HomeMy WebLinkAboutMiscellaneous - 35 EVERGREEN DRIVE 4/30/2018 (2)0
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Lot & Street_ ,;�� Z" 7 Map/Parcel
CONSTRUCTION APPROVAL
Has plan review fee been paid: (E)NO Permit# 9,6 '
Plan Approval: Date: /.61;rl ' Approved by:
Designer:. QSGpo,p ,j p Plan Date:
Conditions:
Water Supply:
Well Permit:
Well Tests: Chemical
Bacteria I
Bacteria II
Plumbing Sign -Off:
Comments:
Form "U" Approval
Date Issued
Conditions:
Final Approval:
Well
Driller:
Date Approved
Date Approved
Date Approved
Sign -Off.
Approval to Issue: YES NO
By:_
All Permits Paid?
Well Construction Approval?
'G�.
NO
Septic System Construction Approval?
YES
NO
NO
Certification?
Other
YES
NO
YES
NO
Any Variance Needed?
YES
NO
FINAL BOARD OF HEALTH APPROVAL:
DATE:
APPROVED BY:
SEPTIC SYSTEM INSTALLATION
Is the installer licensed?
YES
Type of Construction:
NEW
PAIR
New Construction: Certified Plot Plan Review
YES
NO
Floor Plan Review
YES
NO
Conditions of Approval from Form U
YES
NO
Issuance of DWC permit:
NO
DWC Permit Paid?
NO
DWC Permit 00_ Installer:f�/�;j����
Begin Inspection:
NO
Excavation Inspection:
Needed:
Passed:
Construction Inspection:
Needed:
Satisfactory:
Approval of Backfill: Date By: �—
Final Grading Approval: Date: ! cJ/GJ By:
Final Construction Approval: Date: By:
Certificate of Compliance: Approval: Date:
.11
NEW ENGLAND ENGINEERING SERVICES
M
January 31, 1997
North Andover Board of Health
Town Hall Annex
148 Main Street
North Andover, MA 01845
RE: TITLE V REPORT
Enclosed is the Title V report for 35 Evergreen Drive, North Andover, MA. The system passed the
inspection.
If there are any questions please call me at my office, 686-1768.
Yours truly,
&`'�
BenjSmin C. Osgood J .
President
33 WALKER RD. - SUITE 22 - NORTH ANDOVER, MA 01845 - (508) 686-1768
1 - �
Wllllam F. Weld
Go►emor
ArWw Paul Celluccl
Lt Govemor
Commonwealth of Massachusetts
Executive Office of Environmental Affairs
Department of
Environmental Protection
Trudy Coxe
-900 kry
David B. Struhs
commhaiorw
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: c�s t ►'Ctn DI`s .iG
Date of Inspection: i N_ �} cQ Address of Owner.
/gyp • / /31 / i�
Name of Inspector (If different)
P� Benjamin C. Osgood Jr.
Company Name, Address and Telephone Number. New England Engineering Services, Inc.
33 Walker Road, North Andover, Ma 01845
CERTIFICATION STATEMENT Tel. 508-686-1768 Fax. 508-685-1099
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
Passes
Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: 46-7, /j Q'�� /
C, Date:
The System Inspector shall submit a copy of this inspection repoto the A
inspection. It the system is a shared PPi'�+ing Authority within thirty (30) days of completing this
report to the appropriate regional ed syce stem
he Department�a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
Theo ' ' of Environmental Protection.
original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARY.
Check A, B, C, or D:
A] ,SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
B] SYSTEM CONDITIONALLY PASSES:
One more system components need to be replaced or repaired.
inspection. The gym, upon completion of the replacement or repair, passes
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined
The septic tank is metal, cracked, structurally unsound, shows substantial "r explain why not)
imminent. The system will bstantial infiltration or exfiltration, .or tank failure is
Pass inspection if the existing septic tank is replaced with a conforming septic tank as approved
by the Board of Health.
(revised 11/03/95)
One Winter Street a Boston, Massachusetts 02108 • FAX (617) 556-1049 • Telephone (617) 292-5500
0? Printed on Recycled Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Addreem 3,S k u b-rti , N • f� �.Q o ✓ m AAA
Owner.
Date of Inspeotlon: Res-DIJHa^ of C"-AcJ of N- H• V^c,
�
1131`1.7
Check if the following have been done:
ZPumping information was requested of the owner, occupant, and Board of Health.
✓ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
IN± As built plans have been obtained and examined. Note if they are not available with N/A.
ZThe facility or dwelling was inspected for signs of sewage back-up.
The system does not receive non -sanitary or industrial waste flow
VIII -The site was inspected for signs of breakout.
All system components, excluding the Soil Absorption System, have been located on the site.
ZThe septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
.ZThe size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non -intrusive methods.
ZThe facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub.
Surface Disposal System.
(revised 11/03/95) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (oontinued)
Property Address: 3s F� N9 rtie.n Q n� ✓C /V . r7�.cY ovC'2 /Vl )9Owner.
Date of Inspection: Rcso Pro i e' -flea N. f'% .Tnc.
Dl SYSTEM FAILS:
I have determined that the system violates one or more of the following failure criteria as defined is 310 Chit 15.303. The basis for
this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the
failure.
_. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow.
Required Pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
— Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
E) LARGE SYSTEM FAILS:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a s
health and safety and the environment because one or more of the following conditions exist: significant threat to public
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a public
water supply well)
The owner or operator of any such system shall bri
requirements of 314 CMR 5.00 and 6.00. Please cong the system and facility into full compliance with the groundwater treatment program
nsult the local regional office of the Department for further information.
(revised 11/03/95) 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 3,5- C ✓erj ree., p2(o L iv. f4 AJ ,UOJ C tZ, .tA (9
Owner. Reso la fi on PV a crii u of N- r►. 1,. �,
Date of Inspection: �)31/9,7
B) SYSTEM CONDITIONALLY PASSES (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of
Health):
broken pipe(s) are replaced _
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if (with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A
MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)
DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER. THAT PROTECT THE PUBLIC HEALTH AND
SAFETY AND THE ENVIRONMENT:
The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a
surface water supply.
The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water
supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free
from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm.
3) OTHER
(revised 11/03/95)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address:- 367 Fjerq+Yen %. 04nOe2, /�t>q
Owner. �•J!
Date of Inspection: Resoly fio„ P.n f er¢i ea a� Al, H• T'nc.
1[.311g7
RESIDENTIAL: FLOW CONDITIONS
Design flow: ¢allons
Number of bedrooms;
Number of current residents:
Garbage grinder (yes or no):__�IS5
Laundry connected to system (yea or no):?
Seasonal use (yea or no):_1%
Water meter readings, if available:_ Z! '7 G u 1 l e na per- f) a., 1 2( i b 7O I Z/ /
9 6
Last date of occupancy: C'uI' A -r
COMMERCIALANDUSTRIAI:
Type of establishment:
Design flow:__gallons/day
Grease trap present: (yes or no)_
Industrial Waste Holding Tank present: (yes or no)_
Non -sanitary waste discharged to the Title 5 system: (yes or no)
Water meter readings, if available:
Last date of occupancy:
OTHER (Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of
l r..LT t1ll. l (2:.,+n w r1 Pr3 (7Qu L► *c1L
System P6Ped as part of inspection: (yes or no)A
If yes, volume pumped: mlllons
Reason for pumping:
TYPE O�STEM
V, Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
Other (explain)
APPROXIMATE AGE of all components, date installed (if ]mown) and source of information: �OJSc [S
o�cQ. ?ANIS ►s o���;�a� , P' a f- 0-4ax 30 �ea/Ls
p D-8aX
Sewage odors detected when ar ving at the site: (yes or no) eLLX
(revised 11/03/95)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address' 36- f,, tn� n c n Q r� v C N, 41J -00,,M AAA
Owner. f2 a l i �,,�
Date of Inspection: ��° v- �-' of N• I -i. 2'v C.
`131)9-7
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possille; excavation not required, but may PP be approximated
by non -intrusive methods)
If not determined to be present, explain:
W.l-M
leaching pits, number-
leaching
umberleaching chambers, number-
leaching
umberleaching galleries, number-
leaching
umberleaching trenches, number,length: 02 trt nc er , ( (e
leaching fields, number, dimensions: J
overflow cesspool, number:
Comments: : (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.)
CESSPOOLS: _
(locate on siteplan)
Number and configuration:
Depth -top of liquid to inlet invert
Depth of solids layer.
Depth of scum layer.
Dimensions of cesspool:-
Materials
esspool:Materials of construction:
Indication of groundwater:
inflow (cesspool must be pumped as part of inspection)
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY: _
(locate on site plan)
Materials of construction:
Depth of solids: Dimensions:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 11/03/95)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: as- L , vj rc n or. .,c A)- ,/�.�c9 0 ✓e2 AA o,..
Owner.
Date of Inspection: 2 13 11 e' o t -j o.. �,f vfi C-%af N• H. T.. c.
'y�
TIGHT OR HOLDING TANK:_
(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _Fite other(explain)
Dimensions.
Capacity: gallons
Design flow: eallons/day
Alarm level:
Comments:
(condition of inlet tee, condition of alarm and float switches, etc.)
DISTRIBUTION BOX:_
(locate on site plan)
e•
Depth of liquid level above outlet invert:_
Comments:
(note if level and distribution is equal, evidence of solip carryover, evidence of leakage into or out of box, etc.
PUMP CHAMBER:_
(locate on site plan)
Pumps in working order.(yes or no)
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 11/03/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: .6— Crv v. y -ten P.-, ✓ t / /0. 19 4 D- cA. IjA A
Owner. rzes o (r +i pnro
Date of Inspection: //,;
e' °� N-
a (/9 7
SEPTIC TANK:_
(locate on site plan)
Depth below grader
Material of construction: Zooncrete _metal _FRP _cther(e:plain)
69
L..' A TFIZ d E / r
Sludge depth A „
Distance from top of sludge to bottom of outlet tee or baffle:-itrL
Scum thickness: 2 "
Distance from top of scum to top of outlet tee or baffle:,
Distance from bottom of scum to bottom of outlet tee or baffle: O
L1.O N
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity,
evidence of leakage, etc.) T 4 ,J s N o %N o D 5. H.4 PF C oy e R.s 14-2 C
DeTcrl%aPwfii.Q n ; _ d_u^'Jer- I �nfb 1r.ALe_ OJTi_PT 7'--e Ine-s
. tin 7'c e
�..�kcalcV h r Cr 4, -rt-.t s a<
G E _ ,;Hoda0 PRDi0IP6LY Or RtiCIQC&'D rD jAi ,uc 71-tE A-40-46- Ty of
(locate on site plan) VH G 6C- P 77 c s y4 T C-41.
Depth below grade:
Material of construction: _concrete _metal _FRP _other(e:plain)
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity,
evidence of leakage, etc.)
(revised 11/03/95) 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (oontinued)
Property Address:
Owner. v try me -(`, tel. i4 a ., t2 M•. D l 8 'iS
Date of Inspeotioa: (�t8 oIJ h a n ro P a�fi of N. H. 7n c
SKETCH OF SEWAGE DISPOSAL SYSTEM;
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
DEPTH TO GROUNDWATER
Depth to groundwater.Y feet
method of determination or approximation: _ r2d.vt �.s. [.. 3, s n�`
-_i?^Vn K `e 9 G 7Hd fi/1 EA ^^f� Ps 7b
(revised 11/03/95)
9
NEW ENGLAND ENGINEERING
SERVICES, INC.
33 Walker Rd. Suite 23
NORTH ANDOVER, MA 01845
PHONE (( J508) 686-1768 FAX (508) 685-109' 9/
TO
3L?
All
WE ARE SENDING YOU
❑ Shop drawing
❑ Copy of letter
El Attached ❑ Under separate cover via
s ❑ Prints ❑ Plans
❑ Change order ❑
MVVIE >3 @IF 4�° MMUMIL
DATE JOB NO.
ATTENTION
RE:
❑ Samples
the following items:
❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
V 2. v,,
THESE ARE TRANSMITTED as checked below:
For approval
For your use
❑ As requested
❑ For review and comment
❑ FORBIDS DUE
REMARKS
El Approved as submitted
❑ Approved as noted
❑ Returned for corrections
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
19 ❑ PRINTS RETURNED AFTER LOAN TO US
COPY TO
SIGNED:
ff enclosures are not as noted, kindly notify us a nce.
�0000—
FORM 11 - SOIL EVALUATOR FORM
Page 1 of 3
FORM 11 - SOfL EVALUATOR FORM
Page 2 of 3
(7-
Location Address or Lot No. J�r> E verq rfan Or. `
On-site Review
...( .61.q r) Time:: l = via Weather �u,vn��, 70 G
Deep Hole Number 1?�:.N• :.: l Date: -
Location (identify on site plan)
Land Use .::.:. l..a.t w '- .:: , . Slope M Z IL: F Surface Stones "' :.....
Vegetation .....-&rasa.::. ........
Landform ...- D rY Millet
.._ ..... .
Position on landscape (sketch on the back)
Distances from:
Open Water Body > LOQ feet Drainage way -- feet
Possible Wet Area *71100 . feet Property Line bQc feet
Drinking Water Well feet Other.....:..::::" ::.:.::::::.: .....
DEEP OBSERVATION HOLE LOG*
Depth from
Surface (Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil
Mottling
Other
(Structure, Stones, Boulders, Consistency, %
Gravel)
GSI- /3
j-� P
S ► - 1
ID
yr� %a
_
i
5
rn 4.s1 v
13-32
13w
1
�-,
o23y
�
3�i1
mass, VC
32 - 69"
ec9
Pla4-j
v
�,�,
Z�s�s
�•�yRB
tO`o Jcra�e:�
many
Cov t`5C
r lrb m; vie.4
IVIIIVIIVIVIVI yv c 'W -
Parent Material (geologic) tl, la c 1 ,g Ti jl DepthtoBedrock:
Death to Groundwater: Standing Water in the Hole: Weeping from Pit Face: —'
Estimated Seasonal High Ground Water: 3D --
DEP APPROVED FORM - 12/07/95
NEW ENGLAND ENGINEERING SERVICES
INC
July 21, 1997
North Andover Board of Health
Town Hall Annex
School St.
North Andover, MA 01845
Re: 35 Evergreen Drive
Dear Mr. Chairman
�J& 21.1991
Please accept this letter as a request to be included on the July 24, 1997 Board of Health agenda
for the above referenced septic system repair. The reason for the request is to consider the
following:
One local bylaw variance:
1. Reduction of separation distance between trenches from 10' to 6'.
One local upgrade approval
1. Reduction of groundwater separation from 4' to 3'.
I will be at your meeting to discuss these issues.
Yours Truly,
6�
Benjamin C. Osgood, Jr.
33 WALKER RD. - SUITE 22 - NORTH ANDOVER, MA 01845 - (508) 686-1768
Town of North Andover, Massachusetts Form No. 2
f NORf1y BOARD OF HEALTH
oZ-9 19 9T
p "
DESIGN APPROVAL FOR
HU `SOIL, SOIL. ABSORPTION SEWAGE. DISPOSAL SYSTEM
Appllcant'��/IfA-r42MsT'2ay� Test No. _.
-.Site Location
_
-Reference Plans;a6diS-0ecs. G o 2 ��` %
_ ENGINEER DESIGN DATE
T-
y -Permission Is granted"for air individual soil absorption sewage disposal system to be installed
-in accordance wi6-regulations of -Board of Healfh-.LL-
CHAIRMAN, BOARD OF HEALTH
Fee Site System Permit No. q (n s
;,
NORTH ANDOVER BOARD OF HEALTH
DESIGN REVIEW REPORT
DATE
FEE: ��� PERMIT # DATE RECEIVED 8/�/j7
APPLICANT'Dd&i(/.MAP PARCEL
ADDRESS 3,6- CUA-zac&&Aj be LOT #$ STREET # �
ENG. G 6 0-b STREET
ENGINEER'S ADD.
PLAN DATE REV. DATE
CONDITIONS OF APPROVAL
APPROVED
DISAPPROVED_ ,
REASONS FOR DISAPPROVAL:
5 7-19 m )o (1310C�r.� . Z.
/uo 601L L66J o2 -F-6zms C (40) �s
, - iUo q a 6 c -r) m )
4-1 IUO M/? P
%4 155 //UG "-7c- e -6V /47"/0fi J5
No � S 7-A�c Es s h'ac u� o.v sire I`A� C3,16 C /y k� 16-, -O )
G� I�vsuF�icie�,— LC-'r�crr/,u� -�s49;
ed/ � S
ID6,OAJ4- Aek31 6,116
/Av c.om
3 ry C He 1s. aa6
(P j9,4 G' (4)(�'�
?l�sr/ AJ6
ed/ � S
ID6,OAJ4- Aek31 6,116
a - .
WILLIAM J. SCOTT
Director
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
September 12, 1997
New England Engineering
33 Walker Road
North Andover, MA 01845
Re: 35 Evergreen Drive
Dear Ben:
30 School Street
North Andover, Massachusetts 01845
This is to inform you that the proposed plans for the site referenced above have been
disapproved for the following reasons:
No stamp. (3 10 CMR 15.220(2)) .
No soil logs or forms. (3 10 CMR 15.220(4)(h)&j)
No locus. (3 10 CMR 15.220(4)(t)
No map & parcel. (N.A.8.02(a))
Missing perc elevations. (N.A. 8.02(n))
No distances shown on site plan. (3 10 CMR 15.220(4)(e))
Insufficient leaching. (3 10 CMR 15.203)
Pump specs incomplete. (Note 2 et.al.)
Please calculate emergency storage. (3 10 CMR 15.220(4)(r)
What is TDH? (3 10 CMR 15.220(4)(r))
Please supply full existing & proposed floor plans for dwelling.
o p
\• n 9 � x
�a Qv4�rw �PP`�4y/
If new plans satisfactorily addressing all the following issues are submitted to the Health
Department by September 19th then approval for the plans should be given by September
26'h.
CONSERVATION 688-9530 FFALTH 688-9540 PLANNING 688-9535
Page 2
35 Evergreen Drive
September 12, 1997
If you have any questions, please do not hesitate to call the Board of Health Office at the
number below.
Sincerel
y,
_-1-1d L
Sandra Starr, R.S.
Health Administrator
SS/cjp
cc: William Scott, Director, MCD
Donna Armstrong
mile j)
NEW ENGLAND ENGINEERING. SERVICES
INC
September 29, 1997
Sandra Starr, Health Administrator
North Andover Board of Health
30 School Street
North Andover, MA 01845
Re: 35 Evergreen Drive
Dear Sandra:
SEP 3 0
Enclosed are three copies of revised plans for the replacement septic system design for 35
Evergreen Drive along with the soil evaluator sheets and a 25 dollar fee for the re -review.
All of the changes issues of your letter were addressed plus a few other items that I found
were corrected. I apologize for submitting such an incomplete plan, somehow I sent you
three progress prints. Most of the items were already taken care of on the completed plans
that you did not have.
The items that were flagged in your letter that were changed are as follows.
1. The plans are stamped.
2. The soil logs are on the plans and the forms are enclosed.
3. The locus map has been added to the plan.
4. The map and parcel numbers have been added to the plans.
5. The perc elevation has been added.
6. The distances have been added to the site plan.
7. The leaching area has been increased by increasing the trench length to 62
feet.
8. The pump specs have been completed.
9. The emergency storage calculations are on the plans.
10. The TDH has been added to the pump notes.
33 WALKER RD. — SUITE 22 — NORTH ANDOVER, MA 01845 — (508) 686-1768
PAGE 2
Other items that were changed are as follows:
1. A retaining wall was added around the existing garage so it will not have to be
moved.
2. A poly barrier has been added along one side of the leach area. This barrier is
10 feet from the system and it has a 2:1 slope on the back side. This item was
discussed at the Board of Health meeting in August and was approved by the
Board at that time.
3. A note stating that the local upgrade approvals and the local variance were
approved.
This should take care of all of the items except for the house plans for the addition. The
plans will be delivered under separate cover by the owner.
If you have any questions please do not hesitate to call.
Yours Truly,
Benjamin C. Osgood, . EIT
enclosures
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
WILLIAM J. SCOTT
Director
October 7, 1997
Ben Osgood, Jr.
New England Engineering
33 Walker Road
North Andover, MA 01845
RE: 35 Evergreen Drive
Dear Ben:
30 School Street
North Andover, Massachusetts 01845
This letter is to inform you that the proposed septic plans for 35 Evergreen
Drive have been approved.
If you have any questions, please do not hesitate to call the Board of
Health office at the number below.
Sincerely,,
---<Z�ez�
Sandra Starr, R.S.
Health Administrator
cc: Wm. Scott, Dir. CD&S
Donna Armstrong
File
CONSFRVA—TON FR9_9511n
11
PYANNW, r3 ARR-9535
FOS U _
INST*RQ�TIONS : �T RELF�E FO
aPProvals This
have form is used
/Permits from to verif
been obtained. BOards and y that all landowner This does �Partments hav• necessary
regulations rom compliance with not relieve the Ing jurisdiction
or Lequirements, any applicable aPPlicat ion
*********or
******* local or state law,
Applicant fills
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CATION; Assessors Phone %
s Map Number
Subdivision Parcel
Street JSP Lots
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St• NumberrtEc
�',�,C� n ffic'al
A "`.�,0 S OF TO O
' Use Onl
Conservation
03inistrat
Adm
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CommentsD due , Date Rejected
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Town Planner
Comments
Food Inspector -Health
Septic InspeCtor-
Health
Comments
Date Approved
Date Rejected •,
Date Approved
Date Rejected
Date ApprovedQ
Date Rejected
Zz/-�
Public Works"
sewer/water connections
- driveway permit
Fire Department
Received by Building inspector
Date
PLAN REVIEW CHECKLIST
1D DRESSc� 840;QITL. ENGINEER O SG 6,0
'ENERAL '/
3 COPIES STAMPA/, LOCUS,- NORTH ARROW L SCALE
:ONTOURS f/ PROFILE 4,� (Sc) SECTION Lam_ BENCHMARK 6/ SOIL &
'ERCSELEVATIONSX WETS. DISCLAIMER/ WELLS & WETS
JATERSHED?/4/d DRIVEWAY "-� WATER LINE FDN DRAIN M&0/
NOFv2M5
3CH40 TESTS CURRENT? L--' SOIL EVAL
SEPTIC TANK
IIN 150OG li/� .17 INVERT DROP 4""'
GARB. GRINDER/VQ (2 comps +200)
10' TO FDNB MANHOLE 4,"� ELEV GW # COMPS. / GB
D -BOX
SIZE # LINES FIRST 2' LEVEL STATEMENT
INLET 97 (AS - OUTLET _ �z (2" OR .17 FT) TEE REQ'D? dlG
LEACHING o� ,,111 �6
MIN 440 GPD? RESERVE AREA — 4' FROM PRIMARY?2% SLOPE
la�
100' TO WETLANDS L----100' TO WELLS 4' TO S.H.G (5'>2M/IN)
i20' TO FND & INTRCPTR DRAINS L-� 400' TO SURFACE H2O SUPP
4' PERM. SOIL BELOW FACILITY MIN 12" COVER (--�FILL?x(15')
BREAKOUT MET? c-'
TRENCHES
MIN 440 gpd V"' SLOPE (min .005 or 6"/1001) ZSIDEWALL DIST. 3X EFF.
W OR D (MIN 6') V RESERVE/BETWEEN TRENCHES?Z IN FILL? v MUST
BE 10' MIN.
4& 4" PEA STONE?VENT? (>3' COVER; LINES >501)
BOT !�3� + SIDE I ����� % X LDNG ,,ZSJL5
= TOT' �9
(L x W x #) (DxLx2x#) (G/ft2)
7 94 /.4 � � :A Aja, -7
:opyr 1ghc 0 1996 by S.L. Starr
PITS
MIN 440 LEACHING MIN 1 (13'x16') PIT MANHOLE/PIT
GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE
BOT+ SIDE x LOAD = TOTAL
(L x W x #) (2x(L+W)xD x #) (G/ft2)
CHAMBERS
MIN 440 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT
MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005
BED/TRENCH (Bed max. 60' X 601) MIN 13' X 16' PIT
BOT + SIDE X LOAD = TOTAL
(L x W x #) (2 x (L+W)xD X-#) (G/ft2)
FIELDS
MIN 440 GPD 900 ft2 BED GW MIN 4' BELOW BOTTOM OF FIELD
PIPE ENDS JOINED? 4" PEA STONE? DIST LINE SLOPE .005?
>31COVER-VENT SCH 40 MIN 12" COVER
RATE ( X ) X = TOTAL
L W LDG
DOSING TANKS AND PUMPS
DIMENSIONS X X - PUMP CAPACITY gpm
L W D Vol.
DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME
gpm
MANHOLES TO GRADE ALARM SEP. CIRC. L,-' GW (Min. l' below
inlet) HWL W' SO LWL q3 -a/ CHECK VALVE �- BLEEDER HOLE MANUAL
OP. SWITCH -LZ ENUF STORAGE? TDH WEIGHTED? Ll
Copyright 0 1996 by S.L. Starr
Form No. 4
Town of North Andover, Massachusetts
BOARD OF HEALTH
February 101 g 98
CERTIFICATE OF COMPLIANCE
This is to certify that
the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired (K )
by Philip A. Busby, Jr.
INSTALLER
at 35 Evergreen Drive, North Andover, MA 01845
SITE LOCATION
has been installed in accordance with Board of Health Regulations as described in the Design
Approval Site System Permit No. 965 dated 10/7/97 19
The issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
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Town of North Andover, Massachusetts Form No. 1
NORTFj
BOARD OF HEALTH
05 ED `" °0
19
O
APPLICATION
�RATEO
FOR SITE TESTING/INSPECTION
PPp��y
,9
SSACHUS�
Applicant —Y\ -A_U
NAME
ADDRESS , TELEPHONE
Site Location ill
. ,0/Nj— 1 .
Engineer 'sem.
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NAME
4,DDRESS TELEPHONE
Test/Inspection Date and
Time
CHAIRMAN, BOARD OF HEALTH
Fee
Test No.
S.S. Permit No.
D.W.C. No. C.C. Date Plbg. Permit No.
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SEPTIC PLAN SUBMITTALS
LOCATION:
NEW PLANS: YES
$60.00/Plan
REVISED PLAN YES $25.00/Plan
DATE:�c�
DESIGN ENGINEER: 5 G®)6
When the submission is all in place, route to the Health Secretary
SEPTIC PLAN SUBMITTALS
LOCATION:
NEW PLANS: YES .
REVISED PLANS: YES
DATE:
DESIGN ENGINEER:
$60.00/Plan -"
$25.00/Plan
When the submission is all in place, route to the Health Secretary
Town of North Andover, Massachusetts
BOARD OF HEALTH
NORT"
4,
41
G
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,SgACMUSEt
Form No. 3
�_19�
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: o / 2 q 1 CURRENT INSTALLER'S LICENSE#Lj
I o
LOCATION: 36' Eyckgi^cc6
LICENSED INSTALLER:_J,c
SIGNATURE: Ct, TELEPHONE# 3 6� SGS O
CHECK ONE:
—. REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.,
Administrative Use Only
$75.00 Fee Attached? Yes -�''�I J No
Foundation As -Built? Yes`No
Floor Plans? Yes No—
Approval ����� Date: 3
WIMT is
= � , 14 1) Tloou
2� A4 iD `Od/�lS
S Ni,9GL
FORM U - VERIFICATION 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 local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: "O 1. �,. Phone
LOCATION: Assessor's Map Number Parcel t�,®
v �Y
Subdivision -Lot(s)
Street. � u P,.. �'r� 1�,�. A), A UA .St . Number
************************O'Ificial Use Only************************
tc1~a:ul�llrlr: AllUN - U1?" 1'VWPI
�-' Date Approved
Conservation' Administ ator ...,Date ,Rejected
Comments
IPA Date Approved
Town Planner Date Rejected
Comments
Food Inspector -Health
Septic Inspector -Health
Comments
Public Works - sewer/water—connections
- driveway permit
Fire Department
Received by.Building Inspector
Date Approved
Date Rejected
Date Approved
Date Rejected
Date
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