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HomeMy WebLinkAboutMiscellaneous - 42 OLYMPIC LANE 4/30/2018 (2) 42 OLYMPIC LANE 210/106.B-0110-0000.0 1. �7 r,I "\Town of North Andover; - f N°RTH Office of the Health Department Community Development and Services Division . 400 OSGOOD STREET '► °, <._._:.. >' North Andover,Massachusetts 01845 SACHU51 Susan Y. Sawyer,RENS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax C22�;�Iq'ICA�IE O� COJIoI<'.G.L./I. �E As of: March 24, 2006 ,This is to cert that the individualsu6surface dzsposalsystem was a Full System Repair Completed6y: ,john Soucy At: 42 Olympic Lane North Andover, qv,4 01845 Yfas been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Mealth regulations. 'The issuance of this certificate shall not 6e construed as a guarantee that the system will function sat4factorily. Susan 7 Sawyer, 1RE99 S/RR 4 Mlic 9fealth(Director BOARD(.N'APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER of N°R*M Office of COMMUNITY DEVELOPMENT AND�,RVICES HEALTH DEPARTMENT 400 OSGOOD STREET •--s-- NORTH ANDOVER, MASSACHUSETTS 01845 'sswCHU 978.688.9540—Phone Susan Y.Sawyer, REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdept(ci),townofnorthandover.com WEBSITE:http://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( ) constructed; (>/)repaired; by cToL►., Sc,. e-4 (Pint Name) located at 'c- K (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated 9' /3 O_15�' and last Revised on --- , with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CCMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: Engineer Representative(Signature) And-Print Name Final inspection date: 1 t_ S t"_ CD Engi eer Representative Signature) R e, And-grint Name Installe _ (Signature) Date: And-Print Name Engineer: C Q ' (Signature) Date: �Lr,� � ��F7�t�� And-Pr' t Name AS-BUILT CHECKLIST LOT NUMBER STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING TIES TO LOT LINES &DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA V LOCATIONS OF DEEP HOLES &PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES / WITHIN 150' OF SYSTEM LOCATION OF R, GAS. ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX ORIGINAL STAMP& SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW ✓ LOCATION& ELEVATIONS OF BENCHMARK USED ti �1 I� �J NEW ENGLAND ENGINEERING SERVICES lk I INC November 30, 2005 Mrs. Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 RECEIVED Re: 42 Olympic Lane,North Andover,MA DEC 0 1 2005 As-Built Septic System Design TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Dear Mrs. Sawyer, The following As-Built Plans for the above referenced property are being submitted for approval. 1. Three (3) Copies of the As-Built Septic System Design Plans. If you have any comments or questions please do not hesitate to contact this office. Sincerely, Steven E. Pouliot Project Manager cc: Homeowner 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 O TOWN OF NORTH ANDOVER �I pOR7N Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT a 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS Ol 845 SACHUS Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX ADDRESS: 42 Olympic Lane MAP:106B LOT: 110 INSTALLER: Mr. John Soucy DESIGNER: Mr. Benjamin Osgood, P.E. PLAN DATE:9/13/05 Rev: BOH APPROVAL DATE ON PLAN: 11/07/05 DATE OF BED BOTTOM INSPECTION: 11/17/05@11:00- MG DATE OF FINAL CONSTRUCTION INSPECTION: 11/22/05 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ®Existing septic tank properly abandoned ®Internal plumbing all to one building sewer ®Topography not appreciably altered Comments: Information above was completed at thel 1/17/05 inspection by the North Andover Health Department. SEPTIC TANK ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ® Inlet tee installed, centered under access port ® Outlet tee (gas baffle or effluent filter) installed, centered under access port ® 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ® Hydraulic cement around inlet & outlet Comments: The first three items above were completed at the 11/17/05 inspection by the North Andover Health Department. Mill River Consulting inspected the next four items on 11/22/05 Page I of 3 u D-BOX ® Installed on stable stone base ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan ❑ 3/4-1 %2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ® Gravelless disposal systems: type, number and location as per plan ® Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Page 2 of 3 SYSTEM ELEVATIONS Benchmark: 100.00 Rod at Benchmark: 0.80 Height of Instrument: 100.80 INVERT ON DESIGN INVERT ELEVATION PLAN Building Sewer OUT N/A 96.21 Septic Tank IN 95.75 95.77 Septic Tank OUT 95.50 95.50 Distribution Box IN 95.15 95.15 Distribution Box OUT 94.98 94.97 Chamber 1-Inv. 94.88 94.89 Chamber1_Top 95.34 95.33 Chamber 2-Inv. 94.88 94.89 Chamber 2-Top 95.34 95.33 Chamber 3 _Inv. 94.88 94.89 Chamber 3-Top 95.34 95.33 Chamber 4_Inv. 94.88 94.89 Chamber 4_Top 95.34 95.33 Page 3 of 3 +'w� n -MAN t' � i4 spa" �r � 3 � s ywt4�' e - �SWR , MN am a d ]wembr 0,,2005 ,q� n3 # z i. �"x4 '.,,c �.,a t>". Tn car � x -,"'aw c ^X a�M f '•3it� �, t"a"': • •iii" �iur�'� 1ffi�` �°'ri[�iY�r fns ■ isur.�� :'i nlYlf/1It�llR }.Ytt{aRl�' ■�f Yn S'` ti4� si R� ■ IY Y X��1 +`�'h�tiKt*o'^a,ni''� +53�`e»z"Y2 y "f a'i" s39 s'7¢.`'#^ F t38:+`° =•9 &' t ' 04 pO o � Application r Septic Disposal Syste-D_ °L '�J�1'O� OF TODAY'S DATE 9C ►; - onstruction Permit — *��, •�.� �$ Full Repairy --� NORTH ANDOVER MA 01845 ��SSACeHUSFt{h ' .00 - Component Important: Application is hereby made for a permit to: When filling out ❑ C nstruct 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 ❑ Repair or replace an existing system component cursor-do not use the return A. FacilityInformation key. L nab Address or Lot# ,A1. City/Town 2.- *TYPE OF SEPTIC SYSTEM*: ❑ Pump ❑ Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser(Gravel-Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D-Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D-Box Present) S.A.S. 2. Owner Information, v L �D L l2c Name Address(if different from above) City/Town State Zip Code Telephone Number 3. Installer Information Name Name of Compan o i " Address Vn City/Town r State Zip Code Telephone Number(Cell Phone#if possible please) 4. Designer Information Name /J Name of Company le Address A/ City/Town � State Zip Code Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 pF "°aT"'9,y Application for Septic Disposal System It-10 -0S �_ ?" '�+° °� TODAY'S DATE ° pConstruction Permit — TOS OF $ 250.00–Full Repair 9a ORTH ANDOVER MA 01845 °°•CHU r•",�y ' $125.00 -Component S5ISE PAGE 2 OF 2 A. Facility Information continued.... 5. Type of Building: esidential Dwelling or ❑Commercial B. Agreement l«1GG...����� 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 i ed by this Board of Health. N me Date Application Ap oved By: (B rd of Health Representative) 1,2 f�;>57— Name Date Application Disapproved for the following reasons: For Office Use Only: L Fee Attached? Yes_/ No 2. Project Manager Obligation Form Attached? Yes L/ No 3. Pump S sy tem? If so,Attach copyo of Electrical Permit Yes_ No 4. Foundation As-Built?(new construction ronly): Yes_ No_ (Same scale as approved plan) '�d S. Floor Plans?(new construction only): Yes_ No Application for Disposall System Construction Permit•Page 2 of 2 All INSTALLER PROJECT MANAGEMENT OI&f6ATIONS As the North Andover licensed installer for the construction of the septic system for the property at '�� ©P ,grC L ti relative to the application of S' dated 11—,1a-o5_ for plans by c and dated G/—� 3-0 5—with revisions dated I understand the following obligations for management of this project: I. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work(other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersig icensed Septic Installer Date: I North Andover Board of Assr-')rs Public Access Page 1 of 1 Parcel ID: 210/106.11-0110-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge No Picture Available Location: 42 OLYMPIC LANE Owner Name: COLLINS,JOHN A ANN M COLLINS Owner Address: 42 OLYMPIC LANE City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 7 - 7 Land Area: 1.1 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 2414 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 470,700 450,200 Building Value: 271,100 260,200 Land Value: 199,600 190,000 Market Land Value: 199,600 Chapter Land Value: LATEST.SALE Sale Price: 191,250 Sale Date: 09/26/1984 Arms Length Sale Code: Y-YES-VALID Grantor: Cert Doc: Book: 01872 Page: 0197 http://csc-ma.us/NandoverPubAcc/J&sp/Ilome.jsp?Page=3&LinkId=467734 8/4/2005 Residential Property Record Card PARCEL ID:210/106.B-0110-0000.0 MAP:106.13 BLOCK:0110 LOT:0000.0 PARCEL ADDRESSA2 OLYMPIC LANE PARCEL INFORMATION Use-Code: 101 Sale Price: 191,250 Book: 01872 Road Type: T Inspect Date: 06/20/2002 Tax Class: T Sale Date: 09/26/1984 Page: 0197 Rd Condition: P Meas Date: 06/10/2002 Owner: Tot Fin Area: 2414 Sale Type: P Cert/Doc: Traffic: M Entrance: C COLLINS,JOHN A Tot Land Area: 1.1 Sale Valid: Y Water: Collect Id: RRC ANN M COLLINS Grantor: Sewer: Inspect Reas: C Address: 42 OLYMPIC LANE Exempt-B/L% / Resid-B/L% 100/100 Comm-B/L080 Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 9 Main Fn Area: 1188 Attic: NBHD CODE: 7 NBHD CLASS: 7 ZONE: R2 Story Height: 2 Bedrooms: 5 Up Fn Area: 1226 Bsmt Area: 1188 !Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43568 1 199,105 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.1 470 Masonry Trim: Ext Bath Fix: Tot Fin Area: 2414 VALUATION INFORMATION Foundation: CN Bath Qual: T RCNLD: 246457 Current Total: 470,700 Bldg: 271,100 Land: 199,600 MktLnd: 199,600 Kitch Qual: T Eff Yr Built: 1983 Mkt Ad': 1.1 Prior Total: 450,200 Bldg: 260,200 Land: 190,000 MktLnd: 190,000 Heat Type: HW Ext Kitch: Year Built: 1979 Sound Value: Fuel Type: G Grade: G Cost Bldg: 271,100 Fireplace: 2 Bsmt Gar Cap: Condition: A Att Str Vail: Central AC: N Bsmt Gar SF: 564 Pct Complete: Att Str Va12: Att Gar SF: %Good P/F/E/R: /100/100/89 Porch Type Porch Area Porch Grade Factor S 154 SKETCH PHOTO 14 11 154 Sq.R. 11No Picture 522-11 12 M ' 128 Sq.R. 564 Sq.R. 1k AL 2'4Av I a I* 23 1 38 1 12 Parcel ID:210/106.B-0110-0000.0 as of 8/4/05 Page 1 of 1 1 l TOWN OF NORTH ANDOVER Of NORTH 1 ' Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 y'ss�cMus�`h Susan Y. Sawyer, REHS,1RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX November 7,2005 Ann and John Collins 42 Olympic Lane North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 42 Olympic Lane, May 106B, Lot 110 Dear Mr.&Mrs.Collins The North Andover Board of Health has completed the review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated September 13,2005 and received by this office on September 13,2005. The design has been approved for use in the construction of an upgrade onsite septic system.This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work,and a Certificate of Compliance must be endorsed by the installer,designer and the Town of North Andover. This approval is subject to the following conditions: 1. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void, installation shall stop,and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer,septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission,Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 3. The plan does not call for installation of a septic tank effluent filter but one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use, if you choose to install one. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerely,' ; Sus Y. Sawyer, REHS/ S Public Health Director encl: List of licensed septic system installers cc: New England Engineering Services file T Nov• 14,;03 ._N ' ` N''t ANDOVER , ".y 9,7,86""�9.5.4�'': P. 1' Y r Town of North Andover HEALTH DEPARTMENT 27 Charles Street North Andover,MA 01845 978.688.9540 health dentra�ownofnorthandover.cam SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: SITE LOCATION: Q� /� J� an ENGINEER: ") NEW PLANS: YES $225.00/Plans DU Check#• (Includes X"�E amine Re-Review Only) REVISED PLANS: YES $75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: CD NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone#• ?'76p- -/7&, Fax#:- / W 16 q 9 E-mail: ✓6e e'n ad urn_ HOMEOWNER NAME: J61vt OFFICE USE ONLY �• 9;7 When the submission is complete(including check): X• Date stamp plans and letter 2• Complete and attach Receipt 3• ZVY File, Forward to Consultant RECEjtt,ED 4 E/ Enter on Lo Sheet and Database ase SEP 3 2005 TOWN O H p RTH AND �PARTk;��eF? I � • NEW ENGLAND ENGINEERING SERVICES INC September 13, 2005 Susan Sawyer R E C E I North Andover Board of Health 400 Osgood Street SEP 1 3 2005 North Andover, MA 01845 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Re: 42 Olympic Lane, North Andover, MA Septic System Design Plan Submittal Dear Ms. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. L (3) Copies of the Septic System Design Plans. 2. (2) Copies of the Form 1.1 Soil Evaluator Sheets. 3. (2) Copies of the Form 12-Percolation Test Sheets. 4. Septic Design Submittal Form. 5. Check for the Town approval fees. Please contact this office with any questions or concerns. Sincerely, Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 0 Commonwealth of Massachusetts City/Town of AJo41\ Av\dover MEED w Percolation Test Form 12 IT JI Percolation test results must be submitted with the Soil Suitability As e-sint—'firm- nr 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 John Collins only the tab key Owner Name to move your 42 OI m is Lane cursor-do not y--P_ - -- use the return Street Address or Lot# key. North Andover MA 01845 City/Town State Zip Code (978) 682-3874 Contact Person(if different from Owner) Telephone Number B. Test Results 8/24/05 9:08 Date Time Date Time Observation Hole# PT1 Depth of Perc 59 /19 Start Pre-Soak 9.08 – - — End Pre-Soak 9.23 - Time at 12" 9:23 Time at 9" 9:35 Time at 6" 9:53 Time (9"-6") 18 MIN. Rate (Min./Inch) 6 MIN./INCH Test Passed: ® Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Benjamin C. Osgood, Jr Test Performed By: Randy Burley, Mill River Consult n Witnessed By: Comments: t5form12.doc•06/03 Perc Test•Page 1 of 1 z. 'V Commonwealth of Massachus tts - - City/Town of ��er - Form 11 - Soil Suitability Assessment for On-Site Sewage Dispos SEP 1 3 2005 M TOWN OF '` H c • „)v :•� _r DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but t e_i cKnatio'n-must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information 1. Facility Information Owner Name O`yn1G 1 0. Q Map/Lot N + 110 Street Address IV64ti r— 9 y-.5- City/Town State Zip Code B. Site Information 1. (Check one) New Construction ❑ Upgrade ❑ Repair, C 2. Published Soil Survey available? Yes ,< No ❑ If yes: 11 '81 1%1.I✓,8 L� Year Published Publication Scale Soil Map Unit PAV40A go�oid �errncab'UtSoil NamSoil limitations J. Surficial Geological Report available? Yes ❑ No,� If yes: Year Published Publication Scale Map Unit �J 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 DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 1 of 7 Commonwealth of Massachusetts City/Town of A/o4V,% AvNjover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal G. Current Water Resource Conditions (USGS) A-040.14 o2045- Range: Above Normal ❑ Normal Below Normal ❑ Mont ear 7. Other references reviewed: C. On-Site Review (minimum of two holes required at every proposed disposal area) 0 Deep Observation Hole Number: TP l_ $ a`� os $:0 Date Time Weather 1. Location Ground Elevation at Surface ofnnHole q`Ioq r Location (Identify on Plan ) i�Qa��� L e-�'-► 2. Land Use: Res;d�flT% a (e.g.woodland,agricultura�field, acant lot,etc.) Surface Stones Slope(%) 6--rass 0y4wask Fla�/\ QGk S'Dp- Vegetation Landform Position on landscape(attach sheet) 3. Distances from: Open Water Body Q_ Drainage Way SZO Possible Wet Area fee feet feet Property Line AAf ._ Drinking Water Well D Other feet feet 4. Parent Material: q Unsuitable Materials Present: Yes ❑ No� If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock❑ Bedrock❑ 5. Groundwater Observed: Yes No ❑ If Yes: Depth Weeping from Pit_gq_ Depth Standing Water in Hole I DO Estimated Depth to High Groundwater: �f5It %34 DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 2 of 7 Commonwealth of Massachusetts City/Town of /Vor4n Av JOVef- Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal inches elevation Deep Observation Hole Number: Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Structure Soil Horizon/ Color-Moist (mottles) Texture % by Volume Consistence Other Depth Layer (Munsell) (USDA) (Moist) (In.) Depth Color Percent Gravel Cobbles -1J &Stones Var�es Ct q/G AA_S - o 5-h6 q5 it 7.5-Ye8 F5 1b0j0 50716 /A Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 3 of 7 Commonwealth of Massachusetts City/Town of ./jor+hv\d0ve-r - - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal H C. On-Site Review (Cont.) Deep Observation Hole Number: T�oZ g' 30 Date Time Weather 1. Location ,1 Ground Elevation at Surface of Hole Location (Identify on Plan ) Dear R� 0 15 CYO 2. Land Use: RestAASlope (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones ( ) G gags o u+w a s k tp l aau 5/oD e- Position on landscap (attach sheet) Vegetation Landform 3. Distances from: Open Water BodyDrainage Way feet feet Possible Wet Area feet00 feet Property Line To Drinking Water Well > 150 Other feet feet t 4. Parent Material: r0 "f WC1 Unsuitable Materials Present: Yes ❑ No If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s) ❑ Weathered/Fractured Rock[:] Bedrock❑ 5. Groundwater Observed: Yes ❑ No X If Yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: �o" qo,!I_ inches elevation DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal- Page 4 of 7 Commonwealth of Massachusetts City/Town of JVor+ \ AYdoer - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Deep Observation Hole Number: TIOR Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Soil Horizon/ Color-Moist (mottles) Texture % by Volume Structure Consistence Other Depth Layer (Munsell) (USDA) (Moist) (in.) Depth Color Percent Gravel Cobbles &Stones o-aa F;11 VO�c�eS V 0.��eS 9-a 3a 3o-y8 �aYR3/8 S a�� (gyp" I �1fR/8 _5 I o`Yp °la g_9F q Additional Notes DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal • Page 5 of 7 Commonwealth of Massachusetts City/Town of /J04' \ Ahaover ` 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. inches B inches ❑ Depth weeping from side of observation hole A. B. inches inches Depth to soil redoximorphic features (mottles) A. 5y ' TPI B. f'o0 Fa inches inches j ❑ Groundwater adjustment(USGS methodology) A. B. inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally ccurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? YesA No❑ N 11 b. If yes, at what depth was it observed? Upper boundary: y PI Lower boundary: IN T inches inches O F. Certification I certify that I have passed the soil evaluator examination' approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and and experience described in 310 CMR 15.017. 3/0S Si atur of Soil Evaluator Date Ochi ` c. el w�.1, J r /l�ov 1°la5' Typed or tinted Name of Soil Eval or *Date of,.Soil _Evaluator Exam Raundv BVI-)9 -/4"11 RiJ r CariSul-I-�Ylh A)o T�1�+�"hdaVQr- Name of Bo9d of Health Witn ss Board of Health Note: This form must be submitted to the approving authority with Percolation Test Form 12 DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal - Page 6 of 7 Commonwealth'of Massachusetts City/Town of / or4% �v\dover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Use this sheet for field diagrams: lJ DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 7 of 7 . BOARD OF HEALTH NORTH ANDOVER,MASS. 01845LAUG ; toy n 978-688-9540 APPLICATION FOR SOIL TESTS 0 4 2005 ©� MAP&PARCEL: OCA.C3 i I ;[>ovER DATE: tErrr LOCATION OF SOIL TESTS: F�Ag OF OWNER 5�t+� CU t t. t to S TEL.NO.: 91b- (o aZ ' 3924- ADDRESS: 9 74- ADDRESS: 4Z ENGINEER�QW k+u(�t.A-�11 EAV A rK.?1 t lk TEL.NO.: ' !78- (o�C�- t-70b CERTIFIED SOIL EVALUATOR V>eiV TAVWN C, 096M N JK l 1 tt VV1-11S Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing X Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No x THE FOLLOWING MUST BE INCLUDED WrM THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. 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 of3�per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered-Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-1001)shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not WhTe Belo 'ne ZI N.A.Conservation Commission Approval: 2 W5 Date Received: Check Amount: Check Date: iA .01 jM K� (%0) -1-D A�JXM ©� s ;1r� Ptj zs Y ilk jpcG 1 t ANF„ pl1NS`I Nq7•-\4-6Z..�� LY 4q.S� � r y O 0 I r z z N.p � p •Z Y W da ro rN a � rLp w �o A < OUSE �1� n � � O J a /v o - s� 'D s �o N n 0 Page 1 of 1 DelleChiaie, Pamela From: Lisa LeVasseur[lisal@millriverconsulting.com] Sent: Tuesday, August 30, 2005 11:02 AM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: 42 Olympic Lane Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 9/2/2005 1 8/ _� l J Zcr oy Y2 ��yw p''G LRrtt, /V_Aepov-c'-_ Sal-/ /3a�lc�e-c.- R:GLC k peen kclle# Cowsf to 11 7:23 J 3 s 5,7 7•S rK I rr-1 6/-/0/ G� FS s yS� "Wogrx�( 60'{ r .Z,7--Jo A e-s /orKs/ A.rrslc a 60. pro ndk4 /o rn 0 ikNEW ENGLAND ENGINEERING SERVICES -- INC November 7, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 42 Olympic Lane, North Andover,MA Alternative Design Criteria Using Quick 4 Standard Chambers Dear Ms. Sawyer, This letter is written to provide supporting design computations in anticipation of a field change with respect to the Infiltrator Chambers. It has been brought to our attention that the Infiltrator-Standard Chamber has limited availability with some distributors. In the event that the Infiltrator-Standard Chambers are not available,the Infiltrator-Quick4 Standard Chambers shall be used. Equivalent design calculations are as follows: Design Data (Infiltrator Quick 4 Standard Chambers) Percolation Rate: Design for 6 minutes per inch. Soil Class: I Design Flow: 5 Bedrooms x 110 gallons per day= 550 gallons per day Loading Rate: 0.70 gallons per square foot System size required: 500 gallons per day/0.70=785.71 sq. ft. System size provided: Use Quick 4 Standard Infiltrator units in a leach bed configuration Effective leach area per lineal foot of Infiltrator Quick 4 chamber: 4.72 square feet Lineal feet of Infiltrator Chamber required: 785.71 sq. ft. /4.72 sq. ft. per lin. ft. = 166.46 ft. 166.46 lineal feet/4 lineal feet per chamber=41.61 chambers required Use 4 rows of 11 chambers 44 feet long each row= 176 total lineal feet of chamber = 830.72 effective sq. ft. leach area. Septic tank required: 200% of daily flow(550 gallons x 2 = 1100 gallons) Septic tank provided: New 1500 gallon septic tank 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 Profile Data (Infiltrator Quick 4 Standard Chambers) Bottom of Bed Elev.: 94.34 Infiltrator Invert Elev.: 95.01 D-Box Outlet Elev.: 95.11 D-Box Inlet Elev.: 95.28 Tank Outlet Elev.: 95.63 Tank Inlet Elev.: 95.88 Foundation Invert Elev.: To Remain 96.50 Min. *Slope from foundation to tank shall be minimum 2%. *Slope from tank to distribution box shall be 1%. As with the Infiltrator Standard Chambers, the installer must be trained and certified by Infiltrator Systems, Inc. Details of the Infiltrator Quick 4 Standard chamber can be obtained from New England Engineering Services, Inc. at(978) 686-1768, or Infiltrator Systems, Inc. at(888) 886- 7704. The following documents are enclosed: 1. DEP approval-Modified Certification for General Use for the uick4 Standard chamber. pp Q 2. InfiltratorQ uick 4 Standard Chamber Product Brochure. 3. Infiltrator Quick 4 Standard Chamber Installation Instructions Please accept this letter and enclosures as supporting documentation to aid in the review and approval for the septic system design plan entitled, "Proposed Subsurface Sewage Disposal System, 42 Olympic Lane,North Andover, MA, Assessors Map 106B, Lot 110," dated September 13, 2005. Please contact this office with any questions or concerns. Sincerely, Thomas Hector Project Engineer t E I I i tJ 1 ` ` — NT I , F r AIV PIPE OUT OF N5E.T_ .45 E5 U i L 1 I fel V PIPE 1 NTD T.o.>`.l►L - i 6t v PI ouTaF rA"V 17 cJ U 1 N y_ PIPE INTO �j-5 U P.rAC F- D I P05A L . p.13oX i Q�, 'r�? INV D1 P Q ►T-Q.IsnX • ,� FczANK GC7E�.tir.tAS � A'SS�tn.T'ES T �St QtJ DCI�l�i2 5T I�v. L1r,1[7G?�lEt2 1, iMi � r �y t