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Miscellaneous - 414 SUMMER STREET 4/30/2018 (2)
414 SUMMER STREET 21Oil .A-0079-0070.0 i t North Andover Board of Assessors Public Access Page J,of 1 t Ro i Assessors, d of 0 IBM% �4�snet+u e ' Property Return to the Home page click on logo JjQRecord Card Parcel ID:210/107.A-0079-0000.0 Community:North Andover SKETCH PHOTO New Search Click on Sketch to Enlarge Click on Photo to Enlarge Sales Summary F Residence 1 Detached Structure Condo Commercial �. Comparable Sales B 414 SUMMER STREET Location: 414 SUMMER STREET Owner Name: DIGNAM,FRANCIS X,JR DIANA M DIGNAM Owner Address: 414 SUMMER STREET City:NORTH ANDOVER State: MA ZIP:01845 Neighborhood:6-6 Land Area: 1.02 acres Use Code:101-SNGL-FAM-RES Total Finished Area: 1920 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 433,400 463,800 Building Value: 224,600 232,800 Land Value: 208,800 231,000 Market Land Value:208,800 Chapter Land Value: LATEST SALE Sale Price:97,500 Sale Date:07/08/1982 Arms Length Sale Code:Y-YES-VALID Grantor:FARREN R BRUCE Cert Doc: Book:01589 Page:0007 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=1181768 4/29/2008 Residential Property Record Card PARCEL ID:210/107.A-0079-0000.0 MAP:107.A BLOCK:0079 LOT:0000.0 PARCEL ADDRESSA14 SUMMER STREET PARCEL INFORMATION Use-Code: 101 Sale Price:. 97,500 Book: 01589 Road Type: T Inspect Date: 06/20/2002 Tax Class: T Sale Date: 07/08/1982 Page: 0007 Rd Condition: P Meas Date: 06/04/2002 Owner: Tot Fin Area: 1920 Sale Type: P Cert/Doc: Traffic: M Entrance: C DIGNAM,FRANCIS X,JR Tot Land Area: 1.02 Sale Valid: Y Water: Collect Id: RRC DIANA M DIGNAM Grantor: FARREN R BRUCE Sewer: Inspect Reas: C Address: 414 SUMMER STREET NORTH ANDOVER MA 01845 Exempt-B/L% 0/0 Resid-B/L% 100/100 Comm-13/1-080 Indust-B/L% 0/0 Open Sp-B/L% 0/0 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 7 Main Fn Area: 1114 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R2 Story Height: 2 Bedrooms: 4 Up Fn Area: 806 Bsmt Area: 1114 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class . Roof: G Full Baths: 1 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1 208,652 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.02 152 Masonry Trim: 76 Ext Bath Fix: TofFin Area: 1920 DETACHED STRUCTURE INFORMATION Foundation: CN Bath Qual: T RCNLD: 211291 Kitch Qual: T Eff Yr Built: 1975 Mkt Adj: Str Unit Msr-1 II E-YR-Blt Grade Cond%Good P/F/E/R Cost Class . Heat Type: HW Ext Kitch: Year Built: 1965 Sound Value: PV S 648 1988 A A 50///50 13,300 Fuel Type: G Grade: AG Cost Bldg: 211-1300 VALUATION INFORMATION Fireplace: 1 Bsmt Gar Cap: Condition: A Att Str Vall: Current Total: 433,400 Bldg: 224,600 Land: 208,800 MktLnd: 208,800 Central AC: N Bsmt Gar SF: 308 Pct Complete: Att Str Val2: Prior Total: 463,800 Bldg: 232,800 Land: 231,000 MktLnd: 231,000 Aft Gar SF: %Good P/F/E/R: /100/100/80 Porch Type Porch Area Porch Grade Factor E 308 SKETCH PHOTO 10 i v . li Ew 14 308 Sq.R. 12 'h 72 2 FM/B FU 14 308 Sq.Ft. 1114 Sq.R.806 Sq.R. 26 26 22 F 10 31 414 SUMMER STREET Parcel ID:210/107.A-0079-0000.0 as of 4/29/08 Page 1 of 1 S�TTLEnI�6' . r li ui�lJIM ATPn PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE,,.. OF COMPLIANCE As of: 5/15/2013 This is to certify that the individual subsurface disposal system has been installed in accordance with the provisions of Title 5 of the State Environmental Code: Complete Repair and Construction of an On-Site Sewage Disposal System By: Todd Bateson At: 414 Summer Street Map 107A Lot 79 @�;MA 01845 The ce is certificathe onstrued as a guarantee that the system will function satisfactorily. Mi hele Grant Public Health Agent ELE COPY 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com f NOR71M 4 tl. F a AF •i "" RECEIVED PUBLIC HEALTH DEPARTMENT MAY 2 0 2013 Community Development Division �T,0^01FINIU 1WANDOVER i iHr:ALTH DEPARTMENT TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERT CATION The undersigned hereby certify that the Sewage Disposal System( constructed;( )repaired; By: TPyy �j,�'I-E ' (Print Name)/ T Located at: �H �1�i I Z- ` (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated ��i 7�4_-3 and last revised on A,PSI L 11 Z015!5 ,with a design flow of `�J�P 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: 5- 7- 1-22 r2• D_j�� Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: Engineer Repi esentative(Signature) And—Print Name Installer: (Signature) Date: ® And—Print Name Enginer: ature) Date: 9—1� VL,o.D And—Print Name 1600 Osgood Street, North o ee o Andover Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com 8 SUMMARY OF INVERTS BUILDING TIES SEWER 0 FDTN. PRE—EXIST. BLDG. CORNER A I B C D NOTE•• THIS PLAN & CERTIFICATION 1S NOT SEPTIC TANK IN 92.93 SEPTIC TANK OUT 23.2 38.0 — — A WARRANTY OF THE SUBSURFACE DISPOSAL SEPTIC TANK OUT 92.68 PUMP TANK OUT 31.3 30.1 — — SYSTEM. IT IS A RECORD OF THE LOCATION PUMP TANK IN 92.58 DIST. BOX — 19.2 27.4 AND ELEVATION OF THE EXISTING SYSTEM DIST. BOX IN 97.23 COMPONENTS. DIST. BOX OUT 97.04 INV. IN CHAMBER 96.96 BOTT. CHAMBER 96.66 "1 HEREBY CERTIFY THE LOCATIONS, ELEVATIONS, TIES, COVER MATERIAL; EXPOSED COMPONENT COVERS ETC., SHOWN ON THIS AS-BUILT SUBSTANTIALLY AGREE WITH THE APPROVED PLAN AND HAVE DETERMINED THAT THE BREAK OUT ELEVATIONS, IF BLE, HAVE BEEN MET." APPROVED DESI o VtAoiL cyc SIGNAT FER " 4DAT �QNAL E� x A WOOD SCE— ¢� 1500 GAL. '. SEPTIC e ` EXIST. TANK a IN :. yF; j.• 1000 GAL. POOLPUMP °•4 q TANK "a ""�:---�EXIST. CpNa-PA110• N d 00 A N MST, PORCH APPROX, , EXIST. CJS SIT. CONC. DRIVE r DiLL414M L LOT 11 o F , ID-BOX cv g1 (44,260 S.F.) LEA H FIELD W/36 N INR TRATOR CHAMBERS INSP. PORT T 17' o \� ^ VENT 4 73.86' AS BUILT PLAN REST OF SUBSURFACE DISPOSAL SYSTEM LOCATED IN NORTH ANDOVER, MASS./414 SUMMER STREET AS PREPARED FOR FRANK DIGNAM TM: 107A z DATE: 5-8-13 TL 79 " SCALE: 1"=20' 0 10 20 40 MERRIMACK ENGINEERING SERVICES 66 PARK STREET ANDOVER, MASSACHUSETTS 01810 w • •PRATED A44, North Andover Health Department Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 414 Summer St. MAP: 107A LOT: 79 INSTALLER: Todd Bateson DESIGNER: Merrimack Engineering PLAN DATE: 1-15-13 BOH APPROVAL DATE ON PLAN: 5-1-13 INSPECTIONS TANK and Pump Tank INSPECTION: 5/6/13 DATE OF BED BOTTOM INSPECTION:5/8/13 DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: 5/9/13 SITE CONDITIONS N/A 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 ® Outlet tee installed, centered under access port (effluent filter) ® 24" inch cover to within 6" of finish grade installed over one access port ® Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon Pump Chamber installed ® H-10 loading ® Monolithic tank construction ® Inlet tee installed, centered under access port ® Pump(s) installed on stable base ® Alarm float working ® Pump On/Off floats working ® Separate on/off floats ® Drain hole in pressure line ® 24" cover at final grade installed over pump access port ® Water tightness of tank has been achieved by Visual testing ® Hydraulic cement around inlet & outlet Comments: CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement ® Alarm signal located inside: basement Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution N/A Speed levelers provided (not required) 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 N/A 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Low Profile Standard Quick 4 Infiltrator Chambers ® Number of chambers per row:6 ® Number of rows (trenches): 6 Comments: Total Chambers = 36 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 = 100.00 BM = 100.00 (Tanks only) HR = 2.93 HR = -0.48 HI = 102.93 HI = 99.52 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark 100.00 Building Sewer OUT 5.88 93.29 93.6 Septic Tank IN 6.23 92.94 93.25 Septic Tank OUT 6.50 92.67 93.00 Pump Chamber IN 6.60 92.57 92.90 2" Pump Chamber OUT 8.02 91.33 ----- 2" Distribution Box IN 5.53 97.23 97.20 Distribution Box OUT 5.53 97.05 97.03 Lateral 1 TOP 5.58 Lateral 1 INVERT 97.00 96.98 Lateral 2 TOP 5.60 Lateral 2 INVERT 96.98 96.98 Lateral 3 TOP 5.58 Lateral 3 INVERT 97.00 96.98 Lateral 4 TOP 5.60 Lateral 4 INVERT 96.98 96.98 Lateral 5 TOP 5.60 Lateral 5 INVERT 96.98 96.98 Lateral 6 TOP 5.60 Lateral 6 INVERT 96.98 96.98 Top of Chamber Bottom of Bed/Chamberl 6.26 96.67 96.70 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- Waterline 10 10 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib.to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other)Foundation 10(5) 20(10) ® Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws �wgaccFn?; Commonwealth of Massachusetts Map-Block-Lot ' .• 107.A0079 BOARD OF HEALTH Permit No North Andover BHP-2013-0621 --------------- -- FEE $250.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Todd Bateson - - - - - --------------------------------------------------------- ------------------------------- to(Repair)an Individual Sewage Disposal System. at No -4-14-SUMMER-STREET ®PY -------------------------------------------------------------BQ------------------------------------ as shown on the application for Disposal Works Construction Permit No. BHP-2013-062 Dated May 02,2013 ----------------------------------------------------------------- Issued On:Apr-19-2013 BOARD OF HEALTH 4 EUEJ C 0 PY ATtD V North Andover Health Department Community Development Division May 2, 2013 Frank Dignam 414 Summer Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 414 Summer Street,Mau 107A.Lot 79 Dear Mr. Dignam: The proposed wastewater system design plan for the above site dated January 15, 2013 with a final revision dated April 17 2013 received on April 22 2013 has been approved. P p � pp The design has been approved for use in the construction of a replacement onsite septic system. This plan is generally good for 3-years from the date of approval however, as this is for a repair system, this is reduced to 2-years. The plan received the following local upgrade approvals. 1) The use of a sieve analysis in lieu of percolation test 2) Reduction in vertical separation between ground water for septic tank inlet and outlet and the pump tank inlet 3) Separation from S.A.S. to ESWT from 5 feet to 4 feet During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring,the North Andover Board of Health may reduce the time period for which this plan is valid. This approval is also subject to the following conditions: 1. Please keep the attached DEP Form 9b for your records (attached) 2. If site conditions are found in the field to be different from those indi ted 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)). Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 `14414 Summer Street May 2, 2013 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 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. Sinc ly, san Y. e HS/RS Public ealt irector Encl. Form 9B cc: Merrimack Engineering File Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 c • tom& • •�QATED'�p�� North Andover Health Department Community Development Division May 2, 2013 Frank Dignam 414 Summer Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 414 Summer Street,Mau 107A,Lot 79 Dear Mr. Dignam: The proposed wastewater system design plan for the above site dated January 15, 2013 with a final revision dated April 17, 2013, received on April 22, 2013 has been approved. The design has been approved for use in the construction of a replacement onsite septic system. This plan is generally good for 3-years from the date of approval however, as this is for a repair system, this is reduced to 2- years. The plan received the following local upgrade approvals. 1) The use of a sieve analysis in lieu of percolation test 2) Reduction in vertical separation between ground water for septic tank inlet and outlet and the pump tank inlet 3) Separation from S.A.S. to ESWT from 5 feet to 4 feet During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring,the North Andover Board of Health may reduce the time period for which this plan is valid. This approval is also subject to the following conditions: 1. Please keep the attached DEP Form 9b for your records (attached) 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 49 414 Summer Street May 2, 2013 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 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. Si rely, usan . awy HS/RS Publ' Health erector Encl. Form 9B cc: Merrimack Engineering File Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Blackburn, Lisa From: Sawyer, Susan Sent: Thursday,April 25, 2013 1:44 PM To: Blackburn, Lisa Cc: wrdufresne@comcast.net Subject: RE:414 Summer Lisa, Bill will have another revision submission. You do not need to charge an additional fee Thx S From: wrdufresneO)comcast.net [maiIto:wrdufresne(&comcast.net] Sent: Thursday, April 25, 2013 12:43 PM To: Sawyer, Susan Subject: Re: 414 Summer Susan Please accept this response as a request for a local upgrade approval to be 4 ft from the seasonal water table where you believe 5 ft is required. Thank you From: "Susan Sawyer" <ssawyer _townofnorthandover.com> To: "Bill Dufresne" <wrdufresneCaDcomcast.net> Sent: Thursday, April 25, 2013 11:23:03 AM Subject: 414 Summer Bill, I am running like crazy today and have the next 3 working days out of the office at seminars, so please excuse the informality of this email This is in regards to the explanation for the water table issue at 414 Summer Street. I agree with the statement "Title 5 states that when using a sieve analysis in lieu of a perc test,the most restrictive loading rate associate with the textural class shall be used. I also agree that things should be consistent. However, the guidance indicates that "the Soil Evaluator's determination of the soil type,which must be based on the Particle Size Analysis and the USDA Soil Textural Triangle in Title 5;and 5.the Soil Evaluator's determination of the soil class under 310 CMR 15.243,which must be based on the soil type; and 6. plans for a system upgrade designed in accordance with the criteria in this policy for the soil type,class and determination of soil compaction." With this, I believe that the system will actually be smaller in square footage as the guidance indicates the use of.74 for soils >85% sand. , but yes, 5 ft from the water table. If you wish, you could request the local upgrade i which will then place the system at the same elevation as the current one. Of course any request is totally your decision. Other than that, I think the plan is all set. I will be able to approve it and the local upgrade approvals upon submission. Thanks, Feel free to email me if you need to. I will be checking in on occasion. Susan Susan Sawyer Public Health Director Town of North Andover 1600 Osgood Street Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mailto:ssawver@townofnorthandover.com Web www.TownofNorthAndover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/ore/preidx.htm. Please consider the environment before printing this email. 2 ^ •'' Commonwealth of Massachusetts City/Town of North Andover w Local Upgrade Approval Form 913 DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. A. Facility Information Important:When filling out forms 1. Facility Name and Address on the computer, use only the tab Frank Dignam key to move your Name cursor-do not 414 Summer Street use the return key. Street Address North Andover MA 01845 reb City/Town State Zip Code 2. Owner Name and Address (if different from above): ream NameStreet Address City/Town State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 gpd 5. System Designer: Vladimir Nemchenok Name ® PE ❑ RS 66 Park St Andover 01910 Address City/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for: ❑ Reduction in setback(s)—specify: ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction 414 Summer St form9b-rev.7/06 Local Upgrade Approval, Page 1 of 2 k. -�° Commonwealth of Massachusetts F City/Town of North Andover Local Upgrade Approval Form 9B B. Approval (continued) ® Reduction in separation between the SAS and high groundwater: Separation reduction 1 ft. Percolation rate alt to perc min./inch Depth to groundwater 4 ft. ❑ Relocation of water supply well (explain): ® Reduction of 12-inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ® Use of a sieve analysis as a substitute for a perc test List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: Health Department Approving Authority Susan Sawyer May 1, 2013 Print or Type Name and Title ignature , Date 414 Summer St form9b•rev.7/06 Local Upgrade Approval* Page 2 of 2 Y Commonwealth of Massachusetts City/Town of North Andover a Form 9A — Application for Local Upgrade Approval a DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility_ Information Important: APR 22 -20173 When filling out 1. Facility Name and Address: forms on the 'TOWN OF NORTH ANDOVER computer,use Frank-Di nam Residence._._._- _ . _ 11EALIt 22 only the tab key Name — - to move your 414 Summer Street cursor-do not Street Address use the return key. North Andover MA 01845 City/Town State Zip Code ffi 2. Owner Name and Address(if different from above): SAME Name Street Address Citylrown State (978)681-0433 Zip Code Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: 4 Bdrm House 5. Type of Existing_System: ❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits,etc): Unknown t5form9a.doc•rev.7/06 Application for Local Upgrade Approval*Page 1 of 4 N N Commonwealth of Massachusetts City/Town of North Andover Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: unknown gpd Design flow of proposed upgraded system 440 9Pd Design flow of facility: 440 gpd B. Proposed Upgrade of System 1. Proposed upgrade is(check one): Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: Total Replacement(see plan) 3. Local Upgrade Approval is requested for(check all that apply): i ❑ Reduction in setback(s)—describe reductions: i ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction © Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min./inch Depth to groundwater ft t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 2 of 4 n 1� Commonwealth of Massachusetts City/Town of North Andover a Form 9A - Application for Local Upgrade Approval ,M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ® Reduction of 12-inch separation between inlet and outlet tees and high groundwater ❑ Use of only one deep hole in proposed disposal area ® Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: owe Evaluators Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: NA 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: NA t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 3 of 4 I Commonwealth of Massachusetts City/Town of North Andover a Form 9A - Application for Local Upgrade Approval M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: NA 4. Connection to a public sewer is not feasible: I None Available 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit ® Complete plans and specifications ® Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. j Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I, the facilityowner, certify under penalty of law that this document and all attachments to the best of m fY P tY Y knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." 4-17-13 Facility Owner's Signature Date Frank Dignam Print Name Bill Dufresne/Merrimack Engineering 4-17-13 Name of Preparer Date 66 Park Street Andover Preparer's address City/Town MA/01810 (978)475-3555 State/ZIP Code Telephone t5form9a.doc-rev.7/06 Application for Local Upgrade Approval*Page 4 of 4 MERRIMACK ENGINEERING SERVICES, INC, PROFESSIONAL ENGINEERS LAND SURVEYORS PLANNERS 66 PARK STREET• ANDOVER,MA 01810• (978)475-3555,373-5721 • FAX(978)475-1448 • E-MAIL info@merrimackengineering.com RECEIVED April 17, 2013 APR 2 2 2013 Susan Sawyer Public Health Director TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 1600 Osgood Street Building 20, Suite 2035 North Andover, MA 01845 RE: 414 Summer Street Dear Ms. Sawyer, We are in receipt of you review letter dated January 30, 2013 for the above referenced site. We have revised the plan with regard to items 2, 4, 5 &6 of your letter. With regard to items 1 & 3,both myself and the Inspector agreed in the field that the soil textural classification was close to the boundary between a sandy loam and a loamy sand so we logged the soil conservatively as a sandy loam. The fact that the laboratory analysis confirmed that it is a loamy sand is of no surprise.Nonetheless,the soil was not a single grain sand nor did it exhibit the characteristics of a rapid or 2 minute per inch sand as the review letter suggests, furthermore, Title 5 states that when using a sieve analysis in lieu of a percolation test, the most restrictive loading rate associated with the textural class shall be used. In this case,the most restrictive loading rate for a class I soil of 0.66 was used. It is unreasonable and inconsistent to enforce a loading rate associated with a perc rate of 8mpi, and then suggest we enforce a water table associated with a perc rate,of 2 mpi. It is our opinion that the appropriate 4.0 ft. water table offset has been met. Enclosed are copies of the revised plan, in the best interest of Public Health and the environment,we respectfully request that the plans be approved as the owner is anxious to begin construction and upgrade of their septic system. Yours truly, William Dufresne Merrimack Engineering Services Y� a ^� • yv COPY. • " Art.t,,"�. North Andover Health Department Community Development Division January 30, 2013 Vladimir Nemchenok Merrimack Engineering Services 66 Park Street Andover, MA 01810 Re: Subsurface Sewage Disposal System Plan-for 414 Summer Street,Map.107A,Lot-79 Dear Mr. Nemchenok: The proposed wastewater system design plan for the above site dated January 15, 2013 and received on January 22, 2013 has been reviewed. Unfortunately, the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000; or North Andover regulation that is not met by this design follows each item. 1. The field book notes (enclosed)from the BOH representative indicate the C layer was documented as a Sandy Loam during the soil evaluation but the plan and soil evaluation forms indicate a Loamy Sand. Please explain the discrepancy. �r 2. A Local Upgrade Approval to use the sieve analysis in lieu of the percolation test must be requested. Please revise the Form 9A and note the Local Upgrade Approval request on the design plan (3 10 CMR 15.405(1)(i)). 3. The sieve analysis indicates the soil sample is 89.7% sand. According to the alternative to percolation testing guidance, the vertical separation to high groundwater is required to be 5 feet. The proposed plan currently indicates a separation of 4 feet. Please modify the design plan accordingly. 4. A Local Upgrade Approval to reduce the 12 inch separation between the inlet and outlet and high groundwater for the septic tank and pump chamber (inlet only)must be requested. Please revise the Form 9A and note the Local Upgrade Approval request on the design plan (3 10 CMR 15.405(1)0)). 5. The septic tank is below the high groundwater elevation. Please provide buoyancy calculations (3 10 CMR 15.221(8)). 6. The plan indicates there are no wetlands within 50' of the proposed system. Please depict all wetlands on the site plan within 150' of the proposed septic system or provide a statement to satisfy this requirement(NA 3.2). Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2-36, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Since3� usan Y. S er, RE S / Public Health Direc r cc: Frank Dignam 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 I Iril � �I.. ! ' 1 -- f- IT �J y ,pro 41411 P - 44+ ..a 6470 . O • Town of North Andover ;'•�,;:o:: HEALTH DEPARTMENT ,s'SACMUStt CHECK#: ( �U1 DATE: LOCATION: 414 no W I( H/O NAME: CONTRACTOR NA E: 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) ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Too,( IcRak) LuAvr 0/�,- -- YUtiL���� Z NOR,H, Application for Septic Disposal System 3 3 c TODAY'S DATE aConstruction Permit - TOWN OF ORTH ANDOVER NU 01845 $250.00-Full Repair s^�N�g�� • $125.00-Component Important: Application is hereby made for a permit to: When fining out ❑ Construct a new on-site sewage disposal system* forms on the computer,use YRepair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component—What? cursor-do not use the return A. Facility Information key. Ell reD Address or Lot# V Lo mar, City/Town d AP 2Q R 9 2.- * PE OF SEPTIC SYSTEM*: 13 ump ❑ Gravity (choose one) TOWN OF NORTH ANDOVER ***If pump system, attach copy of electrical permit to application*** HEALTH DEPARTMENT ❑ Conventional System(pipe and stone system) infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D-Box)(Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D-Box Present)S.A.S. 2.' Owner Information �1'hiV/l ��ci /U/t Af Name Al/41 J Address(if different from above) Citylrown State Zip Code 1V 4,01!2- Telephone Number 3. Installer Information 'lv.� �7�e sos✓ ��s�� -��s�� .1`�iic . Name Name of Company �j/ �4rgr lh Rd . Address Cityrrown State Zip Code `7.4 Telephone Number(Cell Phone#if possible please) a. Designer Information Name �— Name of Company s4. G� � � l� :54. Address /ydytt2 14y4- t�`a City/Town State Zip Code 01 v'4�-1,a0 . Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 °pTN, Applicati-on..for Septic Disposal :System t3 3r.: .�;•°� TODAY'S DATE A Construction -Permit— TOW O *�°�' •''�"* ORTH ANDOVER, MA 01845 $.250.00--Full Repair 4.'"••,,;,.. $125.00.-Component 9s3,CHS`'£ . PAGE 2OF2 A, Facility.Information continued.... 5. Type-of Building: M 6eldential Dwelling or[]Commercial B. Agreement The undersigned agrees to.ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code,as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been JssueqW this Board of Health. Name Date Application Approved By: (Board of Health Representative) Name Date Application Disapproved.for the following reasons: For Office Use Only: L. Fee Attached. : Yes No 2.- ProjectMatager Obligation Form AttaehedP Yes No ' 3.: Pump S sY tem? Ifsoj Attach copy ofElectrical Permit` Yes No 4. Foundation As Bur'it.?(new construction-ronly). Yes No (Same scale as approved plan) b 5. FloorPlans?(hew construction only): 'es_ No Applidationidrpispoaal 4yster*.0dnstructioh Pennft Page 2 of 2 .. - SEP'T'IC SYSTEM.INS'�AI.IE$PROJECT 11,AT&GEMENT OBLIGATIONS As the North Andover•licensed installer fox t1*constmCtiots fos-the septic system for.the property at X71 I For plans by /!eP/ lit� (Address of septic system) (Engineer) Relative to the.application of = y`1 "�Sd� Acid dated (in'staller's name) ngina date . Dated3 With revisions dated os a e (Last revised date) I understand the following oliligations for management of-this project: 1. As the installer,I am.obligated to obtain. 11 permits and•Board of:Health approved plans:prior to per fo=aiag any work on a site: I must have the'approved titans and the permit:on site when any work is 2. As the installer,•I.must.•call-for.any and all-inspe-.tions: If homeowner,contractor,.projectmnnager,or any schedules aninspection and the system is not ready,then other person not associated with my company item three•shall•he.applicable. As.th' Ftstajler,Z atn req=e to.have.the ttecessarpwork'compiett priot,to the.applicable inspections as in&cated belowY i L+rderstand that teeny .a�„n an 'tho*Ui completion•of the items in accordance e 1 O'•6ne a ed s me-ia d or Bo't otritSf 3.ed Gmeraily,#his'is the`fgst.(1`)..-Mtpeetion p.nless.there is a ietainingwall,culiich should•be do ie<fYrst: The'install4:Must#qui the iiispectlott but sloes not have to be present. b. Find�Qnstructi trspeetinti—Engineer Mius't first clo them nspoction for cTevations;-ti`es,'etc. As-built of-verbal OK(or e-mail•to:}teaitlidgp Cal o o czrthandover.�oml from the engineer must be subsriitfed-to.the.Bo'ard'of Health,aftei.:wliiCh installer.calls for,an inspection time. 'Insmust be present for this.inspection, With a pump::.system,all electrical work.rnust be ready and able to causeptin)p.tai-arork arid•alarni'•to fit d. on.. C. i — staller must request inspection wh li'* l grading•is'complete:. Installer does' not have to be on=site.' 4. As-the installer,'I understand that only I-lnay perform the vork(other than:rimple excavation)and-I atn required to complete the-installation of the system identified in the.atta.ched application for installation: mer.. understand that work•done y others tulliceased.to'ins sep ieysfems in North Andover call Eons&ute reasons for denialof the stentand�orrevocation or suslyentioti of.rn lieense•to operate in.the Town.af North Andover sipiuficant fines o all arsons iffVQlvetl ire also Visible 5.. As the.installer,4 understaiicl that.I e-oa-site during tho,perf&irdance of the following construction. steps: a: Detennrnatronthat•the proper efevation of earcavation hair been reached, - b. rnspeedon oftheIsand and stove to be used. c. Furaf inspecdorr byBoard of ffealth staffor consultant d. Installatron..oftank,D Box pipes,stone, vent,pump chamber,reia rii waft and other components. , 6, Asth2 sf llej;: ,��rstand that Lam s6161v res • nsible for the installation of the system as per the p -P No .iinctipns by the`ht eowri' er general contrttmr •or•= other persons shall-absolve me of flus ob ' tion. ]D Undersigned�:icensed Septic.Installez: (Z'pda�►'s x>e)... Qui7 }_�,��f /� n / .. ,. . ;• •... �,, �,-. 1 Blackburn, Lisa From: Isaac Rowe[irowe@millriverconsulting.com] Sent: Wednesday, January 30, 2013 10:18 AM To: 'Susan Sawyer(ssawyer@townofnorthandover.com)'; Blackburn, Lisa Cc: 'Pam Lally'; 'Dan Ottenheimer'; irowe@millriverconsulting.com Subject: 414 Summer St- Plan review Attachments: 414,Summer St Disapproval Letter 1-30-13.doc Susan, Attached is the disapproval letter for the above referenced property. There is a significant design change required based on my review and few minor edits that the designer may contend so please call me to review. Thanks, Isaac M. Rowe,R.S. Project Manager Mill River Consulting 6 Sargent Street 1 b 0 Of,NO oTM 1ti • Town of North Andover HEALTH DEPARTMENT CMOstt CHECK#: DATE: LOCATION: � '� H/O NAME: ' CONTRACTOR NAAE w ffic.+ knnffi Int 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) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ Other:(Indicate) $� l Health Agent Initials+ White-Applicant Yellow-Health Pink-Treasurer i TOWN OF NORTH ANDOVER of N�RTh , Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20;SUITE 2-36 Y NORTH ANDOVER,MASSACHUSETTS 01845 ��Ss^cNus 978.688.9540-Phone Susan Y.Sawyer,REHS/RS 978.688.8476–FAX Public Health Director E-MAIL:healthdept(a)townofnorthandover.com WEBSITE:hftp://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM RECEIVED Date of Submission: li �l3 JAN 2 2 2013 Site Location: TOWN OF NORTH ANDOVER —r HEALTH DEPARTMENT Engineer: �` � 2�� � 1 New Plans? Yes /$225/Plan Check# W (includes 1St submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes V/ No Local Upgrade Form Included? Yes No__,/' fA. Telephone#: 6TV 2_Y 7,5-'-X5-5 S Fax#: E-mail: Homeowner Name: 6A)A�,/ 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 TerraFilter,LLC. P.O.Box 227 10 Main St. �,♦.L Sturbridge,MA 01566 -FerrmuRer Tel: (508)347-5508 (877)347-7263 Fax:(508)347.9857 January 16,2013 Bill Dufresne Merrimack Engineering 66 Park Street Andover,MA 01810 RE: Particle Size Analysis (Alternative to Perc Test) 414 Summer Street, N.Andover, Mass. Dear Bill: Below are the results of the particle size analysis from the sample submitted for the above referenced property. The analysis was performed utilizing the hydrometer method of Gee & Bauder (1986) in Methods of Soil Analysis, Part 1. Physical and Mineralogical Methods,2nd Edition. Sand Silt Clay (2.00 to.05mm) .05 to.002mm <.002mm Portion Passing 89.7% 8.9% 1.4% #10 Sieve USDA Soil Textural Classification: Sand MA Section 15.243 Soil Classification: Class I Based upon the DEP's Tale 5 Altemat/ve to Percolation Testing Policy for System Upgrades,the following effluent loading rates apply: Un-compacted Soil 0.74gpd/sf Compacted Soil 0.15gpd/sf Should you need additional information, or require further testing services, please do not hesitate to contact our office. Sincerely,^ Mark Farrell,Soil Scientist Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal ie A. Facility Information Frank Dignam Owner Name 414 Summer Street 107A/ 79 Street Address Map/Lot# North Andover MA 01845 City State Zip Code B. Site Information 1. (Check one) ❑ New Construction ® Upgrade ❑ Repair 2. Published Soil SurveyAvailable? Aug. 11, 2008 1:15,840 421 ® Yes ❑ NO If yes: Year Published Publication Scale Soil Map Unit Canton Soil Name Soil Limitations 3. Surficial Geological Report Available? ® Yes ® No If yes: Year Published Publication Scale Map Unit Till Ground Moraine Geologic Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ❑ No Within the 500-year flood boundary? ❑ Yes ❑ No Within a velocity zone? ❑ Yes ❑ No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name 6. Current Water Resource Conditions (USGS): 12/2012 Range: ❑ Above Normal ® Normal ❑ Below Normal Month/Year 7. Other references reviewed: Soil Evaluation Forms.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 t f � Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: T-1 1-3-13 9 a.m. sunny 5-10 degrees Date Time Weather 1. Location Ground Elevation at Surface of Hole: 96.4 Location (identify on plan): see plan 2. Land Use Residential none 0-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) Lawn Ground Moraine top slope Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body >100 g y Drainage Way >100 Possible Wet Area >100 feet feet feet Property Line 35 feet Drinking Water Well >1fee00 Other feet 4. Parent Material: Till Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ® Yes ❑ No If yes: 83 91 Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 44 92.7 inches elevation Soil Evaluation Forms.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal r� C. On-Site Review (continued) Deep Observation Hole Number: T-1 Redoximorphic Features Coarse Fragments Depth in. Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil p ( ) Consistence Other Layer Moist(Munsell) (USDA) Cobbles& Structure Depth Color Percent Gravel (Moist) Stones 0-10 A 10YR2/2 FSL Wk. Gran. Friable 10-40 B 10YR4/6 SL Massive Friable 40-98 C 2.5Y5/4 44 7.5YR4/6 >5 LS 5-10 10 Massive Friable Additional Notes: Soil Evaluation Forms.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of North Andover F Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: T-2 1-3-13 9 a.m. Sunny 5-10 degrees Date Time Weather 1. Location Ground Elevation at Surface of Hole: 97.8 Location (identify on plan): See plan 2. Land Use Residential none 0-3 (e.g.,woodland, agricultural field,vacant lot,etc.) Surface Stones Slope(%) Lawn Ground Moraine top slope Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body >100 Drainage Way >100 Possible Wet Area >100 feet feet feet Property Line 15 feet Drinking Water Well >1fee00 Other feet 4. Parent Material: Till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ® Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: 84 95 ® Yes ❑ NO If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater. 62 92.6 inches elevation Soil Evaluation Forms.doc-rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 4 of 8 �i Commonwealth of Massachusetts City/Town of North Andover a Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: T-2 Redoximorphic Features Coarse Fragments Depth(in.) Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Layer Moist(Munsell) (USDA) Cobbles& Structure Consistence OtherMoist Depth Color Percent Gravel Stones (Moist) 0-53 Fill 53-57 A 10YR2/1 FSL Wk. Gran. Friable 57-66 B 10YR5/8 SL Massive Friable 66-118 C 2.5Y5/4 62 7.5YR4/6 LS 10 10 Massive Friable Additional Notes: Soil Evaluation Forms.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B.inches inches ® Depth to soil redoximorphic features (mottles) A. 44 B. 62 inches inches El Groundwater B.Groundwater adjustment(USGS methodology) inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed? Upper boundary: 40/66 Lower boundary: 98 / 118 inches inches Soil Evaluation Forms.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. ! 1-18-13 Signature of Soil Evaluator Date William Dufresne SE#640 5-9-96 Typed or Printed Name of Soil Evaluator/License# Date of Soil Evaluator Exam Isaac Rowe Mill River North Andover Name of Board of Health Witness Board of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to the designer and the property owner with Percolation Test Form 12. Soil Evaluation Forms.doc•rev. 1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts City/Town of North Andover w Percolation Test Form 12 GSM Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important: A. Site Information When filling out forms on the computer,use Frank Dignam only the tab key Owner Name to move your 414 Summer Street cursor-do not Street Address or Lot# use the return key. North Andover MA 01845 Cityrrown State Zip Code (978)681-0433 Contact Person(if different from Owner) Telephone Number B. Test Results 1-3-13 Date Time Date Time 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) Test Passed: ❑ Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Test Performed By: Witnessed By: Comments: Ground water conditions were too wet on day of testing. Particle size analysis performed by Terra Filter, see attached report. t5form12.doc•06/03 Perc Test•Page 1 of 1 Of NORiM,� 6339 o • Town of North Andover `�.'•°,,,,°.: ,` HEALTH DEPARTMENT �ss�cHuS�� CHECK#: _- DATE: ' LOCATION: 414 H/O NAME. WInEb�0mm CONTRACTOR NAME:H0 ffth 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: ly Septic-Soil Testing $ . i ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ Health Xgent Initials White-Applicant Yellow-Health Pink-Treasurer Cf Mp RTh 1ti _ J 1� 9 Town of North Andover �'•�,,,,o.. HEALTH DEPARTMENT ,SSACHUStt , ' a^' CHECK#: DATE: p�- LOCATION: H/O NAME. , MM CONTRACTOR NAME:4 ffrN 1i f k Fn k_= a 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) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer TOWN OF NORTH ANDOVER of IORT" i•sa: «,,�e O Office of COMIVIUNITY DEVELOPMENT AND SERVICES o e HEALTH DEPARTMENT -7"' Z. 1600 OSGOOD STREET; BUILDING 20; SUI-TE NORTH ANDOVER,MASSACHUSETTS 01845 �SSACHUS 4� Susan Y.Sawyer,REAS,RS 978.688.9540—Phone RECEEIVE— Public Health Director 978.688.8476—FAX healthdept@townofnorthandyer.corrr r www.townofnorthandov er.coir► EC 2' eV 2 APPLICATION FOR SOIL TESTSta =.-M DATE: MAP&PARCEL: I 07A A —2 9 LOCATION OF SOIL TESTS: OWNER: � �� � Contact#: z 0 APPLICANT: , Contact#: ADDRESS: I(4 �j�, M ENGINEER: 161 - Contact#: 7477" ZJ � 4 72--0 CERTIFIED SOIL EVALUATOR: @u FiJ FU 61 66)� LjD7i' � Intended Use of Land: R i i 1 a d. es dent a bdivision in a;FamilyH e Commercial Is This: Repair Testing: Undeveloped Lot TestingUpgrade for Addition: In the Lake Cochichewick Watershed? Yes No 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 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 afleast 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 Approv l Date: / Signature of Conservation Agent: �# _ , Date back to Health Department: (stamp in): pl j . PLOT PLAN 414 SUMMER STREET NORTH ANDOVER, MASSACHUSETTS BUYER: FRANCIS AND DIANE DIGNAM SCA J: 1" = 40' JUNE 24 1982 w d i ;r - Jv i _.. 'o ffir, NOTE: THIS IS NOT A SURVEY AND IS TO BE USED FOR MORTGAGE PURPOSES ONLY. N.B.- DO NOT USE OFFSETS FOR ESTABLISHING LOT LINES"FOR THE ERECTION OF FENCES, WALLS, HEDGES, ETC.' . I HEREBY CERTIFY THAT THE BUILDING ON THIS PROPERTY IS • LOCATED AS SHOWN ON PLAN AND COMPLIES WITH THE ZONING SET BACK REQUIREMENTS OF THE TOWN OF NORTH ANDQVER. I FURTHER CERTIFY THAT THE ABOVE PROPERTY IS NOT LOCATED IN A FLOOD PLAIN ZONE. CYR ENGINEERING SERVICES, INC. ;'. •�; 3= 300 CANAL STREET LAWRENCE, MASSACHUSETTS40 � l Blackburn, Lisa From: Isaac Rowe [irowe@millriverconsulting.com] Sent: Thursday, January 03, 2013 1:05 PM To: Blackburn, Lisa; 'Susan Sawyer(ssawyer@townofnorthandover.com)' Cc: 'Dan Ottenheimer'; 'Pam Lally'; irowe@millriverconsulting.com Subject: RE: 414 Summer Street Attachments: 414 Summer St-Soil testing results 1-3-13.pdf Susan/Lisa, Attached are my field notes from the soil testing today. Please let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone: (978) 282-0014 Fax: (978) 282-1318 irowe(@millriverconsulting.com www.millriverconsulting.com -----Original Message----- From: Blackburn, Lisa [mailto:LBlackburn@townofnorthandover.com] Sent: Wednesday, December 26, 2012 4:23 PM To: Dan Ottenheimer; Isaac Rowe; Pam Lally Subject: 414 Summer Street Attached is soil testing for 414 Summer Street. Please contact the engineer. Thank you. Lisa Blackburn Health Department Town of North Andover 1600 Osgood Street Suite 2035 North Andover, MA 01845 Phone 978.688.9540 Fax 978.688-8476 Email lblackburn@townofnorthandover.com Web www.TownofNorthAndover.com -----Original Message----- From: noreply(atownofnorthandover.com [mailto:noreply(@townofnorthandover.com] Sent: Wednesday, December 26, 2012 3:56 PM 1 To: Blackburn, Lisa Subject: This E-mail was sent from "RNPOA428C" (Aficio MP C5000). Scan Date: 12.26.2012 15:55:49 (-0500) Queries to: noreply@townofnorthandover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please l refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 2 414 Summer Street Page 1 of 2 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, April 29, 2008 1:06 PM To: 'Frank Dignam' Subject: RE: 414 Summer Street Unfortunately, no, I do not have any septic plans on file. Neil Bateson, of Bateson Enterprises in Andover, who pumped your system may be able to give you an idea of where it is located. His number is: (978)475-1474. If you need more specific information,you would have to hire an engineer to pinpoint and draw out the exact location. Ben Osgood of New England Engineering does alot of work in Town, and they are right down the hall from us. I am not advocating them or any other firm,but as I said,they do have alot of experience here. Their number is 978.686.1768. Good luck! Pamela -----Original Message----- From: Frank Dignam [mailto:fxdig@hotmail.com] Sent:Tuesday, April 29, 2008 12:13 PM To: DelleChiaie, Pamela Subject: RE: 414 Summer Street thank you for sending the information to me.......... is there a way of telling where the leeching field is........... that is my major concern..... thank you, frank dignam Subject: 414 Summer Street Date: Tue, 29 Apr 2008 10:30:12 -0400 From: pdellech@townofnorthandover.com To: fxdig@hotmail.com <<S KM BT_600080429102 50.pdf>> Hello Mr.Dignam, You only had two pumping records in your file. I also printed your assessors information for reference. Please call the office if you have any questions. Reference:978.681.0433 -Home phone Nos,(R.Vwm(s, A40#10040 ZPA&Ooedlaia Health Department Assistant Town of North Andover 1600 Osgood Street Building 20,Suite 2-36 North Andover,MA o1845 2978.688.9540-Phone A 978.688.8476-Fax 4/29/2008 Commonwealth.of Massachusetts RECEIVED City/Town of System Pumping Record OCT 2 4 2006 Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health.. Th umping Record must be submitted to the oval Board of Health or other approving authority. . A. Facility Information Important: When Ening out 1. System L cation: �1�'�'D forms the computer,use only the tab key Address to move your cursor-do not f use the return City/Town State Zip Code .key. 2.. System Owner: Name Address(if different from.location) City/Town State ' "ade Telephone Number B. Pumping Record 1. Date.of PumpingDate 2. QuantityPumped. Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight.Tank ❑ Other(describe) 4. Effluent Tee Filter present? ❑ Yes ❑�/ If yes, was it cleaned? ❑ Yes`❑ No 5. Condition of System: J 6. System P mp drB LL Name ehicle License Number Company . 7. Location contents a d' sed: S_ Signature er Date http://www.mass.gov/dep/watertapprovals/t5forms.htm#inspect t5form4.doc-003 System Pumping Record•Page 1 of 1 TOWN OF NORTH ANDOVER E® SYSTEM PUMPING RECORD AUG 3 p 2005 OF NpRTH ANDD��R� TOHEA�TH DEPARTMENT DATE: . SYSTEM OWNER &ADDRESS SYSTEM LOCATION (example: left front of house) ot� �e� qcq � DATE OF PUMPING: " ! .Z> QUANTITY PUMPED GALLONS CESSPOOL: NO J YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY- COMMENTS: CONTENTS TRANSFERRED TO: Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: Left front, left rear, left side of house. Right iron , right ear right si o ouse. forms on the computer,use only the tab key Address l to move your rr L �/L(/til,P�t� J� /U1 cursor-do not use the return Cityfrown State Zip Code key. 2, System Owner: t ^ �i r Via cL V i Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: rl Cesspool(s) eptic Tank El Tight Tank [ Other(describe): 4. Effluent Tee Filter present? 8 Yes No If yes,was it cleaned? -Yes No 5. Conditin n of System: 6. System Pumped By: Neil Bateson F 5821 Name Vehicle.License Number Bateson Enterprises Inc Company 7. Locati where contents were disposed: ligna L.S.DLowell Waste Water ure of H u r Dafe t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts w C ity/Town of LAPR System Pumping Record Form 4 27 2010 DEP has provided this form for use by local Boards of Health. Otherinformation must be substantially the same as that provided here. Beflt 5Qk ith your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System � Left side of house, Right side of house, Left front of house, Right front of house, Le rear of hous fight rear of house. Left rear of building. Right rear of building. Address City/Towh State Zip Code 2. System Owner: IV,AA,11 — Name Address(if different from location) Citylrown State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of S stem: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Lo o er contents were disposed: L .D Lowell Waste Water I Jh W r'9�1 g to a of Haul r Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts RECEIVED City/Town of i System Pumping Record OCT 16 2012 Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used but the information must be substantially the same as that provided here. Before using this form, check with your, local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of hous , Le ig r ar of hous Left/right side of house, Left/ Right side of building, Left/Right front of b Ing, Left/Right rear of building, Under deck Address /-J�� L-1 �U��q� S-1- /yJ /&/4 City/Town ( f State Zip Code 2. System Owner. r� 4� Name Address(if different from location) Cityrrown Stat Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No 5. Conditi n o�y�ste�m: � c,l� 4&v�c- 6. System Pumped By: Neil Bateson F5821 Name .Vehicle License Number Bateson Enterprises Inc Company 7. Lo w ere contents were disposed: /131,S. Lowell Waste Water Sign toe 9t Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 a