HomeMy WebLinkAboutMiscellaneous - 37 WELLINGTON WAY 4/30/2018 (2)r
I
coPUBLIC HEALTH DEPARTMENT
Town of North Andover
Community and Economic Development Division
CERTIFICATE OF:
COMPLIANCE
As of: June 29, 2017
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
New Construction of an
On -Site Sewage Disposal System
By: David Maynard— Maynard Construction
of this
Michele Grant
Public Health Age
At: 37 Wellington Way
Map 105.0 Lot 22
N_ orth Andover, MA 01845
te; shard not be construed as a guarantee that the system will function satisfactorily.
120 Main St., North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.9542 Web www.northandoverma.gov
6/29/2014 Town of North Andover. Mail -Lot 6 #i37 Wellington Way
NOR AN "OVER
Massaft s =. - Michele Grant <mgrant@northandoverma.gov>
Lot 6 #37 Wellington Way
1 message
Marylee Messina <messinanewhomes@gmail.com> Thu, Jun 29, 2017 at 10:15 AM
To: Michele Grant northandoverma. <M rant ov>
9 @ 9
Hi Michele, Bob asked me to email you to let you. know that Messina Development Co.,
Inc. will be responsible for the final grading and seeding over the septic system at lot 6
#37 Wellington Way.
If you need additional information, please let me know. Thanks, Marylee
https:Hmail.google.com/m ai I/ca/.u/O/?ui=2&ik=d4458df3d9&jsver=l EZPUTRTfxl.en.&view=pt&search=i nbox&th=15cf4352a6dl ccl8&si m i=15cf4352a6dl ccl8 1/1
C
North Andover Health Department
Community and Economic Development Division
ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 37 Wellington Way (Lot 6) MAP:105C LOT: 22
INSTALLER: David Maynard — Maynard Construction
DESIGNER: Christiansen & Sergi, Inc
PLAN DATE: 5/20/16 REV 12/22/16
BOH APPROVAL DATE ON PLAN: 1/11/2017
INSPECTIONS
TANK INSPECTION: 6/8/2017
DATE OF BED BOTTOM INSPECTION: 6/13/2017
DATE OF FINAL CONSTRUCTION INSPECTION: 6/20/17
DATE OF FINAL GRADE INSPECTION:
SITE CONDITIONS
❑ Contractor reports any changes to design plan
❑ Existing septic tank properly abandoned
® Internal plumbing all to one building sewer
® Topography not appreciably altered
Comments:
SEPTIC TANK
® Building sewer in continuous grade, on
compacted firm base
❑ Cleanouts per plan
® Bottom of tank hole has 6" stone base
® Weep hole plugged
® 1500 gallon tank has been installed
H-10 loading
® Monolithic tank construction
® Water tightness of tank has been achieved by
visual testing
® Inlet tee installed, centered under access port
T.
® Outlet tee installed, centered under access port
(gas baffle)
❑ inch cover to within 6" of finish grade
installed over one access port
® Boots around inlet & outlet
Comments: 6/13/17 Tank was 16' from the house — Michele Grant
DISTRIBUTION -BOX
❑ Installed on stable stone base
® H-20 D -Box
❑ Inlet tee (if pumped or >0.08'/foot)
® Hydraulic cement around inlet & outlets
® Observed even distribution
❑ Speed levelers provided (not required).
® Schedule 40 PVC Pipe
Comments:
SOIL ABSORPTION SYSTEM (General)
®
Bottom of SAS excavated down to C soil layer,
as provided on plan
®
Size of SAS excavated as per plan
®
Title 5 sand installed, if specified on plan.
❑
40 Mil HDPE barrier installed
®
Laterals installed
®
Elevations of laterals and chambers installed as on
approved plan
❑
Retaining wall (boulder / concrete / timber/ block)
❑
Final cover as per plan
Comments: 6/13/2017
The Bottom of the Bed was approximately 15' down to the "C" layer 55' width x
29 ' length — Michele Grant
FINAL GRADE
❑ Loamed
❑ Seeded
❑ Cover per plan
Comments:
DOCUMENTS NEEDED
❑ Certification of Installation Form submitted
By engineer and signed and dated by
Engineer and installer .
❑ As -Built Plan
/.
BM = 128.42
HR = 9.30
Hl = 137.72
SYSTEM ELEVATIONS
SKETCH PLAN
ROD
ELEVATION
AS -BLT INVERT
ELEV
DESIGN INVERT
ELEV
Benchmark
Building Sewer OUT
3.70
133.69
133.05
Septic Tank IN
4.59
132.80
132.72
Septic Tank OUT
4.76
132.63
132.47
Pump Chamber IN
Pump Chamber OUT
Distribution Box IN
5.18
132.21
132.22
Distribution Box OUT
5.35
132.04
132.05
Lateral 1 Beg
5.38
132.01
131.95
Lateral 1 End
5.64
131.75
131.75
Lateral 2 Beg
5.40
131.99
131.95
Lateral 2 End
5.64
131.75
131.75
Lateral 3 Beg
5.43
131.96
131.95
Lateral 3 End
5.64
131.75
131.75
Bottom of Bed/Chamber
7.46
130.26
SKETCH PLAN
CRITICAL SETBACK DISTANCES
Mark those distances checked in the field against the design plan and regulatory
setback
SAS
10
20
20
10
10
10
1002
100
50
100
150
325
400
400
100
50
20 (10)
25
Sewer
10'
50
Suction line 222(2)
z 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02).
' As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA
wetland bylaws
Tank
®
Property line
10
®
Cellar wall
10
®
Inground pool
10
®
Slab foundation
10
®
Deck, on footings, etc
5
®
Waterline
10
®
Private drinking well
75
®
Irrigation well
75
®
Surface Water
25
®
Bordering Vegetated Wetland ,
Salt Marsh, Inland / Coastal Bank'
75
®
Wetlands bordering surface
water supply or trib. (in Watershed)
150
®
Trib. to surface water supply
325
®
Public well
400
®
Interim Wellhead Prot. Area
®
Reservoirs
400
®
Drains (wat. supply/trib.)
50
®
Drains (intercept g.w.)
25
®
Drains (Other) Foundation
10 (5)
®
Drywells
20
SAS
10
20
20
10
10
10
1002
100
50
100
150
325
400
400
100
50
20 (10)
25
Sewer
10'
50
Suction line 222(2)
z 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance (NA 5.02).
' As defined in 310 CMR 10.55, 10.32, 10.54, and 10.30, respectively, pursuant to 15.211(3), also by NA
wetland bylaws
• � Application for Septic Disposal System _ _d
TODAY'S DATE
Construction Permit —TOWN OF
_.�
NORTH ANDOVER, MA 01845 $lis oo - component
Important: Application is hereby made for a permit to:
When filling out ['Construct a new on-site sewage disposal system*
forms on the
computer, use ❑ Repair or replace an existing on-site sewage disposal system*
only the tab key
to move your ElRepair or replace an existing system component —What?
cursor - do not ,
use the return A. Facility Information i
key. ,
Address ArLot #
vl�
City/Town JUN 0 6..20.11
1ef�' 2.- *TYPE OF SEPTIC SYSTEM*: Voi of NORTHAN00WR
➢ ❑ Pump ❑ Gravity (choose one) ?� OWART�MENT
***If pump sy�s m, attach copy of electrical permit to application*** � �'�
➢ L6Conventional System (pipe and stone system)
➢ ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system.)
❑ Pressure Distribution S.A.S. (No D -Box)
➢ ❑ Pressure Dosed (D -Box Present) S.A.S.
➢ ❑ Does the system require an effluent filter? Yes No
If yes, does plan specify make -and model of filter? YES= (no further info. needed)
NO = (installer must specify brand of filter before DWC issuance)
What A the Make? What is the Model
2. Owner Informatiou
'CC/sA•
Name 9
Address Cif different from above)
i
Stat' -e T
Zip Code
Email address Telephone Numbe
3. Installer Information
,ter C/
Name /y Name of G16mpany
22
Address[ C/)
City/Town mate �. / �" �, / ✓ Zip CodA
4.
�uw caa
City/Town
State Zip Code
Telephone Number (Best # to Reach)
Application for Disposal System Construction Permit • Page 1 of 2
•r����-°�: • Application for Septic Disposal System
--...
Lao(, I
TODAY'S DATE
a. Construction Permit —TOWN OF
NORTH ANDOVER, MA 01845
x;75 00 - component
PAGE 2OF2
A. Facility Information continued....
-
5. Type of Building: esidential Dwelling or FlCommercial
B. Agreement
The undersigned agrees to ensure the construction and maintenance of the afore-described
on-site sewage disposal system in accordance with the provisions of Title 5 of the
Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of
North Andover. I understand that until a final Certificate of Compliance has been issued by
this Board of Health, the installed system is not approved:
Name Date
A
rd of-Repres ntative)
L*nApprov
't-A b4o _�O
tA
r 9
Date
Application Disapproved for the following reasons:
For Office Use Only:
1.: Fee Attached. Yes
/
No
n lanon Form Attached? Yes I/
2. Protect Manager Obi g
No
/
3. Pump System? Ifso, Attach copy ofElectrical Permit .Yes_
No _.
Applican t received copy of
"Electrical Inspection Notes for Septic Systems" Yes
No.
Handout?
4. Reviewed approvalletter, all paperwork received? Yes
No
MlSsing:'
5. Foundation As-Built? (new construction only): Yes
No
(Same scale as approved plan)
6. Floor Plans? (new construction only): Yes
No
Application for Disposal System Construction Permit • Page 2 of 2
Commonwealth of Massachusetts Map-
��� • 105.0O022Lot
022
BOARD OF HEALTH -
• Permit No
North Andover - BHP -2017-0451 ----------------------
P.I. FEEL
F.I. j-----------------------
5� -
DISPOSAL WORKS CONSTRUCTION PERM�T
Permission is herebyanted Dave Maynard _ ,�• a 1� � l
€t --------- ------- ------
to (Construct) an Individual Sewage Disposal System.
at No 37 Wellington Way
---------------------
------------------ -------------------------------------------------- ----------------------------------------
as
------- - - - -
-- _
as shown on the application for Disposal Works Construction PermitNo. -2017( A`-DatLM7 -�J an 06%20 7
------------- ------------------------------------------------
Issued On: Jun -06-2017 BOARD OF HEALTH
•*:eD Commonwealth of Massachusetts Map -Block -Lot
105.00022
`_. BOARD OF HEALTH
North An ver
CERTIFICATE OF OMPLIANCE
THIS IS TO That the Individual Se e Disposal Syste onstruct)
by Dave Maynard
---------------.................. ------- ------ -------
in --------------------------------------------------------------
t
atNo 37 Wellington Way____
has been installed in accordance with e provisio TITLE 5 of the State Environmental Co e escribed in the
application for Disposal Works Constructi ermit No. BHP -2017-045 Dated ---June 06,_2017___---_-
- -----------------------------------------------------------------
Printed On: Jun -06-2017 BOARD OF HEALTH
DISPOSAL
Permission is hereby grant
to (Construct) an Individual Sewage
at No 37 Wellington Way -_-
as shown on the application for p
Issued On: Jun -06y2617
Commonwealth of Massachusetts
BOARD OF HEALTH --
rmit No No
North Andover BHP -2017-0451
------------------
FEE
-------------------
IOM PERMIT
I
-- ---- --- ----- ------
---- -A------------- ----------------------------------
jo al S ste
Works Construction Permit No. BHP -2017-045 Date June 06, 2017
BOARD OF HEALTH
C
' ^ NORT" 7897
0 • '` 9
y ; ; Town of North Andover
HEALTH DEPARTMENT
k ,SSACMUStt
CHECK #: AV4M DATE:
LOCATION:3 6
H/0 NAME: AL Ski/') a V_ r
CONTRACTOR NAME:
Type of Permit or License: (Check box)
❑ Animal $
❑ Body Art Establishment $
❑ Body Art Practitioner $
❑ Dumpster $
❑ Food Service - Type: $
❑ Funeral Directors $
❑ Massage Establishment $
❑ Massage Practice $
❑ Offal (Septic) Hauler $
❑ Recreational Camp $
❑ Sun tanning $
❑ Swimming Pool $
❑ Tobacco $
❑ Trash/Solid Waste Hauler $
❑ Well Construction $
SEPTIC Systems:
❑ Septic - Soil Testing $
❑ Septic - Design Approval $
Septic Disposal Works Construction (DWC) $ 3.50-
❑ Septic Disposal Works Installers (DWI) $
❑ Title 5 Inspector $
❑ Title 5 Report $
❑ Other. (Indicate) $
ka�h Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction for the septic system for the property at:
Gy �.a �l/ 4'0"'_
(Address of septic system) For plans by
Relative to the application of_���//-c�e,tiy
(Installer's name)
Dated - 6, -'w/7
o ay s ate
(Engineer)
And dated I — %/ — /
ngtna date
With revisions dated
I understand the following obligations for management of this project:
/z - 22 - 1-k
(Last revised date)
6
As the installer, I am obligated to obtain all permits and Board of Health approved plans
performing any work on a site. I must have the approved plans and the permit on site uJ work is
being done. l'
2. As the installer, I must call for any and all inspections. If homeowner, contractor, project manager, or any
r.
other person not associated with my company schedules an inspection and the system is not ready, then
item three shall be applicable.
3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as
indicated below. I understand that requesting an inspection, without completion of the items in accordance
with Title 5 and the Board of Health Regulations may result in a $50.00 fine being levied against me and/or
my company.
a. Bottom of Bed – Generally, this is the first (1'� inspection unless there is a retaining wall, which
should be done first. The installer must request the inspection but does not have to be present.
b. Final .Construction Inspection – Engineer must first do their inspection for elevations, ties, etc.
As -built of verbal OK (or e-mail to: healthdept@northandoverma.gov) from the engineer must be
submitted to the Board of Health, after which installer calls for an inspection time. Installer must be
present for this inspection. With a pump system, all electrical work must be ready and able to cause
pump to work and alarm to function.
c. Final Grade – Installer must request inspection when all grading is complete. Installer does not
have to be on-site.
4. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required
to complete the installation of the system identified in the attached application for installation. I further
understand that work done by others unlicensed to install septic systems in North Andover can constitute
reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of
North Andover, significant fines to all persons involved are also possible.
5. As the installer, I understand that I must be on-site during the performance of the following construction
steps:
a. Determination that the proper elevation of the excavation has been reached.
b. Inspection of the sand and stone to be used.
c. Final inspection by Board ofHealth staff or consultant.
d. Installation of tank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other
components.
6. As the installer, I understand that I am solely responsible for the installation of the system as per the
approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve
me of this obligation.
Undersigned Licensed Septic Installer: � oday's Date)
(Name —Print) —(Name —Signed)
PUBLIC HEALTH DEPARTMENT
Community & Economic Development
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM — INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System (constructed; ( ) repaired;
By:
(Print Na
Located at:
(Installation Odress) /
Was installed in conformance with the North Andover Board of Health approved plan, originally dated
/ //1 y and last revised on /2 Z z — /lp with a design flow of
yev V / gallons per day. The materials used were in conformance with those specified on the
approved plan; the system was installed in accordance with the provisions of 310. CMR 15.000, Title 5 and local
regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on
the As -built which has been submitted to the Board of Health.
Bottom of Bed Inspection Date:
Engineer Representative (Signature)
And — Print Name
Final Construction Inspection Date:
Engineer Representative (Signature)
And — Print Name
Installer: (Signature) Date:
Engineer: (Signature) Date:
And — Print Name
And — Print Name
120 Main Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov
North Andover Health Department
(ommunity and Economic Development Division
January 11, 2017
Messina Development Corp
277 Washington Street
Groveland, MA 01834
Re: Subsurface Sewage Disposal System Plan for 37 Wellington Way — Lot 6
(Map 105C, Lot 88)
To Whom It May Concern:
The proposed wastewater system design plan for the above site dated January 8, 2016 with a
final revision date of December 22, 2016 and received on December 29, 2016 has been
approved.
The design has been approved for use in the construction of a new on-site septic system for a 4 -
bedroom (max 9 -room) home utilizing a gravity leach field system. This design plan approval is
valid until January 11, 2020.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover.
This approval is also subject to the following conditions:
1. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit a foundation as -built at the same scale as the approved plan
2. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms
or a total of 9 rooms.
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
37 Wellington Way — Lot 6
January 11, 2017
3. 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)).
4. 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.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely,
:]R/rian J. LaGrasse, CEHT
Director of Public Health
Encl. Installers list
cc: Philip Christiansen, P.E.
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
.
y� LED4 .
TOWN OF NORTH ANDOVER"
Community & Economic Development
HEALTH DEPARTMENT
120 Main Street
NORTH ANDOVER, MASSACHUSETTS 01.845
978.688.9540 — Phone
978.688.9542— FAX
E-MAIL: healthdept@northandoverma.gov
WEBSITE: hqp://www.northandoverma.gov
SEPTIC PLAN SUBMITTAL
FORM RECEIVED
Z Zq �ol DEC 2 y 2016
Date of Submission: TOWN OF NORTH ANDOVER
Site Location:
HEALTH DEPARTMENT
�� �� �\\ � � �e-c� �� �:
Engineer: C�• c ; s�, s �� Sir 5 ', ��rC
New Plans? Yes $275/Plan . Check # (includes 1" submission and one re-
review only)
Revised Plans?Yes %1$125/Plan Check #
Site Evaluation Forms Included? Yes No
Local Upgrade Form Included? Yes No
Telephone # 145 -x`13 - 0 3\O Fax #:
E-mail: 'Q�) C _S k` . CO M
Homeowner
Name: kA k -S Q���e-��
OFFICE USE ONLY
When the submission is complete (including check):
➢ Date stamp plans and letter
➢ Complete and attach Receipt
➢ Copy File; Forward to Consultant
➢ Enter on Log Sheet and Database
PUBLIC HEALTH DEPARTMENT
Community & Economic Development
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM — INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System { ) constructed; ( ) repaired;
By: Dave Maynard
(Print Name)
Located at: 37 Wellington Way (Lot 6 Wellington Woods)
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan, originally dated
118116 and last revised on 12/22/16 , with a design flow of
440 gallons per day. The materials used were in conformance with those specified on the
approved plan; the system was installed in!accordance with the provisions of 310. CMR 15.000, Title 5 and local
regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on
the As -built which has been submitted to the Board of Health.
Bottom of Bed Inspection Date:
And — Print Name
Final Construction Inspection Date: 6j16/
17
And — Print Name
Engineer Representative (Signature)
Representative (Signature)
(Signature) Date:?
An — P int Name
�/����
Engineer: Signature) Date:
Phil Christiansen, P.E.
And — Print Name
120 Main Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.9542 Web hitp://www.northandoverma.gov
North Andover Health Department
Community and Economic Development Division
July 6, 2016
Messina Development Corp
277 Washington Street
Groveland, MA 01834
Re: Subsurface Sewage Disposal System Plan for 3
(Map 105C, Lot 88) /
To Whom It May Concern:
ellington Way — Lot 6
,i S � J �:,aa w
a��
The proposed wastewater system design pla 6for the above site dated January 8, 2016 with a
final revision date of June 23, 2016 and rVeived on June 23, 2016 has been approved.
The design has been approved for use i the construction of a new on-site septic system for a 4 -
bedroom (max 9 -room) home utilizi g a gravity leach field system. This design plan approval is
valid until July 6, 2019.
During this time, a licensed sep c system installer must obtain a permit and complete this work,
and a Certificate of Complian be endorsed by the installer, designer and the Town of North
Andover.
This approval is also sub#ct to the following conditions:
1. Prior to the 'ssuance of the Disposal Works Construction Permit, the applicant must
submit a f ndation as -built at the same scale as the approved plan
2. Prior the issuance of the Disposal Works Construction Permit, the applicant must
sub t the floor plans of the proposed dwelling showing no greater than 4 bedrooms
or total of 9 rooms.
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
4
37 Wellington Way — Lot 6
July 6, 2016
3. 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)).
4. 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.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincere ,
h
rian J. LaGrasse, CEHT
Director of Public Health
Encl. Installers list
cc: Philip Christiansen, P.E.
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
-EAA
Cv A&,,,A 9 N d ••
Z w(
CHRIST I
AiVSEft! & SERGI, INC
PROFESSIONAL ENGINEERS AND LAND SURVEYORS
160 SUMMER STREET, HAVERHILL, MA 01830
tel: 978-373-0310 mm.csi-engr.com fax 978-372-3960
RECEIVED
Michelle Grant, Health Inspector May 23, 2016 MAY 2'4,2016
North Andover Board of health TOWN OF NORTH ANDOVER
1600 Osgood 'St, Suite 2035 HEALTH DEPARTMENT
North Andover, MA 01845
RE: (Lot 6) 37 Wellington Way
Dear Ms. Grant:
In response to your letter of April 15, with Comments on the Septic System Design, I
offer the following:
1. The foundation drain location and elevation are not shown on the design plan (NA 3.2)
A foundation drain has been added
2. An inspection port was not shown on the design plan (3 10 CMR 15.240(13))
An ihspection port has been added
3. The existing topography should be clearly labeled in the area adjacent to the leach
trenches
The exi:sling topography has been ad -,led
4. The breakout elevation is not met on the northeast side of the leach trenches (310 CMR
15.255(2)).
-.....The contours have been adjusted for breakout
5. The manufacturer for the septic tank is not indicated on the design plan (NA 3.2)
The ananufactaarer of the septic lank lugs been added
6. The scales bar for the profiles are not indicated on the design plan.
Scales have been added to the profile and cross-section
7. The test pits should be graphically depicted to show the correct orientation as excavated.
Test pits have been oriented
8. The LATR is incorrect based on the field book notes of the Board of Health
representative. The LTAR for a class I soil can be used which will make the proposed
leach tranches smaller.
717e systein has been reduced in size as suggested and the system elevation is maintained
at 5, feet above the tit-aler table because one of the pore tests Chas 2 ininlinch.
I hope this answers all of your concerns. If you have any additional questions, please do not
hesitate to call me.
�r ko-r-1 Pj�r
Wlr,.., I- i � Maw;i��r:,.� �►•Lll !{- `l
CHRISTIANSEN & SERGI, INC
PROFESSIONAL ENGINEERS AND LAND SURVEYORS
160 SUMMER STREET, KWERHILL, MA 01830
tel: 978-373-0310 www.csi-engr.com fax 978-372-3960
May 23, 2016
Michelle Grant, Health Inspector o
North Andover Board of health RECEIVED
1600 Osgood St, Suite 2035
North Andover, MA 01845 MAY 2 4 2016
RE: (Lot 6) 37 Wellington Way TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Dear Ms. Grant:
In response to your letter of April 15, with Comments on the Septic System Design, I
offer the following:
1. The foundation drain location and elevation are not shown on the design plan (NA 3.2)
A. foarndalion drain has been added
2. An inspection port was not shown on the design plan (3 10 CMR 15.240(13))
An ihspeelion port has been added
3. The existing topography should be clearly labeled in the area adjacent to the leach
trenches
The existing tohogrcrphy has, been added
4. The breakout elevation is not met on the northeast side of the leach trenches (3 10 CMR
15.255(2)).
The contoarrs have been adjusted.for breakout
5. The manufacturer for the septic tank is not indicated on the design plan (NA 3.2)
The manufacturer of the septic tank has been added
6. The scales bar for the profiles are not indicated on the design plan.
Scales have been added to the prgfile and cross-section
7. The test pits should be graphically depicted to show the correct orientation as excavated.
Test pits have been oriented
8. The LATR is incorrect based on the field book notes of the Board of Health
representative. The LTAR for a class I soil can be used which will make the proposed
leach tranches smaller.
The system has been reduced in size cis suggested and the systema elevation is maintained
at .> feet above the water table hecause one of the pert tests it. -as 2 ruin,/inch.
I hope this answers all of your concerns. If you have any additional questions, please do not
hesitate to call me.
V
GED:
North Andover Health Department
Community and Economic Development Division
April 15, 2016
Philip Christiansen, P.E.
Christiansen and Sergi, Inc.
160 Summer Street
Haverhill, MA 01830
Re: (Lot 6) 37 Wellington Way (Map 105C, Lot 22)
Dear Mr. Christiansen,
The proposed wastewater system design plan for the above site dated January 8, 2016 and
received on April 1.3, 2016 has been reviewed. Unfortunately, the plan cannot be approved until
the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North
Andover regulation that is not met by this design follows each item where applicable.
1. The. foundation drain location and elevation are not shown on the design plan (NA 3.2).
2. An inspection port was not shown on the design plan (3 10 CMR 15.240(13)).
3. The existing topography should be clearly labeled in the area adjacent to the leach
trenches.
4. The breakout elevation is not met on the northeast side of the leach trenches (3 10 CMR
15.255(2)).
5. The manufacturer for the septic tank is not indicated on the design plan (NA 3.2)
6. The scales bars for the profiles are not indicated on the design plan.
7. The test pits should be graphically depicted to show the correct orientation as excavated.
8. The LTAR is incorrect based on the field book notes of the Board of Health
representative (see attached). The LTAR for a class I soil can be used which will make
the proposed leach trenches smaller.
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
i
TOWN OF NORTH ANDOVER r
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
NORTH ANDOVER, MASSACHUSETTS 01845
978.688.9540 — Phone
978.688.8476— FAX
E-MAIL: healthdept@northandovertna.gov
WEBSITE: hftp://www.northandoven-na.gov
SEPTIC PLAN SUBMITTAL
FORM
Date of Submission: _41 l �l � � p RECEIVED,.
// �n � .�� APR 13 2016
Site Location: 3 7 nide,% 1 i n5 D�►y R �� TOWN OF NORTH ANDOVER
�a HEALTH DEPARTMENT ��
Engineer: Ck Y (s -f ci hS P/Yiy Se/ ' _rrl ` o�
� i 75 I
New Plans? Yes L�$455/Plan Check # (includes 1St submission and one re-
review only)
Revised Plans?Yes $75/Plan Check #
Site Evaluation Forms Included? Yes k" No
Local Upgrade Form Included? Yes No
Telephone #: g 79 - 3 73 —0 3 10 Fax #:
E-mail: @ CSc. -Cnq i. Cdr
Homeowner n /
Name: Nf L`SS' llia D c°VU o
OFFICE USE ONLY
When the submission is complete (including check):
➢ yl"' Date stamp plans and letter
➢ l% Complete and attach Receipt
➢ ,/ Copy File; Forward to Consultant
➢ t/ Enter on Log Sheet and Database
TOWN OF NORTH ANDOVER
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
NORTH -ANDOVER, MASSACHUSETTS 01845
Susan Y. Sawyer, REAS, RS 978.688.9540 — Phone
Public Health Director 978.688.8476 — FAX
healthdeptr.townofno rth
,Ativw. townofnorthandovt
APPLICATION FOR SOIL TESTS
NO,V l:5 2014
com
q UF NOKI f -f ANDOVER
WfH DEEPARTfAIEN'l
DATE: 11/24/2014 MAP & PARCEL: 105C.22
LOCATION OF SOIL TESTS: 602 Boxford St, NA Lot 6
..Gorton Tamil Trust.--.____
OWNEY R. Contact #:
APPLICA ,,.Messina Development Contact#:978-837-95I. j
ADDRESS 277 Washington St, Groveland; MA -0 1834
ENGINEER
Christiansen -&-Sergi,-Inc --- -contact#:'978=373=031-0
p-
CERTIFIED SOIL EVALUATOR: Philip Christiansen
Intended Use of Land:. Residential Subdivision Single Family Home Commercial
Is This: Repair Testing: Undeveloped Lot Testing: X Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes No X
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
➢ Proof of land ownership (Tax bill, or letter from owner permitting test)
➢ 8.5"x 11 "Plot plan & Location of Testinz (please indicate test nit sites on the plan)
➢ Fee of $425.00 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
➢ Only Certified Soil Evaluators may perform deep hole inspections.
➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system disposal area.
➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH
representative.
➢ Full payment will be required for all additional tests within two weeks of testing.
➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health
showing the location of all tests (including aborted tests)..
➢ Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date: C�r-h
Signature of Conservation Agent.
Date back to Health Department: (stamp in):
al
- TOWN OF NORTH ANDOVER.
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
.--NORTH ANDOVER; MASSACHUSETTS 01845 - -
Susan Y. Sawyer, REAS, RS 978.688.9540 — Phone -31
Public Health Director 978.688.8476 — FAX
healthdeptCwtownofnorthandover.com
A�vw.townofnorthandover.com 0�' /Il.'�J✓
APPLICATION FOR SOIL TESTS
11/24/2014 105C.22
DATE: MAP &PARCEL:
LOCATION OF SOIL TESTS: 602 Boxford St, NA Lot Fr(� r
OWNER. Gorton Family Trust___ Contact#:
e.At I n r:F� &114
APPLICANT: Messina Development contact #:978-837-95�
ADDRESS. 277 Washington St,-Groveland, MA 01834
Christiansen -&-Ser i, Inc--------- - -- - --- 978=373-0310 -
ENGINEER: g _ Contact #:
CERTIFIED SOIL EVALUATOR: Philip Christiansen
Intended Use of Land: Residential Subdivision _ - Single Family Home. Commercial,
LO
Is This: Repair Testing: Undeveloped Lot Testing: X Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
No X
➢ Proof of land ownership (Tax bill, or letter from owner permitting test)
➢ 8.5"x l ]"Plot plan & Location of Testing (please indicate test nit sites on the plan)
➢ Fee of $425.00 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
➢ Only Certified Soil Evaluators may perform deep hole inspections.
Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system disposal area.
➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH
representative.
➢ Full payment will be required for all additional tests within two weeks of testing.
➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health
showing the location of all tests (including aborted tests).i
➢ Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Dat :l / t
Signature of Conservation Agent. '�-
Date back to Health Department: (stamp in):
fs ckj,-aj
r,�r
North Andover Health Department
Community and Economic Development Division
January 11, 2017
Messina Development Corp
277 Washington Street
Groveland, MA 01834
Re: Subsurface Sewage Disposal System Plan for 37 Wellington Way — Lot 6
(Map 105C, Lot 88)
To Whom It May Concern:
The proposed wastewater system design plan for the above site dated January 8, 2016. with a
final revision date of December 22, 2016 and received on December 29, 2016 has been
approved.
The design has been approved for use in the construction of a new on-site septic system for a 4 -
bedroom (max 9 -room) home utilizing a gravity leach field system. This design plan approval is
valid until January 11, 2020.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover.
This approval is also subject to the following conditions:
1. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit a foundation as -built at the same scale as the approved plan
2. Prior to the issuance of the Disposal Works Construction Permit, the applicant must
submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms
or a total of 9 rooms.
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
"�)'
37 Wellington Way — Lot 6
January 11, 2017
f
3. 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)).
4. 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.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely, "
?13/rian J. LaGrasse, CERT
Director of Public Health
Encl. Installers list
cc: Philip Christiansen, P.E.
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
No. THE COMMONWEALTH OF MASSACHUSETTS FEE
®OAR® OF HEALTH
T
I oy,f�J OF too ANDOU 2
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to Construct (Repair ( ) Upgrade ( ) Abandon ( ) - 'Complete System ❑ Individual Components
ilUeb
W&
ose - anon
! V ` Map/Parcel #
Lot #
Installer's Name
Address
Telephone #
mes. nk Ut71usD�t'�7.�
Owner's Name
77 WaS it rt S7 a re. be -1 a/ny /W 471
ddress
979-- 991 —91-6
Ch1 Telephong k
riSh&,ns&&. i eT' ._L, A L.
Desi ei's Name
f �, iQ? Sudrlme� S �/ avec l�; ll 1W o1 k.36
_Ip
' _313
73 iAddress
Telephone #
Type of Building: 9/l Xd &YYI°. Lot Size -16 -78(D Sq. feet
Dwelling — No. of Bedrooms Garbage Grinder ( Wb
Other — Type of Building No. of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow (min. required) gpd Calculated design flow gpd Design flow provided 'tj4Z)gpd
Plan: Date l f� 1201 Number of sheets –2 Revision Date
'r.,+] -'r.,+]-<3 C . -J,. II-),-ri.a..,. - / -4 % :e -7 I/ij, %/ :.4,-L�.I. I,/ -
Description
e/_
Description of Soil(s)
Soil Evaluator Form No.f (4- i Z Name of Soil Evaluator,
DESCRIPTION OF REPAIRS OR ALTERATIONS
Evaluation f
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed
Inspections
Date
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
No. THE COMMONWEALTH OF MASSACHUSETTS FEE
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: ❑ Individual Component(s) ❑ Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded ( ), Abandoned ( )
by:
at
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built
plans relating to application No. dated Approved Design Flow (gpd)
Installer _
Designer: Inspector Date
The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
Commonwealth of Massachusetts
City/Town of North Andover
Percolation Test
Form 12
�M
SyO
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
Important: When
filling out forms A. Site Information
on the computer,
use only the tab Gordon Family Trust
key to move your Owner Name
cursor - do not 37 Weillington Way Lot 6 - formerly 602 Boxford Street LOT 8
use the return Street Address or Lot #
key.
North Andover MA 01845
City/Town State Zip Code
Philip Christiansen 978.373.0310
Contact Person (if different from Owner) Telephone Number
' B. Test Results
Observation Hole #
Depth of Perc
Start Pre -Soak
End Pre -Soak
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rate (Min./Inch)
Philip Christiansen
Test Performed By:
Isaac Rowe
Witnessed By:
Comments:
I
1/9/2015 9:58
Date Time
8A
9+18
10:51
11:06
11:06
11:14
11:18
4 MIN
<2 MIN/INCH
Test Passed:
Test Failed: ❑
8b (PSA
9+18
10:17
10:32
10:32
10:37
10:48
11 min
4 min/inch
Test Passed:
Test Failed: ❑
t5form12.doc• 06/03 Perc Test • Page 1 of 1
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a
. , BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: I
Date Issued:
Date °teceived
IMPORTANT: Applicant must complete all items on this page
LOCATION ;L��"6 ""'S7 O &Z -LI &Te-, tj W A T
Pint,
PROPERTY nWNFR NAt="C,'4,-I 11114 aoC'
Print 1 100 Year Structure yes
MAP I
a5C PARCEL:.8 ZONING DISTRICT: Historic District yes
Machine Shop Village yes
NORTH
OF �zLED I6 q�C
. ry
`� �� eoewrc�ewrcw
q M
P -
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
"ew Building
XOne family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
i_.Ueptic®We Ili
f® [M
Elm to la s
® 1/l/atershecl strtctQ.
L��®�V1/ate�/Sewet�i,.. -. •{ -
' � .� ���� �'_ ...�.. � �
�_- �. # � � �
Y'_ 344tx &)
OWNER: Name:
Address:
Contractor Name:
Email ! A
Address -9-77 lel
DESCRIPTION OF WORK TO 6t NtRI-OKmt
q /,- 7=-A m i L`/ D W CL/C,//JG e
9i
Identification - Please Ty 5r or Print Clearly
�cf
A194 nrl�'=
Phone:��'
nL_ ,C_ 6W
C_
a1
i�
�14 MEWFAFTWIS1.0
Supervisor's Construction License:CS fA - 102%3% Exp. Date: 3/ /4
Home Improvement License: Exp. Date: 17
ARCHITECT/ENGINEER_�)qQs,,O 6 Phone: g2o - 9,5-2"` F,3 /8
Address: x) N PA .a ?'-U Reg. No. 2-774��
FEE SCHEDULE: BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S. F.
Total Project Cost: $ e!c -000,3z FEE: $ x
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Pl M—§OOubrnitted�-K-j Plans Waived ❑ Certified Plot Plan;. Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Well ❑
Private (septic tank, etc.
Tanning/Massage/Body Art ❑
Tobacco Sales ❑
Permanent Dumpster on Site ❑
Swimming Pools ❑
Food Packaging/Sales ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING & DEVELOPMENT
COMMENTS
,,
Reviewed On Signature,
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
Reviewed ori � - 1 /'� ldb
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: CommPntc
Water & Sewer Connectio
DPW Town Engineer: Signai