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HomeMy WebLinkAboutMiscellaneous - 35 HOLLOW TREE LANE 4/30/2018Oil e , a _ r 14 PO OAK y vs 1 WAV 100. Moe v ASSAM AIR Ell 1 .n Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/RS Public Health Director 978.688.9540 - Phone 978.688.9542 - Fax �E12�II�F7CA�IE OAF C091�l�LIANC� As of: August 4, 2004 This is to certify that the individual subsurface disposal system repairec!(X) — (FuCCSystem by James XeCCett at 3S JrLl-flow Tree .Gane North Andover, 31,4 01845 has been installed in accordance with the provisions of Title v of the State Sanitary Code and with the North Andover Board of .Meath regulations. The Issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. Susalin T Sawyer, REAM Tu6CL Yfealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 E9 RECEIVED AUG 0 2 2004 O H OEPAR MENTE T®HEAR TOWN*OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System* constructed; ( ) repaired; by located at 3 1-f leo 72 e CL r4,%�, AJ4, was installed in conformance with the North Andover Board of Health approved plan, System Design Permit .# , plan dated 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 C1VIR.15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bed inspection date:1 z� o y Final inspection date: _ - 1 S / 3 y Installs Engin( T Engineer Representative Engineer Representative Date: Date: z aG Page 1 of 1 Dellechiaie, Pam From: Pamela DelleChiaie[pdellechiaie@townofnorthandover.com] on behalf of Dellechiaie, Pam Sent: Monday, July 19, 2004 9:54 AM To: Sawyer, Susan Subject: FW: 35 Hollow Tree Lane - Request for Final Grade Susan, Can you do a Final Grade on this? Jim Kellett was in looking for the COC due to escrow and getting paid, etc. I said that this one needs the following: • As Built • Installation Certification • Final Grade I can then issue the COC from the Health Dept. Tx, P -----Original Message ----- From: Dan Ottenheimer [mailto:info@millriverconsulting.com] Sent: Tuesday, July 13, 2004 7:30 PM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie' Subject: 35 Hollow Tree Lane Sue and Pam, Attached please find final inspection for 35 Hollow Tree Lane. All went well, gave ok to backfill. Dan Ill River consulting Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting. coin 7/19/2004 TOWN OF NORTH ANDOVER NOR*N Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT t f 27 CHARLES STREET► ,r NORTH ANDOVER, MASSACHUSETTS 01845 CHUs� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 _ FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 35 Hollow Tree Lane MAP: 104A LOT: 27 INSTALLER: James Kellett DESIGNER: Richard TanQard PLAN DATE: April 29, 2004 BOH APPROVAL DATE ON PLAN: 5/5/04 DATE OF BED BOTTOM INSPECTION: 7/8/04 DATE OF FINAL CONSTRUCTION INSPECTION: 7/13/04 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION X PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK= 1500 LOADING OF SEPTIC TANK= H-10 GALLON PUMP CHAMBER = 1000 LOADING OF PUMP CHAMBER = H-10 TYPE OF SAS = Infiltrator Trenches DIMENSIONS AND DETAILS OF SAS: 3 trenches. 7 chambers each 26.5 x 43.75 SITE CONDITIONS Comments: e Existing septic tank properly abandoned d Internal plumbing all to one building sewer Topography not appreciably altered Page 1 of 4 0 O TOWN OF NORTH ANDOVER < NOR711 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET ° NORTH ANDOVER, MASSACHUSETTS 01845 "Ss„CH„sst Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX SEPTIC TANK X Bottom of tank hole has 6" stone base ❑ Weep hole plugged In use/ not verified El 1500 gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) El Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) 0 Inlet tee installed, under access port O Outlet tee (gas baffle or effluent filter) installed, under access port 20 inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present Hydraulic cement around inlet & outlet Comments: Riser over center access port. Water level below seam, could not check watertightness. PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base did not see X Weep hole plugged 1000 gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) Inlet tee installed, under access port D Pump(s) installed on stable base 0 Alarm float working O Pump On/Off float working ff] Drain hole in pressure line 0 20 inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs El Hydraulic cement around inlet & outlet Comments: Water level in operating zone of tank will remain below seam. Page 2 of 4 r 0 O TOWN OF NORTH ANDOVER ct NORT s yho Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT *� 27 CHARLES STREET * �, NORTH ANDOVER, MASSACHUSETTS 01845 ,SS^CHU Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX D -BOX stone base El El a Comments: SOIL ABSORPTION SYSTEM a P ❑ Installed on stable Inlet tee (if pumped or >0.087foot) Hydraulic cement around inlet & outlets Observed even distribution Speed levelers provided (not required) Bottom of SAS excavated down to 6° into C soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan 3/4-1 '/" double washed stone installed 1/8-1/2" (peastone) double washed stone installed laterals installed and ends connected to header (and vented if impervious material above) Orifices @ 5 & 7 o'clock positions Gravelless disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan 40 Mil HDPE barrier installed Retaining wall (boulder / concrete / timber/ block) Final cover as per plan Comments: Water line re-routed per plan. CONTROL PANEL Comments: D Alarm & Pump are on separate circuits D Alarm sounds when float is tripped ❑ Location of control panel: Basement ❑ Rated for exterior if placed outside Page 3 of 4 0 .. o TOWN OF NORTH ANDOVER °E NORTH 7 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845ACM Ss "CH U51 Susan Y. Sawyer, REHS/RS 978.688.9540 - Phone Public Health Director 978.688.9542 - FAX SYSTEM ELEVATIONS Benchmark: 100.00 Rod at Benchmark: 3.88 Height of Instrument: 103.88 Rain at time of inspection, performed limited number of elevation shots to confirm installation. Page 4 of 4 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 96.70 97.12 Septic Tank IN 96.50 96.87 Septic Tank OUT 96.25 96.62 Pump Chamber IN 96.20 Pump Chamber OUT 95.95 96.42 Distribution Box IN 99.92 D -Box OUT 99.75 Bottom of Chamber 99.11 Top of Chamber 100.11 100.10 Chamber Inlet Invert 99.65 99.67 Rain at time of inspection, performed limited number of elevation shots to confirm installation. Page 4 of 4 TOWN OF NORTH ANDOVER f 40RTFI Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET + �o NORTH ANDOVER, MASSACHUSETTS 01845 . �y 9,TS<1GHUS4t Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX D -BOX 1 L6c 'i ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.087foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to t%soil layer, as provided on plan L-- S Ixe S3 , S ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 W double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: PRESSURE DISTRIBUTION Comments: inch manifold laterals installed with end sweeps size: material: Squirt test ft in height Equal distribution to all .laterals orifice size inch as per plan, Page 3 of 4 Commonwealth of Massachusetts Map -Block -Lot 104.A- 0027 Board Of Health pe►mit No North Andover BHP -2004-0484 P.I. FEE F.I. $250.00 Disposal Works Construction Permit P , AMES KELLETT Permission is hereby granted -- J-_-_- ---- ---------------------------- -.,_.--.----_-- -- __ _ - .__ - to (Repair) an Individual Sewage Disposal System. at No 35 HOLLOW TREE LANE ------------- --------------------------------------- - ----- -- -------------- - es shown on the application for Disposal Works Construction Permit No. BHP -2004-048 Dated July 06, 2004 ------ -.-.._ Issued On Jul -06-2004 Board Of Health o 1 TOWN OF NORTH ANDOVER f HorrTh o t«eu 6'qH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET dAAT6P NORTH ANDOVER, MASSACHUSETTS 01845 9S�ACHUSEK Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX healthdept @ townofnorthandover. com www.townofnorthandover.com APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: '/ ` 6- 0 q LOCATION: � H� �O w �fi r;ll� �� LICENSED INSTALLER NAME: PLEASE PRINT SIGNATURE: 4 CHECK ONE: FULL SYSTEM REPAIR: COMPONENT REPAIR (indicate what parts): * NEW CONSTRUCTION: TELEPHONE# %J�/ - ' Sf 3 — 71 V 4 * If NEW CONSTRUCTION, please attach the Foundation As -Built Plan. $"ww 00 Fee Attached? Project Manager Obligation From Attached? Foundation As -Built? Floor Plans? Yes ✓ No Yes No Yes No Yes No Approval of Health Agent Date: I �. ' ' INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at 35 lwLLo w fi2EC relative to the application of dated f for plans by All< 111(e c i t and dated 4 — -)- 0 q with revisions dated 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 prior to 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 manger, 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 Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license 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. Under 'gned Licensed Septic Installer Date: '7 �Q Di sal Works Construction Permit # NEW ENGLAND ENGINEERING SERVICES INC. April 13, 2004 Susan Sawyer North Andover Board of Health 27 Charles Street North Andover, MA 01845 Re: 35 Hollow Tree Lane, Septic System Design Dear Susan: MN OF FORTH ANDOVF BOARD OF HEALTH APR i 3 2M4 Enclosed are the following documents concerning the above referenced property. 1. 5 Copies of septic system design plans. 2. Copy of soil evaluator sheets. 3. Application for approval plans. 4. Check to cover the approval fee. These plans are being submitted for approval. Please contact this office with any questions or concerns at (978)-686-1768. Sincerely, Thomas Hector, EIT New England Engineering Services, Inc. 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 ndoverTown of North A HEALTH-DEPARTMENT 27 Charles Street North Andover, MA 01845 978.688.9540 healthilegg&owngfnorthandover.com SEPTIC PLAN SUBMITTAL APR i 3 ?r�A DATE OF SUBMISSION: SITE LOCATION: �5 A11DW Flee Z c;Oe_ ` ENGIN: /l% ENGINEER: �n�%av►� �Mr e.n 0 r) _ �>.1 ,/Itr oC NEW PLANS: YES_ $225.00/Plan VZ Check #: (Includes IdE and one Re -Review Only) REVISED PLANS: YES $ 75.00/Plan Check #: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone #: q 7 6 96 _ 12 6Faz #: L q29) 6 g,S—) 0 qC1 E-mail: GOl d Con, HOMEOWNER NAME: Si OFFICE USE ONLY When the submission is complete (including check): I. Date stamp plans and letter 2. Complete and attach Receipt 3. Copy File; Forward to Consultant 4. Enter on Log Sheet and Database o No. 2 3/ ?` `7 FORM 11 - SOIL EVALUATOR FORMM Page I of 3 Date: /Z Commonwealth of ]Massachusetts Massachusetts Soil Suitabilio Assessment for On-site Sewage Disposal Performed B ��c � ......C:.........�/7—., Date: By: Witnessed By: .................... ..... 0w xr's Name, Lo( 1 (� Addrcu, ud a!/�'vv Tcicptarc 1 /✓74 LC`%�// V"p lew construction ElRepair ® �B ---o-- Office Office Review Published Soil Survey Available: No ❑ Yes Year Published / 9��.................. Publication Scale/ � '' .... Soil Map Unit �b `� Drainage Class ........ Soil Limitations�G ..........e, .... .. Surficial Geologic Report Available: No N� Yes ❑ Year Published Publication Scale Geologic Material (Map Unit)I .......... ......................... ............. .............. I .......... ....... ............ _.. Landform... .................................. .................................................................. ............. .......... ........... Flood Insurance Rate Map: Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No ❑ Yes ❑ Within 100 year flood boundary No []Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) .................... .. ........................ Wetlands Conservancy Program Map (map unit) ........ ......... . ........ ... .. ..... - .... Current Water Resource Conditions (USGS): Month Range :Above Normal ❑Normal ®Below Normal ❑ Other References Reviewed: kiDEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORA Page 2of3 Location Address or Lot iJo.:0-4�OGdT%�� Ive On-site Review Review D Deep Hole Number .::. Date: O� Time: 1&52 — WeatherCLp� Location (iden iifiy�y {�on site plan) T _ r— .... Land Use Slope (%) Surface Stones Vegetation . .... Landform ..:: ...:...:. Position on landscape Distances from: Open Water Bodyfeet Drainage way � feet Possible Wet Area ... feet Property Line _ feet Drinking Water Well,/j`0 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) yts -/ / / l ��% �Z- � Com✓ �r • L rt 0o yr-$rrA.(cr- Parent Material (geologic) L DepthtoBedrock: Depth to Groundwater: Blanding Water in the Hole: CP� Weeping from Pit Face: �a s tr Estimated Seasonal High Ground Water:_ _— - - — - DEP APPROVED FORM • 12/07/95 0 0 FORM 11 - SOIL EVALUATOR FORM Page 2of3 Location Address or Lot 140.-���CG���'" G�✓t/ /1/O �iC�G��/�Z On-site Review / o Deep Hole Number Z ... Date:.:.. '/. Time: WeatherC ���/� L�— Location 0dentl on site plan) i QST . Land Use Slope M 2 Surface Stones Vegetation ��2�1..... Landform ...... Position on landscape Distances from: O Open Water Body ��d� feet Drainage way ��� feet Possible Wet Area .��� .. feet Property Line .47�. feet Drinking Water Well,�/5-Z-2 feet Other ..:.. r%rr-n ^MC%CM%1A"rinRll'Ur11 C y r)t-.* Parent Material (geologic) ` DepthtoBedrock: _. Depth to Groundwater: Standing Water in the Hole: �z Weeping from Pit Face: r Estimated Seasonal High Ground Water:__ iiDEP APPROVED FORM • 12/07/95. Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency. °b Gravel) � Z •- 49 �, y ��o , o _ /0 Z Parent Material (geologic) ` DepthtoBedrock: _. Depth to Groundwater: Standing Water in the Hole: �z Weeping from Pit Face: r Estimated Seasonal High Ground Water:__ iiDEP APPROVED FORM • 12/07/95. O O FORM 11 - SOIL EVALUATOR F0101 Page l of 3 Location Address or Lot IJo����Ty'S`�,(/� V6. 4—) On-site Review 2O Deep Hole Number Date:`3/�����t Time: �1�.�/O Weatherra)Y,��7 Location (identify on site plan) .:::. T C .,.. . Land Use 34V�014'7W! Slope (%) 2- Surface Stones Vegetation. 5. Landform Position on landscape Distances from: Open Water Body �feet Drainage way/_-��o feet Possible Wet Area l®8 feet Property Line ? ... feet Drinking Water Well feet feet Other DEEP OBSERVATION HOLE LOC Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling other °b (Structure, Stones, Bould)rs, Consistency,Gravel SVP 71– L 1'/Z_ Owl — 4q &w ft/li x - /'o'Y' v���� Parent Material (geologic) Lid S �� L C— DepthtoBedrock: r, Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: 70 t Estimated Seasonal High Ground Water:__ -- kiDEP APPROVED FORM - 12/07/95 Mr 0 0 FORM 11 - SOIL EVALUATOR FMN1 Page l of 3 Location Address or Lot No. �� GAG N /Y�• ��m� On-site Review Lj o Deep Hole Number Date:.:�P/4� Time:�e �4Z WeatherC���3� Location (identify on site plan) 77��'%:..�Gi�T: Land Use Slope (%) . 2- Surface Stones . Vegetation Landform G2ol��rJ>�l/f?/!(/ Position on landscape Distances from: Open Water Body �� ®q� feet Drainage way ��feet Possible Wet Area / feet Property Line .5''5 feet Drinking Water Well feet Other 777. DEEP OBSERVATION HOLE LOG Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, °/b Gravel) g 1 107 Parent Material (geologic) T ' G DepthtoBedrock: r Depth to Groundwater: Standing Water in the Hole: �� d Weeping from Pit Face: Estimated Seasonal High Ground Water:___ DEP APPROVED F0101 - 11/07/95 L O 0 a FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole ............ inches ❑ Depth weeping from side of observation hole ................ inches © Depth to soil mottles ...: .:: inches 2 _ ❑ Ground water adjustment ................... feet– o Index Well Number .................. Reading Date .................. Index well level .. ..... Adjustment factor ................... Adjusted ground water level ................................................... . Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in a�areas observed throughout the area proposed for the soil absorption system? If not, what 'is the depth of naturally occurring pervious material? — Certification I certify that on/�C(date) I have passed the soil evaluator examination approved by the Dep rtment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15 Signatur /"` / Date DEP APPROVED FORM • 12/07/95 v FORM 12 - PERCOLATION TEST Location Address or Lot No. 35 11alla w Tree. keine COMMONWEALTH OF MASSACHUSETTS Ar4k kJover , Massachusetts Percolation Test` D :. 3jII01oy. 10,'5 -OAA T)(e:, y�t�Ot/:...._T5()Awt Observation Hole # JOT . j� / d pr yhr. ) Depth of Pero 5a �, 18 r� OA ,5 7 1/0 1,, Start -Pre-soak /,D,' 5-1 End Pro -soak f f 6 Time at 12" Time at 9" Time at 6" ff 1-1 hr Sov,K 3 Time (9"-6") . S3 ►'►'1�Y1 Rate Min./Inch I Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ Performed By. Benla.,n .... ..................................... . �6 0A ............. _... _.............................. :................. _................... .._._....... _....... ; /JeW Enaiand ElA 'A erg 4,. Service ' Witnessed BY: �i�el O+�Q�hP:�pr 1� �r�U �t j�i4.�t�ti,1l ��.t Comments: ..v.......�_ - w........w ax...... nr ... wN.......... w�.. M ..w...�.�............ DEP APPROVED FORM - 12/07195 Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer [info@milldverconsulting.com] Sent: Wednesday, April 28, 2004 9:26 AM To: Susan Sawyer; 'Pamela Dellechiaie' Subject: misc. Sue and Pam, Tried calling back, phone,'s been busy (oh how popular you are... ) Yes we did re ve 35 Hollow Tre ane and should have the review completed today or tomorrow. Also, the designer r 19'3" acy Street called to move the soil test date. It is now May 7m at 10:00 instead of May 6th Dan 0 Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com 4/28/2004 Page 1 of 1 DelleChiaie, Pamela From: Pamela DelleChiaie[pdellechiaie@townofnorthandover.com] Sent: Thursday, April 29, 2004 9:36 AM To: 'amckay@townofnorthandover.com' Cc: 'ssawyer@townofnorthandover.com' Subject: FW: 35 Hollow Tree Lane Importance: High Hi Alison, See note below from our septic consultant. I will leave a copy of the plan for your review in your inbox. If you can look at it by Friday, that would be great. Thanks, Pam -----Original Message ----- From: Dan Ottenheimer [mailto:info@millriverconsulting.com] Sent: Thursday, April 29, 2004 9:14 AM To: Susan Sawyer; 'Pamela Dellechiaie' Subject: 35 Hollow Tree Lane Sue and Pam, Attached please find the plan approval for 35 Hollow Tree Lane. There are a few typographical errors which we discussed with NEES and they will submit a revised plan. I didn't see it necessary to disapprove for such minor matters. Please note that the wetland delineation ;line should be confirmed by the conservation commission and if they do not concur then the plan should be deemed invalid. I'd suggest not issuing a construction permit until the delineation is confirmed by Con Comm. Dan 0 Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultiniz.com info@millriverconsulting.com 4/29/2004 0 O NEW ENGLAND ENGINEERING SERVICES INC. May 3, 2004 1CWj� 0 0 1 A4� ANLJ% % BOARD' J Susan Sawyer y MAY 5 ?_ D4 North Andover Board of Health 27 Charles Street - - North Andover, MA 01845 Re: 35 Hollow Tree Lane, Septic System Re -submittal Dear Susan: Please accept this re -submittal for the above referenced property. Only minor changes have occurred, thus no new distances, elevations, or calculations were performed. We have addressed the following issues: Soil Log on Test Pit 4; Water table should show 51 inches. Original plan showed 60 inches, but calculations were based on 51 inches. We have changed soil log to show 51 inches. 2. Impervious Barrier; Extended 40 mil impervious barrier approximately 10 feet along southwesterly side of the system (side closest to driveway). 3. Construction Notes; Numbering of the notes did not correspond with appropriate sentences. 4. Distribution Box Notes (Page 2); References to construction notes did not correspond correctly. Problem alleviated once previous issue was addressed. Five (5) copies of these plans are being re -submitted for approval. Please contact this office with any questions or concerns at (978)-686-1768. Sincerely, Thomas Hecor, EIT New England Engineering Services, Inc. 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 0 1 0 TOWN OF NORTH ANDOVER F NCRTp, Office of COMMUNITY DEVELOPMENT AND SERVICES oro`t°`eo °�Om HEALTH DEPARTMENT _ p 27 CHARLES STREET t q�A�TEO �PT'�'(TJ NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX May 6, 2004 Steven Nugent 35 Hollow Tree Lane North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 35 Hollow Tree Lane, Map 104A, Parcel 27 Dear Mr. Nugent, The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated April 7, 2004 and received by this office on April 13, 2004. The design has been approved for use in the construction of a replacement onsite septic system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection, which did not meet the acceptable criteria in the state regulations. The time period for which this plan is valid may be reduced by the North Andover Board of Health in the event an imminent health problem such as sewage backup into the dwelling is occurring. This approval is subject to the following conditions: 1. 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)). 2. 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. 3. Approval by the North Andover Conservation Commission of the wetland delineation as depicted on this design. 4. The impervious barrier shown on the southwest side (driveway side) of the leaching area must be placed to ensure a minimum distance of 15' from edge of trenches to start of 3:1 slope (3 10 CMR 15.255(2)). Place as shown on plan or adjust on site to achieve required result. 5. The plan does not call for installation of a septic tank effluent filter but one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use, if you choose to install one. 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. Sincerely, Pr..y. �Mf y y S an Y. Sawyer, REHS S Public Health Director encl: . List of licensed septic system installers cc: New England Engineering Services No. Andover Conservation Department file Town of North Andover Licensed Septic System Installers (Disposal Works Installer's) Year 2004 List Last Updated: 5/6/04 /Please note that the septic installer is licensed only -- not the comnanv) 1 Amor, Robert* R.T. Amor BHP -2004-0022 978-887-5468 2 Bateson, Todd* Bateson Enterprises, Inc. BHP -2003-0396 978-475-1474 3 Breen, Peter* Peter Breen Excavating, Inc. BHP -2003-0400 978-687-7774 4 Busby, Philip A. Jr.* Busby Construction Co., Inc. BHP -2003-0405 603-362-4650 5 Carr, John* Ramey Construction BHP -2004-0031 978-633-6791 6 Colosi, Philip A.* Colosi Construction LLC BHP -2004-0165 978-777-5679 7 Coyle, Kevin - NEW LaPlume Excavation . BHF -2004-0159 978-479.2818 8 Currier, James H.* James H. Currier Construction Co, Inc. BHP -2004-0008 978-774-6685 9 Daigle, Rob* Creative Builders BHP -2004-0308 978-682-4948 10 DeLucia, Rocci Jr.* Frank DeLucia & Son, Inc. BHP -2003-0393 978-686-8200 11 DiVincenzo, John L.* Andover Septic/J&S Dev. Corp. BHP -20.03-0394 978-521-5251 12 Giard, Daniel* Daniel A. Giard Septic Service BHP -2003-0402 978-686-7653 13 Hall, Bill, Inc.* Bill Hall, Inc. BHP -2003-0407 978-689-3711 14 Henderson, George* G. Henderson Co., Inc. BHP -2004-0101 978-686-5845 15 Hutton, Arthur* Hutton's General Construction, Inc. BHP -2003-0398 978-685-2627 16 Innis, Robert L.* R.L.I. Corp. BHP -2003-0397 978-663-6006 17 Kellett, James* Kellett Excavating BHP -2004-0291 781.953.7146 18 Linskey, William M.* Linskey Construction, Inc. BHP -2003-0408 978-744-2700 19 Maker, Ronald* T Ford Co., Inc. BHP -2203-0404 978-352-5606 20. Marsh, Steve* The Westchester Co. BHP -2003-0316 978-742-9778 21 Maynard, Dave* Maynard Construction BHP -2003-0399 603-228-4436 22 McKee, Brian* D.P. McKee & Son Excavators BHP -2004-0023 781-942-7608 23 Osgood, Ben* New England Engineering BHP -2004-0024 978-686-1768 24 Patenaude, Richard* Dracut Sewer Service, Inc. BHP -2004-0034 978-452-4851 25 Petrosino, Angelo* Angelo Petrosino BHP -2003-0391 978-664-2030 26 Quinlan, Timothy* Quinlan & Rand Builders BHP -2004-0025 978-682-1570 27 Reilly, Michael W.* F.P. Reilly & Son's, Inc. BHP -2003-0401 978-475-1237 28 Richard, Roger* R.J. Richard Corp. BHP -2004-0035 978-686-7445 29 Sawyer, William T.* Arco Excavators, Inc. BHP -2004-0028 978-685-5113 30 Shaw, John III* Wildwood Excavation, Inc. BHP=2004-0265 978-474-8088 31 Simard, Ralph* Ralph Simard BHP -2004-0293 508-958-2002 32 Soucy, John J.* Soucy's Sewer Service BHP -2004-0026 978-470-1400 33 St. Hillaire, Paul* Andover Construction & Dev. BHP -2003-0403 978-749-0073 34 Surianello, Joseph* Ralph Surianello, Inc. BHP -2003-0406 617-799-3900 35 Todd, Charles R.* Charles R. Todd Contractor, Inc. BHP -2003-0392 978-667-7853 36 Zaher, Charles* Charles Zaher BHP -2004-0030 978-441-9429 Note: The Septic Installer Exam is held in January, March, May, July and September of each year. You must call the Health Department to sign up for the exam at 978.688.9540. The testing fee is $25. Last Updated: 5/6/2004 o DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Monday, May 10, 2004 12:25 PM To: Sawyer, Susan Subject: FW: 35 Hollow Tree Lane Importance: High Alison left me the following note this a.m.: Page 1 of 2 "Just to let you know, 35 Hollow Tree Laneis on my Conservation Agenda for Wednesday. I'll let you know if changes are necessary from my board or if during my review of wetland line (I'm hoping to do it Monday) changes are made." Alison The letter already went out on May 6th. Not sure how you want to handle this update from Alison. P -----Original Message ----- From: Sawyer, Susan Sent: Wednesday, May 05, 2004 4:27 PM To: DelleChiaie, Pamela Subject: FW: 35 Hollow Tree Lane Pam, I edited the approval as necessary and stamped the plans. Please cc Allison and give her a plan to review. I hope she already has... Thanks -----Original Message ----- From: Dan Ottenheimer [mailto:info@millriverconsulting.com] Sent: Thursday, April 29, 2004 9:33 AM To: Susan Sawyer; 'Pamela Dellechiaie' Subject: 35 Hollow Tree Lane Sue and Pam, Attached please find the plan approval -for 35 Hollow Tree Lane. There are a few typographical errors which we discussed with NEES and they will submit a revised plan. I didn't see it necessary to disapprove for such minor matters. Please note that the wetland delineation line should be confirmed by the conservation commission and if they do not concur then the plan should be deemed invalid. I'd suggest not issuing a construction permit until the delineation is confirmed by Con Comm. Dan D Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center 5/10/2004 d' 0 N EI tv 1 IV it zti a 0 00 x �mM czo'a °�z¢z u _ E °-' v c F- > i b o� � 3 3 u E co U C O w t � wx�x O i C E Vi M M c c m or - U > CL E g 0 w c v O � w a o c O v -0 F 6> C L .C U O ro OU a > � 0 3a� ti o 3 C d n.T � � �•or7� � c cu �p O M C '�-' 00 i \ O U 00 C O C C)O O N � � ti w O � � D O O O O E N U [— C O O W) Q O �. L oyo•� 40 D o 0 o w A w w O �Q Y C4 cn 0 0 .2 0 C a Q 0 O N 0 w �mM czo'a u _ E °-' v c F- > i b o� u E co U C O w t � C i C E u c c m or - U > CL E g 0 w c w18 75 o o c O v -0 F bD .C U O ro OU a > a �-' o H m 0 o ti o 3 d n.T � � �•or7� � c �p O M C '�-' 00 i \ o w A w w O �Q Y C4 cn 0 0 .2 0 C a Q 0 O N 0 � a O l� N ^O Q 4� y z N � z 3 � ` o a •� r ;; o 0 O y` ou c c7 N N p, O m ti ti 00 00 rn rn � r 0 0 O O Cl O N N D O C7J G O 7 O D\ O O CD CD O O N N N O N 0., W ^O Q 4� y z � z •� ;; o 0 O c7 N N p, O m ti ti O O Ca oo oo W o 0 CS z o o 0 0 a a a d x x a m m O 7 O D\ O O CD CD O O N N N O N 0., r. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. rab renin MassachuseDepartment of Environmental Protection Bureau of Resource Protection - Wetlands WPA Forma 5 - ®rderxn,fConditions Massachusetts 1/ r Sands Protech i) Act M.G.L. c. 131, §40 A. General Information .. From: North Andover Conservation Commission This issuance if for (check one): ® Order of Conditions ❑ Amended Order of Conditions To: Applicant: Steven Nugent Name 35 Hollow Tree Lane Mailing Address North Andover MA. 01845 DEP File Number: ')A7 Property Owner (if different from applicant): Same Mailing Address City/Town State Zip Code City/Town. State Zip Code 1., Project Location: 35 Hollow Tree Lane North Andover Street Address City/Town Map 104A Lot 27 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Essex North 1320 172 County. Book Page Certificate (if registered land) 3. Dates: 4/23/04 5/12/04. 6/1/04 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4. Final Approved. Plans and Other Documents (attach additional plan references as needed): NOI April 2004 Title Date Proposed Subsurface Sewage Disposal System 4/7/04 revised Title 4/29/04 Proposed Subsurface Sewage Disposal System (Detail Sheet) 4/7/03 revised Title 4/29/04 5. Final Plans and Documents Signed and Stamped by: Richard C. Tangard P. E. Name 6. Total Fee: $ 55.00 (from Appendix B: Wetland Fee Transmittal Form) Wpaform5.doc • rev. 12/15/00 Page 1 of 7 /1 O L1Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands 1 WPA Form 5 Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: DEP File Number: 242-1241 Provided by DEP Following the review of the above -referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: ® Public Water Supply ® Private Water Supply ® Groundwater Supply ❑ Land Containing Shellfish ❑ Fisheries ® Storm Damage Prevention ® Prevention of Pollution ® Protection of Wildlife Habitat ® Flood Control Furthermore, this Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations, to protect those interests checked above. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. Wpaform5.doc - rev. 12/15/00 Page 2 of 7 0 o Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: ' WPA Form 5 - Order of Conditions 242-1241 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings (cont.) 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including, but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"] "File Number 242-1241 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. Wpaform5.doc • rev. 12/15/00 Page 3 of 7 0 O Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands Ll WPA Form 5 - Order of Conditions 242-1241 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. Findings as to municipal bylaw or ordinance Furthermore, the North Andover hereby finds (check one that applies): Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Municipal Ordinance or Bylaw Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: North Andover Wetland Protection Bvlaw Chapter 178 unicipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. Wpaform5.doc • rev. 12/15/00 Page 4 of 7 DEP FILE # 242 - 1241 Therefore, the North Andover Conservation Commission (hereafter the "NACC") hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the State Regulations, the local ByLaw and Regulations, to protect those interests noted above. The NACC orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced below. To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. GENERAL CONDITIONS 18. Failure to comply with all conditions stated herein; and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 19. This Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of property rights. However, the NACC, agent of the NACC or the Department of Environmental Protection (DEP) reserves the right to enter and inspect the property at all reasonable times until a Certificate of Compliance is issued, to evaluate compliance with this Order of Conditions, the Act (310 CMR 10.00), the North Andover Wetland ByLaw and Regulations, and may require any information, measurements, photographs, observations, and/or materials, or may require the submittal of any data or information deemed necessary by the NACC for that evaluation. Further, work shall be halted on the site if the NACC, agent or DEP determines, that any of the work is not in compliance with this Order of Conditions. Work shall not resume until the NACC is satisfied that the work will comply and has so notified the applicant in writing. 20. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by- laws or regulations. 21. The work authorized hereunder shall be completed within three years from the date of this order. 22. This Order may be extended by the issuing authority for one or more periods of up to one year each upon application to the issuing authority at least thirty days (30) prior to the expiration date of the Order (Refer to Section 8.3 (p.37) of the North Andover Wetland Regulations). C:\Winword\OOC\35Ho11owTree242-1241.doe 1 NACC 6/1/04 A; DEP FILE # 242 - 1241 23. The NACC reserves the right to amend this Order of Conditions after a legally advertised public hearing if plans or circumstances are changed or if new conditions or information so warrant. 24. Where the Department of Environmental Protection (DEP) is requested to make a determination and to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before the Department. 25. This Order of Conditions is issued under File No. 242-1241. 26. The conditions of this decision shall apply to, and be binding upon, the applicant, owner, its employees and all successors and assigns in interest or control. These obligations shall be expressed in covenants in all deeds to succeeding owners of portions of the property. 27. The term "Applicant" as used in this Order of Conditions shall refer to the owner, any successor in interest or successor in. control of the property referenced in the Notice of Intent, supporting documents and this Order of Conditions. The. NACC shall be notified in writing within 30 days of all transfers of title of any portion of property that takes place prior to the issuance of a Certificate of Compliance. 28. The proposed work includes: the construction of a replacement subsurface sewage disposal system with associated grading in the buffer zone to a bordering vegetated wetland. 29. The work shall conform to the following Notice of Intent filed by: Steven Nugent 35 Hollow Tree Lane North Andover, MA 01845 Site Plans and Notice of Intent prepared by: New England Engineering Services, Inc. 60 Beechwood Drive North Andover, MA 01845 Plans Entitled: Proposed Subsurface Sewage Disposal System Dated 4/7/04, revised 4/29/04 Proposed Subsurface Sewage Disposal System -(Detail Sheet) Dated 4/7/03, revised 4/29/04 Stamped and signed by Richard C. Tangard, P.E C:\Winword\OOC\35Ho11owTree242-1241.doe NACC 6/1/04 0 o DEP FILE # 242 -1241 30. The following wetland resource areas are affected by the proposed work: Buffer Zone to. Bordering Vegetated Wetland (BVW). These resource areas are significant to the interests of the Act and Town ByLaw as noted above and therein. The applicant has not attempted to overcome the presumption of significance of these resource areas to the identified interests. 31. The NACC agrees with the applicant's delineation of the wetland resource areas on the site as shown on the plans dated referenced herein. 32. The NACC finds that the intensive use of the upland areas and buffer zone proposed on this site will cause further alteration of the wetland resource areas. In order to prevent any alteration of wetland resource areas a twenty-five foot (251 No -Disturbance Zone and a fifty -foot (501 No -Construction Zone shall be established from the edge of the adjacent wetland resource area except in areas that previously existed within these locations. The Conservation Administrator and/or other agents of the NACC do not have the authority to waive these setbacks as established under the local bylaw. No disturbance of existing grade, soils or vegetation is permitted in the No -Disturbance zone. (See Section 3.4 & Appendix.F of the local Regulations). 33. Several areas of yard waste deposits (brush and stump piles) were observed on the property, specifically between wetland flags A3 & A4 and adjacent to wetland flag A5. These areas of yard waste deposits appear to be old therefore removal is not required. However, future deposits of yard waste of any kind shall be prohibited within the resource area and the 25 -foot No -Disturbance zone. 34. There shall be no increase in the post development discharges from the storm drainage system or any other changes in post development conditions that alter the post development watershed boundaries as currently depicted in the Notice of Intent and approved by this Order of Conditions, unless specifically approved in writing by the Commission. 35. This document shall be included in all construction contracts, subcontracts, and specifications dealing with the work proposed and shall supersede any conflicting contract requirements. The applicant shall assure that all contractors, subcontractors, and other personnel performing the permitting work are fully aware of the permits terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order resulting from failure to comply with its conditions. 36. The owners of the project and their successors in title, in the event they proceed to alter areas subject to the Commission's jurisdiction under the order, agree that the Order does not in itself impose upon the Town any responsibility to maintain the proposed drainage system and that said Town shall not be liable for any damage in C:\Winword\OOC\35HollowTree242-1241.doc 3 NACC 6/1/04 c� o DEP FILE # 242 - 1241 the event of failure. By acceptance of this Order, the owners agree to indemnify and hold harmless to the Town and its residents for any damage attributable to alterations undertaken on this property pursuant to the Order. Issuance of these Conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage or any other form of water damage. Maintenance of the drainage system, if accepted by the Town as part of a public way, becomes the responsibility of the Town. 37. Issuance of these Conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage or any other form of water damage. PRIOR TO CONSTRUCTION 38. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department or Court have been completed. 39. This Order shall be recorded by the applicant at the Registry of Deeds immediately after the expiration of all appeal periods. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is to be done. The recording information shall be submitted to the North Andover Conservation Commission on the form at the end of this Order prior to commencement of the work. Any Order not recorded by the applicant before work commences may be recorded by the NACC at the applicant's expense. 40. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bearing the words "Massachusetts DEP, File Number 242-1241." 41. Any changes in the submitted plans caused by the applicant, another Board's decision or resulting from this Order of Conditions must be submitted to the NACC for approval prior to implementation. If the NACC finds said changes to be significant, the NACC will call for another public hearing (at the expense of the applicant). Within 21 days of the close of said public hearing the NACC will issue an amended or new Order of Conditions. Any errors found in the plans or information submitted by the applicant shall be considered as changes. The proposed project may be still under review by other local or state boards or agencies. This may result C:\Winword\OOC\35HollowTree242-1241.doe 4 NACC 6/1/04 U DEP FILE # 242 - 1241 in changes to the project plans or wetland impacts. If any such changes occur a revised plan and an explanation of the revisions shall be submitted to the NACC for review and approval prior to the start of construction. No work shall begin on a project until written approval has been granted by the NACC. 42. It is the responsibility of the applicant, owner, and/or successor(s) to ensure that all conditions of this Order of Conditions are complied with. The project engineer and contractors are to be provided with a copy of this Order of Conditions and referenced documents before commencement of construction. 43. Prior to any work commencing on-site, the applicant shall submit to the NACC for approval, a detailed sequence of construction, including the construction of compensation and retention areas, installation of sedimentation/ erosion control devices and re -vegetation to be completed before other work begins on-site. 44. Wetland flagging shall be checked prior to start of construction and shall be re- established where missing. All wetland flagging shall remain visible and enumerated per the approved plan(s) throughout the life of the project and until a Certificate of Compliance is issued so that erosion control measures can be properly placed and wetland impacts can be monitored.. The proposed limit of work shall be shall be clearly marked with stakes or flags and shall be confirmed by the NACC. Such markers shall be checked and replaced as necessary and shall be maintained until all construction is complete. Workers should be informed that no use of machinery, storage of machinery or materials, stockpiling of soil, or construction activity is to occur beyond this line at any time. All flags used for the above purposes shall be of a color different from other flagging used on the site. . 45. A row of staked hay bales backed by trenched siltation fence shall be placed between all construction areas and wetlands. The erosion control barrier will be properly installed and placed as shown on the plans approved and referenced herein and shall be inspected and approved by the NACC prior to the start of construction and shall remain intact until all disturbed areas have been permanently stabilized to prevent erosion. All erosion prevention and sedimentation protection measures found necessary during construction shall be implemented at the direction of the NACC. The NACC reserves the right to impose additional conditions on portions of this project to mitigate any impacts which could result from site erosion, or any noticeable degradation of surface water quality discharging from the site. For example, installation of erosion control measures may be required in areas not shown on the plan(s) referenced in this Order of Conditions. Should such installation be required by the NACC, they shall be installed within 48 hours of the Commission's request. C:\Winword\OOC\35Ho11owTree242-1241.doc 5 NACC 6/1/04 0 0 DEP FILE # 242 - 1241 46. The applicant shall have on hand at the start of any soil disturbance, removal or stockpiling, a minimum of 10 hay bales and sufficient stakes for staking these bales (or an equivalent amount of silt fence). Said bales shall be used only for the control of emergency erosion problems and shall not be used for the normal control of erosion. 47. A check payable to the Town of North Andover shall be provided in the amount of $1,500, which shall be in all respects satisfactory to Town Counsel, Town Treasurer, and the NACC, and shall be posted with the North Andover Town Treasurer through the NACC before commencement of work. Said deposit of money shall be conditioned on the completion of all conditions hereof, shall be signed by a party or parties satisfactory to the NACC, and Town Counsel, and shall be released after completion of the project, provided that provisions, satisfactory to the NACC, have been made for performance of any conditions which are of continuing nature. The applicant may propose a monetary release schedule keyed to completion of specific portions of the project for the NACC's review and approval. This condition is issued under the authority of the local ByLaw. 48. The applicant shall designate a Wetland Scientist as an "Erosion Control Monitor" to oversee any emergency placement of controls and regular inspection or replacement of sedimentation control devices. The name and phone number of the erosion control monitor must be provided to the NACC in writing by the hired professional in the event that this person has to be contacted, due to an emergency at the site, during any 24-hour period, including weekends. This person shall be given the authority to stop construction for erosion control purposes. The erosion control monitor will be required to inspect all such devices and oversee cleaning and the proper disposal of waste products. Cleaning shall include removal of any entrapped silt. At least once during each week in which construction activities occurs on-site and for as long thereafter as ground remains unstabilized, the applicant shall submit a written report from the "Erosion Control Monitor" to the NACC certifying that, to the best of his/her knowledge and belief based on a careful site inspection, all work is being performed in compliance with this Order of Conditions and that approved setbacks are being adhered to. The erosion control monitor must visually inspect all sedimentation/erosion control measures and assume responsibility for their maintenance on a weekly basis and that they are functioning as intended. In addition, all wetland resource areas must be visually inspected for siltation, turbidity, and/or other water quality impacts. 49. Prior to construction, the applicant shall permanently mark the edge of the "25' No - Disturbance Zone" with signs or markers spaced evenly every 25 feet incorporating the following text: "Protected Wetland Resource Area". This will designate their sensitivity and assure no further inadvertent encroachment into the wetland. These permanent markers are available at the Conservation Office for $2 C:\Winword\OOC\35Ho11owTree242-1241.doc 6 NACC 6/1/04 DEP FILE # 242 - 1241 apiece and are subject to review and approval by the NACC. The applicant shall instruct all agents to explain these markers to buyers/lessees/landscapers and all persons taking over the property from the applicant. 50. The applicant and/or the legal owner of that portion of land upon which these Orders of Conditions have been placed shall provide to the NACC prior to transferring, or assigning any portion of said land to another party, subject to said Orders of Conditions, the "Compliance Certification Form Affidavit" attached via "Appendix A" signed under the pains and penalties of perjury, stating that said applicant and/or owner has read these Orders of Conditions and is in compliance with each and every condition. This document shall apply to each of the conditions referenced herein and shall be provided to the Conservation Department at least five (5) business days prior to the closing of said land transaction. 51. Once these above mentioned pre -construction requirements are complete, the applicant shall contact the Conservation Office prior to site preparation or construction and shall arrange an on-site conference with an NACC representative, the contractor, the engineer, wetland scientist and the applicant to ensure that all of the Conditions of this Order are understood. This Order shall be included in all construction contracts, subcontracts, and specifications dealing with the work proposed and shall supersede any conflicting contract requirements. The applicant shall assure that all contractors, subcontractors and other personnel performing the permitted work are fully aware of the permit's terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order of Conditions resulting from failure to comply with its conditions. The applicant or contractor shall notify the NACC in writing of the identity of the on-site construction supervisor hired to coordinate construction and to ensure compliance with this Order. A reasonable period of time shall be provided as notice of the pre - construction meeting (e.g. 72 hours). 11 DURING CONSTRUCTION 52. Upon beginning work, the applicant shall submit written progress reports every month detailing what work has been done in or near resource areas, and what work is anticipated to be done over the next period. This will update the construction sequence. 53. Approved de -watering activities anticipated at the roadway entrance location shall be supervised and witnessed by the designated erosion control monitor. This designee must be on-site while work specific to the roadway retaining wall installation is occurring and until this section is complete. De -watering activities shall be conducted as shown on the approved plans and shall be monitored daily by C:\Winword\OOC\35Ho11owTree242-1241.doc 7 NACC 6/1/04 0 DEP FILE # 242 - 1241 ,the erosion control monitor to ensure that sediment laden water is appropriately settled prior to discharge toward the wetland resource areas: No discharge of water is allowed directly into an area subject to jurisdiction of the Wetlands Protection Act and/or the North Andover Wetland ByLaw. If emergency de -watering requirements Arise, the applicant shall submit a contingency plan to the Commission for approval, which provides for the pumped water to be contained in a settling basin, to .reduce turbidity prior to discharge into a resource area. 54. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts on any of the foregoing. 55. No exposed area shall remain unfinished for more than thirty (30) days, unless approved by the NACC. 56. No re -grading in the buffer zone shall have a slope steeper than 2:1 (horizontal: vertical). Slopes of steeper grade shall be rip -rapped to provide permanent stabilization. 57. There shall be no stockpiling of soil or other materials within twenty-five. (25) feet of any resource area. 58. Washings from concrete trucks, or surplus concrete, shall not be directed to, any drainage system, or wetland resource area. 59. All waste generated by, or associated with, the construction activity shall be contained within the construction area, and away from any wetland resource area. There shall be no burying of spent construction materials or disposal of waste on the site by any other means. The applicant shall maintain dumpsters (or other suitable means) at the site for the storage and removal of such spent construction materials off-site. However, no trash dumpsters will be allowed within 50' of areas subject to protection under the Act or local ByLaw. 60. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 61. During and after work on this project, there shall be no discharge or spillage of fuel, or other pollutants into any wetland resource area. If there is a spill or discharge of any pollutant during any phase of construction the NACC shall be notified by the applicant within one (1) business day. No construction vehicles are to be stored within 100 feet of wetland resource areas, and no vehicle refueling, equipment lubrication, or maintenance is to be done within 100 feet of a resource area. C:\Winword\OOC\35HollowTree242-1241.doe 8 NACC 6/1/04 0 0 DEP FILE # 242 - 1241 11 AFTER CONSTRUCTION 62. No underground storage of fuel oils shall be allowed on any lot within one hundred (100) feet of any wetland resource area. This condition shall survive this Order of Conditions and shall run with the title of the property. This condition is issued under the authority of the Town's Wetland protection ByLaw. 63. Fertilizers utilized for landscaping and lawn care shall be slow release, low -nitrogen types (< 5%), and shall not be used within 25 feet of a resource area. Pesticides and herbicides shall not be used within 100 feet of a wetland resource area. This condition shall survive this Order of Conditions and shall run with the title of the property. This condition is issued under the authority of the Town's Wetland Protection ByLaw and shall remain in perpetuity. 64. Upon completion of construction and grading, all disturbed areas located outside resource areas shall be stabilized permanently against erosion. This shall be done either by loaming and seeding according to SCS standards. If the latter course is chosen, stabilization will be considered complete once vegetative cover has been achieved. 65. Upon approved site stabilization by Conservation staff, the erosion controls shall be removed and properly disposed of and all exposed unvegetated areas shall be seeded. 66. Upon completion of the project the applicant shall submit the following to the Conservation Commission as part of a request for a Certificate of Compliance: a. WPA Form 8A — "Request for a Certificate of Compliance." b. A letter from the applicant requesting a Certificate of Compliance. c. The name and address of the current landowner. d. Signed statements from the individual property owners shall be submitted with the request for a Certificate of Compliance indicating that they read and understood the recorded Order of Conditions prior to purchasing their property. e. The name and address of the individual/ trust or corporation to whom the compliance is to be granted. f. The street address and assessor's map/parcel number for the project. g. The DEP file number. h. A written statement from a Registered Professional Civil Engineer (and/or Registered Professional Land Surveyor) of the Commonwealth certifying that the work has been conducted as shown on the plan(s) and documents referenced above, and as conditioned by.the Commission. C:\Winword\OOC\35Ho11owTree242-1241.doc 9 NACC 6/1/04 0 DEP FILE # 242 - 1241 0 i. An "As -Built" plan prepared and signed and stamped by a Registered Professional Civil Engineer (and/or Registered Professional Land Surveyor) of. the Commonwealth, for the public record. This plan will include: ➢ "As -Built" post -development elevations and grades of all filled or altered wetland resource areas including the encompassing buffer zone, which is regulated as a resource area under the local Wetland Protection Bylaw. ➢ Distances from structures to wetland resource areas. Structures include (but are not limited to) septic systems, additions, fences, sheds, stone walls, pools, retaining walls, subsurface utilities and decks. ➢ A line showing the limit of work and the extent of existing erosion control devices. "Work" includes any disturbance of soils or vegetation. ➢ Location of all subsurface utilities entering the property. 66. The following special conditions shall survive the issuance of a Certificate of Compliance (COC) for this project: ➢ 25' No -Disturbance Zone and a 50' No -Construction Zone shall be established from the edge of adjacent wetland resource areas except in those previously disturbed locations as shown on the approved plan. Future work within 100' of existing, wetland resource areas will require a separate filing with the NACC. The Conservation Administrator and/or other agents of the NACC do not have the authority to waive these setbacks as established under the local ByLaw; ➢ Prohibition yard waste deposits (Condition #33); ➢ Discharge or spillage of pollutants (Condition # 60); ➢ Prohibition of underground fuels (Condition #61); ➢ Limitations on the use of fertilizers, herbicides, and pesticides (Conditions #62).. C:\Winword\OOC\35HollowTree242-1241.doc 10 NACC 6/1/04 0 DEP FILE # 242 -1241 APPENDIX A - AFFIDAVIT I, on oath do hereby depose and state: (authorized agent applicant and/or current owner) (PLEASE CHECKAT LEAST ONE BLOCK) 1. I am the of ( position with applicant) (applicant name or company name) the applicant upon whom Order of Conditions have been placed upon by (DEP or NACC number) the North Andover Conservation Commission. 2. I am the &/or of (position with owner) (owner name) the owner upon whose land Order of Conditions have been placed up by (DEP or NACC number) the North Andover Conservation Commission. 0 3. I hereby affirm and acknowledge that I have received said Order of Conditions and have read the same and understand each (DEP File #) and every condition which has been set forth in said Order of Conditions. 4. I hereby affirm and acknowledge that on this day of 19_ I inspected said property together with any and all improvements which have been made to the same and hereby certify that each and every condition set forth in Order of Conditions are presently in compliance. (DEP File #) 5. I hereby affirm and acknowledge that this document will be relied upon by the North Andover Conservation Commission as well as any potential buyers of said property which is subject to said Order of Conditions (DEP File #) Signed under the pains and penalties of perjury this day of 19 (Signature - authorized agent of applicant or owner) C:\Winword\OOC\35HollowTree242-1241.doc 11 NACC 6/1/04 Massachusetts Department of Environmental Protection I Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions 242-1241 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: See attached This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions #4, from the date of issuance. This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental P#ion Regional Office (see Appendix A) and the property owner (if different from applicant).e S On Day before me personally appeared E5 0 f+ PI ca.SS c_ � C. L i17 14'04" L Of M' aoo y Month an4 Year to me known to be the person described in and who executed the fo acknowledged that he/she executed the same as his/her free act an DONNA M. WEDGE NOTARY PUBLIC COMMONWEALTH OFMASSACHUSEM Notary Public My commiss n s This Order is issued to the. applicant as follows: ❑ by hand delivery on Date R/by certified mail, return receipt requested, on Dates Wpaform5.doc • rev. 12/15/00 Page 5 of 7 0 0 Massachusetts Department of Environmental Protection DEP File Number. Bureau of Resource Protection - Wetlands ' WPA Form 5 - Order of Conditions 242-1241 1 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. D. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of Form 5 shall be -submitted to the Conservation Commission listed below. North Andover Conservation Commission Wpaform5.doc • rev. 12/15/00 Page 6 of 7 a o Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 242-1241 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP D. Recording Information (cont.) Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: North Andover Conservation Commission Please be advised that the Order of Conditions for the Project at: 242-1241 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant Wpaform5.doc • rev. 12/15/00 Page 7 of 7 0 o F Massachusetts Department of Environmental Protection Bureau of Resource Protection Wetlands WPA Appendix E— Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information Important: 1. Person or party making request ( if appropriate, name the citizen group's representative): filling out forms on the computer, Name use only the tab key to Mailing Address move your cursor - do City/Town State Zip Code not use the return key. Phone Number Fax Number (if applicable) rab Project Location Mailing Address remm City/Town State Zip Code 2. Applicant (as shown on Notice of Intent (Form 3), Abbreviated Notice of Resource Area Delineation (Form 4A); or Request for Determination of Applicability (Form 1)):. Name Mailing Address City/Town State Zip Code Phone Number Fax Number (if applicable) 3. DEP File Number: B. Instructions 1. When the Departmental action request is for (check one): ❑ Superseding Order of Conditions ❑ Superseding Determination of Applicability ❑ Superseding Order of Resource Area Delineation Send this form and check or money order for $50.00, payable to the Commonwealth of Massachusetts to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform5.doc - Appendix E • rev. 5/24/04 Page 1 of 2" J Q Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Appendix E — Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131 §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office (see Appendix A). 4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. wpaform5.doc • Appendix E • rev. 5/24/04 Page 2 of 2 BOARD OF HEALIkill NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: 2 MAP & PARCEL: LOCATION OF SOIL TESTS: -3,5- L t-0 ,-j LAni OWNER: po TEL. NO.: Z ` 5 /- y -7 % .. ADDRESS: 35 - ENGINEER: -Wt SL, SENGINEER:NeSL, �A) !�r'�N k ✓iGl� i (t1N r TEL. NO.: - 178- E>Q CERTIFIED SOIL EVALUATOR 8t- t -t iga o ► f},y C�-'r � / !�1 �5 ��c, Intended use of land: Residential Subdivision ingle Family Home Commercial Is This Repair testing 1�( Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of L425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing th. location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. N.A. Conservation Commission Approval: �� ` �n YOd'�d k6j; Date Received: Check Amount: Check Date: r TOWN OF NORTH ANDOVER 0 ORTH ANDODER BOARD OF HEALTH REPORT OF PERC TEST ADDRESS OF SYSTEM���'l�x�.n DATE AZ*4 NAME OF PROFESSIONAL ENGINEER. OR SANITARIAN CONDUCTING TESTS NAME OF LOT OWNER �/tiy, ,�,, ADDRESS Soil L 4 SHOW APPRO)M1ATE LOCATION OF PITS ON SKETCH ON REAR OF THIS SHEET 17 Total Water Level Pit Depth s ,o ,, 7 . ✓4 Perc Tests �/rDepthd Subsoil �r Saturation Time the & T oeS FA Time to ' D12t'-gil Other Considerations: _ (� --��-- Time to Drop 91f - Gtr Recommendations: Signature f Page 1 of 1 1-. DelleChiaie, Pamela From: Dan Ottenheimer [info@milldverconsulting.com] Sent: Wednesday, March 17, 2004 1:28 PM To: Susan Sawyer; Brian LaGrasse; 'Pamela Dellechiaie' Subject: soil tests Sue, Brian and Pam, Attached please find the soil and percolation test resul from 35 Hollow Tree Lane an � 545 Winter Street. Both sites had a percolation test result which required an ove ght'soakD.ue-to the scao , we could not perform it today. We have scheduled both sites for Thursday April 1 beginning at 7:00 a.m. Happy shoveling. Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info millriverconsulting.com 3/17/2004 19 35 �I - - PO 1 Eo 'I i I 1 i.LY i (L � ! f COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROF BOARD OF HEA jAN - 8 2004 TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 35 Hollow Tree Lane _ _ North Andover_ Owner's Name: _James Seed _ Owner's Address: _35 Hollow Tree Lane- - North Andover, MA 01845_ Date of Inspection: _1/8/2004 Name of Inspector: Neil J. Bateson_ Company Name: _Bateson Enterprises Inc._ Mailing Address: _111 Argilla Road_ _Andover, Ma. 01810_ Telephone Number: _( 978 ) 4754786_ CERTIFICATION STATEMENT 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 the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority .X Fai s Inspector's Signature: Date: _1/8/2004_ The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments: ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 35 Hollow Tree Lane- - North Andover— Owner: _Seed Date of Inspection: _1/8/2004_ Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D A. System Passes: _ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: _ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If "not determined" please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 ND explain: n Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 35 Hollow Tree Lane- - North Andover_ Owner: _Seed Date of Inspection: _1/8/2004 C. Further Evaluation is Required by the Board of Health: _X_ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, 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 any) determines that the system is functioning in a manner that protects the public health, safety and environment: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance _ _ "This system passes if the well water analysis, performed at a DEP certified laboratory, 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, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _35 Hollow Tree Lane _ — North Andover— Owner: _Seed Date of Inspection: _1/8/2004_ D. System Failure Criteria applicable to all systems: You must indicate "yes" or `no" to each of the following for all inspections: Yes No _Yes Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ —No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _Yes_ _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool No Liquid depth in cesspool is less than 6" below invert or available volume is '/2 day flow. _No_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped No_ Any portion of the SAS, cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _No_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _No_ 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. [This system passes if the well water analysis, performed at a DEP certified laboratory, 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, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] _Yes_ (Yes/No) The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd. You must indicate either "yes" or "no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no 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 If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Page 5 of l l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 35 Hollow Tree Lane- - North Andover — Owner: _Seed Date of Inspection: _1/8/2004 Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No Yes_ _ Pumping information was provided by the owner, occupant, or Board of Health No Were any of the system components pumped out in the previous two weeks ? _Yes_ _ Has the system received normal flows in the previous two week period ? No Have large volumes of water been introduced to the system recently or as part of this inspection ? N/A _ Were as built plans of the system obtained and examined? (If they were not available note as N/A) _Yes_ — Was the facility or dwelling inspected for signs of sewage back up ? Yes_ _ Was the site inspected for signs of break out ? _Yes_ _ Were all system components, excluding the SAS, located on site ? _Yes_ _ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum ? _Yes_ _ Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes no _Yes_ _ Existing information. _No_ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 35 Hollow Tree Lane- - North Andover — Owner: _Seed Date of Inspection: _1/8/2004_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): _4_ Number of bedrooms (actual): _4_ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): _400_ Number of current residents: Does residence have a garbage grinder (yes or no): —No— Is o_Is laundry on a separate sewage system (yes or no): _ No_ Laundry system inspected (yes or no): Seasonal use: (yes or no): _No_ Water meter readings: Yes_ Sump pump (yes or no): —Yes— Last es_Last date of occupancy: _Current COMMERCIALANDUSTRIAL Type of establishment: Design flow (based on 310 CMR 15.203): gpd Basis of design flow (seats/persons/sgft,etc.): 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/use: OTHER (describe): GENERAL INFORMATION Pumping Records Source of information: Pumped 1999. Info at B.O.H.- Was system pumped as part of the inspection (yes or no): Yes _ If yes, volume pumped: _1500___gallons -- How was quantity pumped determined? _Measured tank_ Reason for pumping: _Inspect tank & baffles. Tank full to top of all covers._ TYPE OF SYSTEM _X_ 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) _ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank _ Attach a copy of the DEP approval Other (describe): _ Approximate age of all components, date installed (if known) and source of information: 27 years old, 4/13/1977, Info at B.O.H.- Were sewage odors detected when arriving at the site (yes or no): _No Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Hollow Tree Lane- - North Andover— Owner: _Seed_ Date of Inspection: _1/8/2004_ BUH,DING SEWER (locate on site plan) X Depth below grade: _1411 _ Materials of construction: _X _ cast iron _40 PVC other Distance from private water supply well or suction line_ Comments (on condition of joints, venting, evidence of leakage, etc.): _ SEPTIC TANK: X locate on site plan) Depth below grade: _2"_ Material of construction: —X—concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: _ Is age confirmed by a Certificate of Compliance (yes or no): _ (attach a copy of certificate) Dimensions: 7'x 5'x 4' Sludge depth 6"_ Distance from top of sludge to bottom of outlet tee or baffle: 0"_ Scum thickness: _6"_ Distance from top of scum to top of outlet tee or baffle: _0" Distance from bottom of scum to bottom of outlet tee or baffle: _0" How were dimensions determined: _Difi'erence in sludge & scum depth to baffle length _ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumped septic tank. Inlet baffle ok. Outlet baffle ok. Depth of liquid above outlet invert. Tank full to top of covers. No evidence of leakage. _ GREASE TRAP: _(locate on site plan) Depth below grade: _ Material of construction: _ _concrete _metal _fiberglass _polyethylene _other (explain): 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: Date of last pumping: Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Page 8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Hollow Tree Lane- - North Andover— Owner: _Seed Date of Inspection: _1/8/2004 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass _polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present (yes or no): Alarm level: Alarm in working order (yes or no): Date of last pumping: Comments (condition of alarm and float switches, etc.): DISTRIBUTION BOX: X (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: _1"_ Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.):_ D -box level & distribution equal. Evidence of leakage. Evidence of solid carryover. Liquid above all inverts._ PUMP CHAMBER: _ (locate on site plan) Pump in working order (yes or no): Alarm in working order (yes or no): Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Hollow Tree Lane _ North Andover — Owner: _Seed Date of Inspection: _1/8/2004_ SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, excavation not required) If SAS not located explain why: Type leaching pits, number: _ leaching chambers, number: leaching galleries, number: leaching trenches, number, length: X leaching fields, number, dimensions: 20' x 45' Leach Field_ overflow cesspool, number: innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): _ Soil ok. Vegetation ok. No sign of ponding to surface. _ CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth — top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow (yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): U Page 1.0 of 11 X1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Hollow Tree Lane _ _ North Andover_ Owner: _Seed Date of Inspection: _1/8/2004_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. A to Tank = A to D -Boz = B to Tank = B to D -Boz = Page l I of l l OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Hollow Tree Lane _ _ North Andover— Owner: _Seed Date of Inspection: _1/8/2004 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 4'_ Please indicate (check) all methods used to determine the high ground water elevation: X_ Obtained from system design plans on record - If checked, date of design plan reviewed: _5/29/1976_ T Observed site (abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health -explain: _ Checked with local excavators, installers- (attach documentation) Accessed USGS database -explain: You must describe how you established the high ground water elevation: Design Plan_ Jan 08 04 01:32p Eo ",'.. ,114I 91SOUR wlM. icrosoft z Mvo�v�vM�oMo124 Ull UNw w ©©O• �OrMOti©b t`t. 00vrO. kn Gf © f0 0� � C. r. 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C. 4, ease :, pp to U) N •e°•o°o r tLU Q© Q o [r W S: W co W :kii5rr. :. r r � � �' I— m Q u1 :'lii�;ij a1 = G M �' N W '+ W 1•: -U.: N W T W fn J O S WLW Lf� 7 T 0 �' Ln 1 li. ... (iJ V O Ln •O O O N N N LU 7 T rr CL +"L •p O O I W Q Q Q o d C Cl H I V N N N 1 O N O cc S I O T T T I W \ \ \ F CL ©© s •. J p ID o . W I .-1 1 M d r a C y C] I W I I I Ua.. 9i nr W I } ©QO • �:H I V NNN ...' CL .UI.3 I '$ r N Cl) 9171 O t i A� L�t S O C V1 2 i CA a) cc ff Cy Ar IAItR? t `O as v v x p A o Microsoft i N C,"'1 TO kn 4n . G GI O H N S W Ln S i O _ K A tM O .. ~ W = a W v 'tea, o` it W OU CD O S V o - U W � r W � . � O 1-04 Cu Cl Z p.2 Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 35 Hollow Tree, North Andover Owner: Seed Date of Inspection: 1/8/2004 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. i Nei J. B eson Bateson Enterprises, Inc.