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Home My WebLink AboutMiscellaneous - 315 ABBOTT STREET 4/30/2018 (3) I- RecarT STUTT LL p U5T 0 • • S�gT�EDy�s -� • COPY PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 9/11/2014 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Construction of an On-Site Sewage Disposal System By: Jesse Warren At: 315 Abbott Street (lot 2) Map Lot North Andover, MA 01845 The Issuann of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Susa Sawyer ,Public Health Age 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com i • �gTLEB j�� . FHEALTH • EIVERD F 2014 n A��•'' TH ANDOVER ARTMENT PUBLIC HEALTHDEPARTMENT Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System Kconstructed;( )repaired; By: is e k,0a c, -e. 'Tvi (Print Name) Located at: L'S + Z 0jr 2 (Installation Address) F Was ' stall d in conformance with the North Andover Board of Health approved plan,originally dated j and last revised on with a design flow of 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 310.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. Bottom of Bed Inspection Date: Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name Installer: (Signature) Date: And—Print Name Engineer: (Signature) Date: And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com Blackburn, Lisa From: Isaac Rowe <irowe@millriverconsulting.com> Sent: Wednesday, May 21, 2014 1:05 PM To: Blackburn, Lisa;Grant, Michele Cc: 'Pam Lally';'Isaac Rowe' Subject: RE:Abbott Street Attachments: 303 Abbott St - Lot 1 - Final Construction Inpsection.doc; 303 Abbott St- Lot 2 - Final Construction Inspection.doc; 303 Abbott St- Lot 3 - Final Construction Inspection.doc Michele/Lisa, Attached are the (3)final inspec 'on reports for Lots 1,2, 3 Abbott St. Everything looked good and the installer Jesse Warren did a great job. From eve thing I observed this project appeared to be well engineered and well constructed. Lot 3-This I needs a pump test wh the electricity is established at the site. Please let me know if MRC should do that inspection if the BOH office wants do the inspection. Please let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone:978-282-0014 ext.804 Fax:978-282-1318 irowe d-millriverconsultinci.com www.miliriverconsulting.com From: Blackburn, Lisa [mailto:LBlackburnCatownofnorthandover.com] Sent:Tuesday, May 20, 2014 8:39 AM To: Dan Ottenheimer; Isaac Rowe; Pam Lally Subject: Abbott Street Good Morning, Could you please contact Dan MacRitchie regarding final construction for lots 1, 2, and 3 Abbott St.?Thank you. www.D C M ac Ritchie.com Phone (603) 845-3572 or(978) 801-0667 Lisa Blackburn Health Department Town of North Andover 1600 Osgood Street,Suite 2035 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION S.. 2_ .0 sf: Print PROPERTY OWNER 4e4 Er-I ,v. Ll c-, �o.d e ax.c-o./uy CL /L Print' 100 Year OI Structure yes no 1MAP'NO: PARCEL-: O ZONING DISTRICT: PZ_ Historic District yes no _. s achihe Shop Village yes no TYPE OF IMPROVEMENT- PROPOSED USE Residential Non- Residential ew Building .,�ne family El Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic q Well' ❑ Floodplain E Wetlands ❑ Watershed District ij Water/Sewer ; DESCRIPTION OF WORK TO BE PERFORMED: (1-a Identification Please Type or Print Clearly) OWNER: Name: �DSe�-N L�c� ,ln6 Gate-,up.,w /gt y,,,,, Phone: G/7,_r/z- 3VK? Address: � ~fnl� /� M,/�r 0170- / CONTRACT TOR Name: - -_. _Q_ _C ..c��.Go _. 1_, Phone:_ k7_ Address: Supervisor's Cpns_truction 'License: C --- O ,Exp. Date Horne ImprovemeritFLlcense: .__ _. -7 N.3 Exp ARCHITECT/ENGINEER R f' 7z a Rct VeLi- Phone: _727- "� - 14 7 F Address: y 9 4P I EAS✓ -Tf, ,/t'1 C IrQ vP- A-4 d„2,/7 Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund r .... .. y..._..-w .,...... ....- .�- ignature�of,Agent/Owner Si mature of contractor: Plans Submitted I Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted PlansWaived-El Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF.SE TRAGEDiSPOSAL Public Sewer ❑ Tanning/Massage/Body-Art ❑. . Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc_. Permanent Dumpster on Site ❑ THE.FOLLOWING SECTIONS FOR-OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM .:_. DATE REJECTED: DATE.APPROVED PLANNING &DEVELOPMENT ❑ ❑ COMMENTS :CONSERVATION . Reviewed on Co 3 Signature �b COMMENTS _ HEALTH Reviewed on llSignature COMMENTS 0 P Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: -�-Q�- 1 (C7 . ,Comments N^� � Water& Sevier Connection/Si nature ate Driveway Permit v � DPW Tows Engineer: Signature: rn-,rle Loca ed 3' O good Street FIRE DEP,dRTlyf�ef T Temp Dumpster on site. yes no Located-6t-124 Mair Street Fire Departme►�t signature/date COM M.ENTS_`. _� 41 1 `✓ North Andover Health Department (ommunity Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 30SAbbott St. Lot 2 MAP: 38 BLOCK: 20 LOT: 02 INSTALLER: Jesse Warren DESIGNER: Dan MacRitichie PLAN DATE: 10/29/13 BOH APPROVAL DATE ON PLAN: 11/13/13 INSPECTIONS TANK INSPECTION: 5/9/14 DATE OF BED BOTTOM INSPECTION: 5/9/14 DATE OF FINAL CONSTRUCTION INSPECTION: 5/20/14 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS N/A Contractor reports any changes to design plan N/A Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: SEPTIC TANK ® 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 H-10 loading X Monolithic tank construction ® Watertightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port i ® Outlet tee installed, centered under access port (effluent filter) ® 24" inch cover to finish grade installed over outlet access port ® Neoprene boots around inlet & outlet Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or>0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) ® Schedule 40 PVC Pipe 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 N/A 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Width stake to stake 20' w/over dig 32'; length stake to stake 37' w/over dig 40'; B to C 39'; A to D 98'1" FINAL GRADE Loamed Seeded Cover per plan Comments: DOCUMENTS NEEDED ❑ Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer VAs-Built Plan BM = 93.66 HR = 5.10 HI = 98.76 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 2.21 96.20 95.75 Septic Tank IN 2.84 95.57 95.41 Septic Tank OUT 3.20 95.21 95.16 Distribution Box IN 3.32 95.09 94.92 Distribution Box OUT 3.49 94.92 94.75 Lateral 1 TOP 3.54 /3.67 Lateral 1 INVERT 94.87 / 94.74 94.75 /94.70 Lateral 2 TOP 3.54/3.67 Lateral 2 INVERT 94.87 / 94.74 94.75 /94.70 Lateral 3 TOP 3.54/ 3.67 Lateral 3 INVERT 94.87 / 94.74 94.75 /94.70 Bottom of Bed/Chamber 4.52 94.24 94.20 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback 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 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 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 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws • �� Commonwealth of Massachusetts Map-Block-Lot h. 038.00020 f BOARD OF HEALTH^ Permit No North Andover BHP-2014-0549 FEE $250.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Jesse T.-Warren ---- -------------------------------------------------------------------------------------------------- to(Construct)an Individual Sewage Disposal System. at No 303 ABBOTT STREET L*----ICA-------------------------------------------------- ----------------------------------- - - -- - ---------------- as shown on the application for Disposal Works Construction Permit No. BHP-2014-054 Dated April 29,2014 --------- - --- ------------------------- Issued On:Apr-29-2014 �$OARD OF 14EALTH Application for Septic Disposal System z-5— 20 /4-1' Z. TODAY'S DATE =Construction Permit — TOWN OF $250.00—Full Repair �isa.,ryo.s ORTH ANDOVER, MA 01845 $125.00-Component S�fNUSE Important: Applicatio is hereby made fora permit to: When filling out forms on the Construct a new on-site sewage disposal system* computer,use ❑ Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component—What? cursor-do not use the return key. A. Facility Information �( ,S 3 G' "ISI Address or Lot# City/Town 2.-*TYPE OF SEPTIC SYSTEM*: ❑ Pump ® Gravity(choose one) ***If pump system, attach copy of electrical permit to application*** ❑Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser(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 (D-Box Present)S.A.S. 2. Owner Information 7)01�e,r,f- t,U_ j Name 'I Address(if differe9tfrom above) S 019-7- ( CityrTown State Zip Code 61� — LI►3— �10C) Telephone Number 3. Installer Information NameName of Company /-n , Address IR City/Town State Zip Code 7 d�/ "�? ri --/-2 / i Telephone F4umber(Cell Phone#7 possible pleasb) 4. Designer Information / 11N- V'(- y Tit ' -Ya ✓1 o if i 55t A, G/e44 ,Y c 1 C L-4 oI 5111 > c-c''S Name Name of Company Address CityrTown StateZip Code `')_-) 1�— 2 �U— �o�-6 Telephone Number(Best#to Reach) Application for Disposal System Construction Permit-Page 1 of 2 . r Q, °er;,tio Application for Septic Disposal System 3?•`'_ ' ''•'' �� TODAY'S DATE Xonstruction Permit — TOWN OF * * ORTH ANDOVER MA 01845 $250.00—Full Repair $125.00-Component S.�cHUSE PAGE 2 OF 2 A. Facility Information continued.... 5. Type of Building:QResidential Dwelling or❑Commercial B. Agreement 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 Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. / Nam Date Application Approved By: (Board of Health Representative) Name Date Application Disapproved for the following reasons: For Office Use Only: L Fee Attached? Yes No 2. Project Manager Obligation Form Attached? Yes No 3. Pump System? If so,Attach copy offlectrical Permit Yes No 4. Foundation As-Built?(new construction ronly): Yes No (Same scale as approved plan) 5. Floor Plans?(new construction only): Yes No Application for Disposal System Construction Permit•Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: `fit S 10�_ t (Address of septic system) For plans by (Engineer) Relative to the application of S LJ t r" (Installer's name) And dated t rig rina ate o ay s Dated �— Z S— od o sate With revisions dated 1l /�// (Last revised date) I understand the following obligations for management of this project: 1. As the installer,I am obligated to obtain all permits and Board of Health approved plans PAOr to j performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer,I must call for any and all inspections. If homeowner,contractor,project manager,or any other person not associated with my company schedules an inspection and the system is not ready,then item three shall be applicable. 3. 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 Title 5 and the Board of Health Rcgulations may result in a$50.00 fine being levied against me and/or my company. a. Bottom of Bed—Generally, this is the first(P) inspection unless there is a retaining wall,which j should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection—Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OK(or e-mail to: healthdel2t@townofnorthandover.co from the engineer must be submitted to the Board of Health,after which installer calls for an inspection time. Installer must be present for this inspection. With a 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. Installer does not have to be on-site. 4. As the installer,I understand that only I may perform the work (other than simple excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done 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 to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. 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 or consultant. d. Installation of tank, D-Box, pipes, stone, vent,pump chamber, retaining wall and other components. 6. 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: (Today's Date) (Name—Print) (Na e—Signe �-�� µ.�•✓V CYC- II • I ��!� • S�'C`SLED j��' . • North Andover Health Department Community Development Division November 21, 2013 Boberin LLC 9 Whitney Rd Boxford,MA 01921 Subsurface Sewage Disposal System Plan for 303 Abbott Street, Lot 2,North Andover, Massachusetts Map 38, Block 20, Lot 2 Dear.Applicant, 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 D. C. MacRitchie, Inc. dated November 12, 2013, last revised on November 20, 2013 and received November 21, 2013. The design has been approved for use in the construction of a new onsite septic system for a 4- bedroom(max 9-room)home. This plan is good for 3 years from the date of approval. 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. This approval is also subject to the following conditions: 1. Prior to the issuance of a Disposal Works Construction permit the following must be submitted. a. A Foundation plot plan in a 1"=20' scale;the same as the approved plan b. Floor plans of the proposed home (must be 9 rooms or less) 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(1)). 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 Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 303 Abbott Street, Lot 2 November 21, 2013 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. Sincere y, S san Y. S er, S/RS Public Health D' ector cc: Daniel MacRitchie file Encl. copy of the approved Installers List for N.A. L Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035 North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 I &FO 1� RECEI V t-b DC MacRitchie Inc. NOV 21 2013 7 Hillside Avenue TOWN OF NORTH ANDOVER Exeter,New Hampshire 03833 HEALTH DEPARTMENT (603)845-3572/(978)801-0667 DCMacRitchie.com November 20, 2013 Ms. Susan Sawyer,Health Agent Send via: USPS Town of North Andover 1600 Osgood St. N. Andover, MA 01845 Reference: 303 Abbott Lot 2 Revised Septic System Design Dear Ms. Sawyer: Attached for your review are the above-referenced drawings that have been revised to incorporate your review comments. Please feel free to contact me by telephone at (603) 845-3572 or by email at dangdcmacritchie.com if you have questions or require any additional information. Sincerely, D.C. MacRitchie, Inc. Daniel C. MacRitchie, P.E. President I r { COPY North Andover Health Department (ommunity Development Division November 18, 2013 Daniel MacRitchie,P.E. D.C. MacRitchie, Inc. 7 Hillside Avenue Exeter,NH 03833 Re: Subsurface Sewage Disposal System Plan for Lot 2 -303 Abbott Street(Map 38, Lot2) Dear Mr. MacRitchie, The proposed wastewater system design plan for the above site dated November 12, 2013 and received on November 12, 2013 has been reviewed. Unfortunately,the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item. 1. Cleanouts need to be proposed at all changes in direction of the building sewer line(3 10 CMR 15.222(8)). 2. On sheet 2 of 2,under"Soil Test Data"TP-5 the soil texture for B2 was recorded by the Board of Health representative as a fine sandy loam. The soil log and the data sheets depict this layer as a loamy sand. A copy of the Board of Health representative's field notes are included for reference. 3. An H-20 septic tank should be proposed considering the close proximity of the proposed driveway to the tank location. 4. On sheet 2 of 2,under"Calculations", the perc rate should be depicted as 5 mins/inch. 5. On sheet I of 2,please show the breakout elevation will be met on the south and south east portion of the leach field. Proposed spot elevations are sufficient. 6. Please indicate clearly on the plan the depth of the crushed stone (3/4"-1 1/2")below the leach field distribution pipes. The profile and cross section show a 6 inch depth but it should be stated clearly for the installer. Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 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, Susan 7Sa er, REHS/RS Public Health Director cc: Boberin LLC File Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 II U2ijli i , ld ........ I � _- _ f , i �} �, i -� r - - -----1IT q x-86 z�Y� 0-3 ------------- J-1, d a_. /.d_ ld^2Aal z IT r- �� 3g 2C2.8L Z,5-)"(3 S For T VZ21 _ __-��.�- �-rs�- ��,1�%¢.. _�?-',/ -_off_ �i_------; �►-i F6L- G � , c, tr 4 F54„ io yp �- /o _ r --la-- �. __ Blackburn, Lisa From: Isaac Rowe <irowe@millriverconsulting.com> Sent: Monday, November 18,2013 2:24 PM To: Blackburn, Lisa; 'Susan Sawyer(ssawyer@townofnorthandover.com)' Cc: 'Dan Ottenheimer'; 'Pam Lally'; irowe@millriverconsulting.com Subject: RE: 303 Abbott St. Lots 02 and 03 Attachments: 303 Abbott St - Lot 2 Disapproval letter 11-18-13.doc; 303 Abbott St- Lot 3 Disapproval letter 11-18-13.doc; 303 Abbott St- Soil testing results 8-22-13.PDF Susan/Lisa, Attached are the disapproval letters for the above referenced properties. Just a few minor edits nothing major. Lot 2 letter should included a copy of my field books notes as it relates to comment#2. Let me know if you have any questions. Thanks, Isaac M.Rowe,R.S. Project Manager Mill River Consulting 6 Sargent Street i i TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES "` HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdeptgtownofnorthandover.com WEBSITE: hqp://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM kjL'.cov Date of Submission: 11/12/2013 toll 303 Abbott Street (LOT 2) TOWN o NORTH ANDOVER Site Location: I HEALTH DEPARTMENT Engineer: Daniel MacRitchie P.E. New Plans? Yes X $225/Plan Check# (includes 1St submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes X No Local Upgrade Form Included? Yes No X Telephone 4:978-801-0667 Fax#:866-571-1995 E-mail:dan@dcmacritchie.com Homeowner Name:Estate of Regina Bomba OFFICE USE ONLY When the submission is complete (including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ Enter on Log Sheet and Database Commonwealth of Massachusetts City/Town of North Andover Percolation Test 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:When filling out forms A. Site Information on the computer, use only the tab Regina Bomba key to move your Owner Name cursor-do not 303 Abbott Street use the return Street Address or Lot# key. N. Andover MA Ci my City/Town State Zip Code same Contact Person(if different from Owner) Telephone Number B. Test Results 8/21/13 12:57 8/22/13 9:47 Date Time Date Time Observation Hole# P5 P8 Depth of Perc 10"+ 18"to bottom 27'+ 18"to bottom Start Pre-Soak 12:27 9:47 End Pre-Soak 1:12 10:02 Time at 12" 1:12 10:03 Time at 9" 1:22 10:19 Time at 6" 1:36 10:43 Time(9"-6") 14 min 24 min Rate(Min./Inch) 5 8 Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Dan MacRitchie Test Performed By: r" rtkr• Isaac Rowe Witnessed By: Comments: T�lWN ur NUftTM DOVER HEALYH RU FP'—\' ENT t5form12.doc•06/03 Perc Test•Page 1 of 1 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal MassDEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information Estate of Regina Bomba Owner Name 303 Abbott Street 38-20-1 Street Address Map/Lot# North Andover MA City State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 2. Published Soil SurveyAvailable? 8/11/08 1:15,840 420/421 ® Yes ❑ NO If yes: Year Published Publication Scale Soil Map Unit Canton fine sandy loam_, 3 to 8%slopes SAS-Very Limited Soil Name Soil Limitations 3. Surficial Geological Report Available? ® Yes El No 1:15840 242B No If yes: Year Published Publication Scale Map Unit Artificial Fill/Thin Till Geologic Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No Within the 500-year flood boundary? ❑ Yes ® No Within a velocity zone? ❑ Yes ® No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name Corcoran Test Pits 5-6.doc-rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 1 of 8 Commonwealth of Massachusetts City/Town of North Andover F Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information (Continued) 6. Current Water Resource Conditions(USGS): Month/Year Range: ❑ Above Normal ❑ Normal ❑ Below Normal 7. Other references reviewed: C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 5 8/21/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: 92'5 Location (identify on plan): primary sas 2. Land Use woodland 3-8 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) leaf litter Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 39 89.25 inches elevation Corcoran Test Pits 5-6.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 5 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Cobbles& Structure ConsistenceOther Depth Color Percent Gravel Stones 3 O 10 A 10YR4/4 FSL M L 21 B1 10YR7/8 FSL 5 M FR ROOTS 28 B2 10YR6/4 LS 5 5 BK FR ROOTS 87 C 2.5Y6/4 39 7.5YR5/8 5 LS 10 5 M F 87+ REF Additional Notes: Corcoran Test Pits 5-6.doc-rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal Page 3 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 6 8/21/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: 92.70 Location (identify on plan): 2. Land Use WOODLAND (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) LEAF LITTER PRIMARY SAS Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: TILL Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes 0 No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 30 90.20 inches elevation Corcoran Test Pits 5-6.doc•rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 6 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Cobbles& Structure Consistence Other Depth Color Percent ravel Stones 3 O 10 A 10YR4/4 FSL M L 30 B 10YR7/8 FSL 5 5 M FR ROOTS 74 C 2.5Y6/4 30 7.5YR5/8 3 LS 10 5 BK F 74+ REF Additional Notes: Corcoran Test Pits 5-6.doc•rev. 10107 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B.inches inches ® Depth to soil redoximorphic features (mottles) A. 39 B. 30 inches inches ❑ Groundwater adjustment(USGS methodology) A. B.inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: hones Lower boundary. 74 acnes Corcoran Test Pits 5-6.doc•rev. 10107 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information (Continued) 6. Current Water Resource Conditions(USGS): Monthnrear Range: ❑ Above Normal ❑ Normal ❑ Below Normal 7. Other references reviewed: C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 7 8121/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: 94.5 Location (identify on plan): RESERVE AREA 2. Land Use woodland 3-8 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) leaf litter Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 24 92.50 inches elevation Corcoran Test Pits 7-8.doc•rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 7 Redoximorphic Features Coarse Fragments (mottles) %by Volume Soil Soil Soil Horizon/Soil Matrix:Color- Soil Texture Depth(in.) Layer Moist Munsell USDA Structure Consistence Other y (Munsell) Depth Color Percent ( ) Gravel Cobbles 8 Stones (Moist) 3 O 6 A 10YR4/4 FSL 17 B1 2.5Y6/6 FSL 24 B2 2.5Y7/6 FSL 62 C 2.5Y7/3 24 7.5YR5/8 FSL 62+ REF Additional Notes: Corcoran Test Pits 7-8.doc•rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of North Andover r Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 8 8/21/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: 94.8 Location (identify on plan): RESERVE AREA 2. Land Use WOODLAND (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) LEAF LITTER Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: TILL Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 39 91.55 inches elevation Corcoran Test Pits 7-8.doc•rev. 10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 8 Redoximorphic Features Coarse Fragments Depth(in.) Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Munsell Consistence Other Layer Moist Y (Munsell) (USDA) Cobbles& Structure Depth Color Percent Gravel Stones (Moist) 3 O 6 A 10YR4/4 FSL M L 27 B 2.5Y7/6 FSL BK FR 60 C 2.5Y7/3 39 7.5YR5/8 FSL BK F 60+ REF Additional Notes: Corcoran Test Pits 7-8.doc•rev. 10107 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal r D. Determination of High Groundwater Elevation 1. Method Used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B. inches inches ® Depth to soil redoximorphic features (mottles) A.24 B. 39 inches inches ❑ Groundwater adjustment(USGS methodology) A. B. inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 6cnes Lower boundary: 60nes Corcoran Test Pits 7-8.doc•rev.10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal y F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. /a/j,40'o xs�� lull/ S' nature of Soil Evaluator Date Dan MacRitchie, Number 1447 7/24/1996 Typed or Printed Name of Soil Evaluator/License# Date of Soil Evaluator Exam Isaac Rowe N. Andover Name of Board of Health Witness Board of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to the designer and the property owner with Percolation Test Form 12. Corcoran Test Pits 5-6.doc•rev. 10107 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8