Addtionally, this site is not within an environmentally sensitive area.
t5form9a.doc - rev. 7/06
Application for Local Upgrade Approval, Page 3 of 4
-C\ Commonwealth of Massachusetts
City/Town of
Form 9A - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
C. Explanation (continued)
3. A shared system is not
feasibl
_ �(' Aar(& 00/w amkf�o I 1SW
f),v1XW kvff2&AJ
4. Connection to a public sewer is not feasible:
/4 InillrotiPot j;FvW 1�v Alq�Q
5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the
appropriate boxes):
/I Application for Disposal System Construction Permit
Complete plans and specifications
Site evaluation forms
E] A list of abutters affected by reduced setbacks to private water supply wells or property lines.
Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2).
Ej Other (List):
D. Certification
"l, the facility owner, certify under penalty of law that this document and all attachments, to the best of my
knowledge and belief, are true, accurate, and complete. I am aware that there may be significant
consequences for submitting false information, including, but not limited to, penalties or fine and/or
imprisonment for deliberate violations."
1) Ae-� // I -
kly o 10
Facility Owner's Signature Yale
Print Name .6
37A -iv,
Name of Preparer Date
7- 7- M7 4XA/�o
Preparer's address Cityrrown
State/ZIP Code fi%n Telephone IJ
t5form9a.doc - rev. 7106 Application for Local Upgrade Approval* Page 4 of 4
t1\1
Commonwealth of Massachusetts
City/Town of
System Pumping Record
Form 4
t5form4.doc- 06/03
DEP has provided this form for use by local Boards of Health butthe
information must be substantially the same as that provided Uffini,
-4 W. - check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location- se, right front of house, left side of house, right side of house, Left
rear of house right e r of house, I ft side of building, right rear of building, under deck.
a(q15 Req- S-��4'e2+ AV-A-&J-J21�
Cityf'rown
2. System Owner:
Name
Address (if different from location)
City/Town
B. Pumping Record
1. Date of Pumping
3. Type of system: El
0 Other (describe):
State
Zip Code
State ode
-- �; <�� 1� �- tv
Telephone Number
Z
e- Wua tity Pumped:
Date Gallons
Ptic T
Cesspool(s) �eptic Tank Tight Tank
4. Effluent Tee Filter present? El Yes Eg""No If yes, was it cleaned? [:1 Yes F1 No
5. Condition of Slyst
(7 'VA--Nl
6. System Pumped By:
Neil J. Bateson
Name
Bateson Enterprises Inc.
Company
7. Loc _here contents were disposed:
I
��G. L. IS Loell V#!qAater
e-, // r1l --/ ---#—
of
F5821
Vehicle License Number
— '�:?- - rf
Date
System Pumping Record - Page 1 of 1
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9
Commonwealth of Massachusetts
City/Town of
Percolation Test
o Form 12
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
Important: A. Site Information
When filling out
forms on the
mmmitpr imp Bob Norbedo
only the tab key Owner Name
to move your -1 295 Rea Street
�Uiavi - UV —, Street Address or Lot #
use the return
key. North Andover MA 01845
Cityrrown State Zip Code
&1 978-687-3002
r% '17 Contact Person (if different from Owner) Telephone Number
B. Test Results
John D. Sullivan 111, P.E.
Test Performed By:
Randy Burley, Consultant for Town of North Andover BOH
Witnessed By:
Comments:
Date Time
Test Passed: El
Test Failed: El
t5form I 2.doc- 06/03 Perc Test - Page 1 of 1
Date
Time
PT -1
Observation Hole #
Depth of Perc
28"-4611
Start Pre -Soak
9:33
End Pre -Soak
9:49
Time at 12"
9:49
Time at 9"
10:25
Time at 6"
11:09
Time (9"-6")
44 min
Rate (Min./inch)
15 MPI
Test Passed:
Test Failed:
El
John D. Sullivan 111, P.E.
Test Performed By:
Randy Burley, Consultant for Town of North Andover BOH
Witnessed By:
Comments:
Date Time
Test Passed: El
Test Failed: El
t5form I 2.doc- 06/03 Perc Test - Page 1 of 1
IAORTil
4A
ArHki
North Andover Health Department
(ommunity Development Division
March 2, 2012
John Sullivan, P.E.
22 Mount Vernon Road
Boxford, MA 0 1921
Re: Subsurface Sewage Disposal System Plan for 295 Rea Street, Mai) 38, Lot 34
Dear Mr. Sullivan:
The proposed wastewater system design plan for the above site dated February 1, 2012 and
received on February 15, 2012 has been reviewed. Unfortunately, the plan cannot be approved
until the following items are corrected. The specific section in Title 5: 3 10 CMR 15.000, or
North Andover regulation that is not met by this design follows each item where applicable.
L--,�, - Neither test pit touches the leaching area. VAiile it is a local upgrade approval to only
have one test pit in the leaching area; it is a State Variance to not have any test pits in the
,,,"leaching area (102(2))
2. Please adjust the groundwater elevation for the location of the leaching field. For
example; TP- I has the highest groundwater table at 37". There is a spot grade in the
middle of the system at 99.2. The adjusted groundwater table is 99.2 — 37" = 96.12. The
highest elevation of the proposed leaching field must be used for the "design"
groundwater elevation unless further test pits are dug to prove otherwise.
Ll-!( Please show risers on septic on the system profile and indicate the cover(s) are to be
L,-4childproof (221(13))
. Please revise buoyancy calculations based on the groundwater depth at the closest test pit.
For example; if the closest test pit is TP -2 and the groundwater is at 48" and the grade
where the tank is going is 99.9 then the watertable is to be assumed at 99.9 -4 = 95.9
(221(8))
5. Please indicate the grade of the septic tank is to be 9" min and 36" max (228(l)) and
(221(7))
6. The toe of the slope is required to be at least 5' from the property line; please revise
(225(2))
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, Page 1 of 2
North Andover, MA 0 1845 Phone: 978.688.9540 Fax: 978.688.8476
el , "
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely,
Y. Sawyer, RRF.14S/RS
Health Direz or
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, Page 2 of 2
North Andover, MA 0 1845 Phone: 978.688.9540 Fax: 978.688.8476
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
April 18, 2012
North Andover Health Dept.
c/o Susan Sawyer
1600 Osgood Street
Building 20, Suite 2-36
North Andover, MA 0 1845
Re: 295 Rea Street, North Andover (Tax Map 38 Lot 34)
Revised Septic Upgrade Plan
Susan;
APR �.O- 201
Enclosed are three (3) copies of the revised Septic Upgrade Plan for 295 Rea Street. The revisions to the plan
were based on the March 2, 2012 review letter by the Board of Health. All of the items in the review letter
have been addressed and reflected on the revised plans.
The two testhole locations have been more accurately depicted to demonstrate that they do touch the proposed
leaching field. Additionally, the homeowner is going to have a licensed plumber raise the internal plumbing
to eliminate the need for a pump system (a local upgrade approval for a I foot vertical reduction in
groundwater separation is still required).
The homeowner is submitting a Notice of Intent to the Conservation Commission for a May 9, 2012 public
hearing to construct the proposed septic system as shown on the enclosed plans.
If you have any questions or comments please feel free to contact me.
Very Tilluly Y
van, PE
Cc: Robert & Nancy Nordedo
22 Mount Vernon Road — Boxford, Massachusetts 01921 — (978) 352 -7871 -Phone — 978 352-7871 - Fax
X
North Andover Health Department
(ommunity Development Division
April 27, 2012
Robert Norbedo
295 Rea Street
North Andover, MA 0 1845
RE: Re: Subsurface Sewage Disposal S.
ystem Plan for 295 Rea Street (Man 38, Lot 34)
Dear Homeowners,
The North Andover Board of Health has completed the review of the septic system design plans,
for the above referenced property, submitted on your behalf by Sullivan Engineering Group
dated February 1, 2012, last revised March 23, 2012, received on April 20, 2012.
This design has been approved for use in the construction of a replacement, three (3) bedroom
(maximum seven (7) room home), on-site septic system, Generally, this plan is good for 3 -years
fi-om the date of approval, however as this is a repair system Title V requires that the system be
installed within 2 years.
This approval included local upgrade approval to allow;
1) a one foot reduction in the required separation of four feet between the Soil Absorption
System and the high groundwater.
2) An eleven foot setback from the soil absorption system to the foundation wall rather than
the required twenty feet.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover, In the event an imminent health problem such as sewage backup into the dwelling is
occurring, the North Andover Board of Health may reduce the time period for which this plan is
valid.
North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, Page I of 2
North Andover, MA 01845 Plione: 978.688.9540 Fax: 978.688,8476
295 Rea Street April 27, 2011
1. Maintain a copy of the enclosed form 9b for your records
2. If site conditions are found in the field to be different from those indicated on the
design plan and/or soil evaluation, the originally issued Disposal System Construction
Permit is void, installation shall stop, and the applicant shall reapply for a new
Disposal Systems Construction Permit (3 10 CMR 15.020(l)).
3. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system installer or other representative to ensure that all other state and
municipal requirements are met. These may include review by the Conservation
Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector
and/or Electrical Inspector. The issuance of a Disposal System Construction Permit
shall not construe and/or imply compliance with any of the aforementioned
requirements.
Your effort to provide a properly functioning septic system for your dwelling is greatly
appreciated. The Health Department may be reached at 978-688-9540 with any questions you
might have. e
Sincerel
7
/wanX-1
S
awyer,
Public Health Dir
cc: John Sullivan, PE
file
North Andover 11 1 ealth Department, 1600 Osgood Street, Building 20, Suite 2-36, Page 2 of 2
North Aii(lover, MA 0 1845 Phone: 978.688.9540 Fax: 978.688.8476
11
# --C\- " Commonwealth of Massachusetts
Cityfrown of
Local Upgrade Approval
Form 913
DEP has provided this form for use by local Boards of Health if they choose to do so.
The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided
to the system owner.
Important: When
filling out forms
on the computer,
use only the tab
A. Facility Information
1 . Facility Name and Address
Bob Norbedo
key to move your
Name
cursor -do not
295 Rea Street
use the return
key.
Street Address
North Andover
MA 01846
City/Town
State Zip Code
2. Owner Name and Address (if different from above):
Name
Street Address
Ci Dwn
State
Zip Code
Telephone Number
3. Type of Facility (check all that apply):
x Residential EJ Institutional El Commercial El School
4. Design flow per 310 CIVIR 15.203:
5. System Designer:
22 Mount Vernon Road
Address
B. Approval
330
gpd
John Sullivan
Name x PE EIRS
Boxford MA 01921
City/Town
1. Local Upgrade Approval is granted for:
State, ZIP
El Reduction in setback(s) — specify.
Separation reduction from 20 between the building foundation to the leaching field to 11 feet.
D Reduction in SAS area of up to 26%:
295 Rea Street form9b-doc - rev. 7/06 295 Rea Street 4/26/12
SAS size, sq. ft.
% reduction
Local Upgrade Approval, Page I of 2
Commonwealth of Massachusetts
City/Town of
Local Upgrade Approval
Form 9B
B. Approval (continued)
x Reduction in separation between the SAS and high groundwater:
V %A W"
Percolation rate
Depth to groundwater
El Relocation of water supply well (explain):
ft.
16
min.Anch
3
ft.
[I Reduction of 12 -inch separation between inlet and outlet tees and high groundwater
El Use of only one deep hole in proposed disposal area
0 Use of a sieve analysis as a substitute for a perc test
List local variances granted not requiring DEP approval per 310 CIVIR 15.412(4):
List variances granted requiring DEP approval:
North Andover Health Dep�__
Approving Author4
Susan Sp)yyer
Print or Type Name and Title
Signature
Datb
295ReaStfeetform9b.doe'rev.7/06 296 Rea Street 4/26112 Local Upgrade Approval@ Page 2 of 2
o%
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Tuesday, May 01, 2012 9:27 AM
To: 'Jack Sullivan'
Cc: Sawyer, Susan
Subject: Septic P)lan Approval - 295 Rea Street, North Andover, MA
Attachments: 20120430162242801.pdf
Hijack,
Attached is your plan approval for 295 Rea Street, North Andover, as well as your Local Upgrade Approval.
Have a great day! @
Pamela DelIeChiaie
Health Department
Town of North Andover
1600 Osgood Street I Bldg. 20 1 Suite 2-36
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email i)dellechiaie@townofnorthandover.com
Web www.TownofNorthAndover.com
TOWN OF NORTH ANDOVER T
Office of COMMUNITY DEVELOPMENT AND SERVICES Z
0
HEALTH DEPARTMENT
1600 OSGOOD STREET; BUILDING 20; SUITE 2-36
.' 4
NORTH AN 4P3 4U -R A 4 A91R4WllJSQ;o S01845
'TWCE1VM--
Susan Y. Sawyer, REHS, RS 94.688.9540 — Phone
Public Health Director 3 97'�.688.8476 — FAX
OT he iltlidept@townofnorthandover.com
TOWN OF NORTH ANDOVE9) rw.townofnorthandover.com
HE4LTH DEPARTMENT
APPLICATION FOR SOIL'FESTS
DATE: MAP & PARCEL: ^4�
— e_,—
LOCATION OF SOIL TESTS: AWM*9@W 2 T?)Mq I '...
OWNER:- 666 milf—toao Contact#: 365 Z
APPLICANT: Contact #:
ADDRESS.
--� 6/y P/
ENGINEER: J Contact #-
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This: Repair Testin Undeveloped Lot TestingF-1 Upgrade for Addition:F-1
In the Lake Cochichewick Watershed? Yes No
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
Z11 Proof of land ownership (Tax bill, or letter from owner permitting test)
/> 8.5"x .1.1"Plot j*n &Location of Tesdnjz (please indicate test Pit sUffien theplan)
Fee of $425.00 per lot for new construction. This covers theyAilifinum.Avo deep holes and
two percolation tests required for each disposal area. Fee oW60.00 r lot for repairs or upp-rades.
GENERAL INFORAJAJJO-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 I"-100') shall be submitted to the Board of Health
showing the location of all tests (including aborted tests).
> Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Cominission Approval 1)
Signature of Conservation Agent:
Date back to Health Department: (stamp in): 4j 'Z4
October 24, 2011
Town of North Andover
Board of Health
Sullivan Engineering Group, LLC
0 vil EbgjDeers & Land De velopmeDt Cansultan ts
Re: 295 Rea Street, North Andover (Tax Map 38 Lot 34)
Owners Permission to Conduct Soil Testing
Board of Health,
We, Robert & Nancy Norbedo, owners"of 295 Rea Street grant Sullivan Engineering Group, LLC permission
to conduct soil testing on our property in order to locate a feasible area for an upgraded septic system.
V Truly(r ij
TJ A
--k- -, "I 13-'I�IjI_-eJC3
Robert & Nancy Nor4edo
22 Mount Vernon Road — Boxford, Massachusetts 01921 — (978) 352 -7871 -Phone — 978 352-7871 - Fax
LOT 119
WSSINCHAM
REA SMEET
25'
ONO=-= ZONE7
W BVW BUFFER
'NO STRUCTURE ZONE'
IOlY INNER RIPARIAN
BUFFER ZONE
—'Go
BUXZONE
.00-M=Wftwmm--
ask
DelleChiaie, Pamela 661X
From: Marianne Peters [mpeters@millriverconsulting.com]
Sent: Monday, November 07, 2011 8:43 AM
To: DelleChiaie, Pamela
Cc: Sawyer, Susan; Grant ' ele
c
Subject: RE: Soil Test Applic ion- 295 Rea Street, Nort Andover, MA 01845 (Jack Sullivan)
Awaiting Jack's call back; offered him this Thurs or next Mon; will keep you posted.
From: DelleChiaie, Pamela rmailto:pdellech(atownofnorthandover.com
Sent: Thursday, November 03, 20114:19 PM
To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley'
Cc: Sawyer, Susan
Subject: FW: Soil Test Application - 295 Rea Street, North Andover, MA 01845 (Jack Sullivan)
Hello,
Please move forward with scheduling soil testing at 295 Rea Street with Jack Sullivan - 978.352.7871.
Conservation comments from Heidi Gaffney: "Test pits to remain outside of the 50' to BUW and 100'to RA."
Thank you.
Pamela DelleChiaie
Departmental Assistant I Community Development I Health Department
Town of North Andover
1600 Osgood Street I Bldg 20 1 Suite 2-36
North Andover, MA o1845
2 Office - 978-688-9540
2 Fax - 978-688-8476
Eal Email - pdellechiaieotownofnorthandover.com
Website http://www.townofnorthandover.com/Pai!es/index
"We can never see the path of our life ifwe are too busyfocusing on the pebbles under ourfeet. "--Anonymous
From: DelleChiaie, Pamela
Sent: Monday, October 31, 2011 10:17 AM
To: Gaffney, Heidi; Hughes, Jennifer
Subject: Soil Test Application - 295 Rea Street, North Andover, MA 01845 (Jack Sullivan)
Hello,
Attached is a soil test application for 295 Rea Street from Jack Sullivan. Please let me know your comments
after a site visit, and I will then forward on to schedule testing. I will provide Heidi with a hard copy. Thank
you! @
MW ReqdV4,
Pamela DelleChiaie
Departmental Assistant I Community Development I Health Department
Town of North Andover
1600 Osgood Street I Bldg 20 1 Suite 2-36
North Andover, MA o1845
2 Office - 978-688-9540
R Fax - 978-688-8476
H1 Email - pdellechiaieotownoffiorthandover.com
Website http://www.townofnorthandover.com/Pages/index
"We can never see the path of our life ifwe are too busyfocusing on the pebbles under ourfeet. "--Anonymous
t
Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more
information please refer to: hftp://www.sec.state.ma.usll)re/preidx.htm.
Please consider the environment before printing this email.
2
DelleChiaie, Pamela
From: Randy Burley [rburley@miliriverconsulting.com]
Sent: Monday, November 14, 2011 1:24 PM
To: 'Daniel Ottenheimer'; Grant, Michele; 'Isaac Rowe'; 'Marianne Peters'; DelleChiaie, Pamela;
Sawyer, Susan
Subject: 295 Rea St
Attachments: 295 Rea St soil scan. pdf
Please find attached the results of the soil testing done this morning with Jack Sullivan
Sincerely,
Randy Burley
Project Manager
Mill River Consulting
6 Sargent Street
Gloucester, MA 01930
Ph 978-282-0014
Fx 978-282-1318
www.millriverconsultina.com
rburley@millriverconsulting.com
Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more
information please refer to: hftr)://www.sec.state.ma.us/pre/preidx.htm.
Please consider the environment before printing this email.
L-4
1-7
-T- 71 --T-
i b
7 t't,
4, 1 1
4L.
t, -
DheC'h*iaie, Pamela
From: Randy Burley [rburley@millriverconsulting.com]
Sent: Monday, April 30, 2012 3:02 PM
To: 'Daniel Oftenheimer'; Grant, Michele; 'Isaac Rowe'; 'Marianne Peters'; DelleChiaie, Pamela;
Sawyer, Susan -
Subject: Emailing: 1476 Salem St soils.PDF
Attachments: 1476 Salem St soils.PDF
Soil testing with Richard Grady went well today (once the machine showed up around 10:30). Richard was very pleasant
to work with.
Sincerely,
Randy Burley
The message is ready to be sent with the following file or link attachments:
1476 Salem St soils.PDF
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attachments. Check your e-mail security settings to determine how attachments are handled.
Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices
and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/�reidx.htm.
Please consider the environment before printing this email.
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