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Miscellaneous - 42 PENNI LANE 4/30/2018 (2)
P 42 PENNI LANE 210/107.D-0060-0000.0 .... _.. -. ,,•.;.,,� du a�o,;�v,. d,�..„,.;"'w'�„�,�r..aw,..ww,�,r,amw���ra::w�ars�wws�•n� a'�re-�� ma„. - .-�re�anw�»•ws.zb.�w.e„.-ra'.'gv�wSaW^mw.,sclawm �..._ u�ratia;n�-,.,.,�„�,,.. .,, ,. y .,•,s.s.� ►. ,�.W........._ .s.. s. 42 PENNI LANE JS-2005-0074 Project Detail Report Printed On:Mon Jul 26,2004 Project Name: GIS#: 7935 Project No: JS-2005-0074 Owner of Record TAGARAS,MICHAEL A&JO Map: 107.1) Date Submitted: May-17-2004 42 PENNI LANE Block: 0060 Status: Open NORTH ANDOVER, MA 01845 Lot: Work Category: Work Location: 42 PENNI LANE Zoning: Proposed Use: District: land Use: 101 Proposed Use Detail Subdivision Description Septic System Comments: of Work: Department Status - GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2004-0104 Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: Plan Review BHP-2004-0534 Jul-23-2004 SIGNED OFF JS-2005-0074 Plan Review Soil Testing-Repair BHP-2004-0533 Jul-07-2004 SIGNED OFF JS-2005-0074 Soil Testing GeoTMS®2004 Des Lauriers Municipal Solutions,Inc. Page I of 1 Commonwealth of Massachusetts RECEIVE® City/Town of No Andover System Pumping � 'v `I 201 p 9 Record Form 4N 1 GVYN C). OR, N �h i, DOVER - I HEA.` rroE7P,P DENT 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, use only the tab e jn 1 key to move your Address cursor-do not No Andover use the return Ma key. City/Town State Zip Code 2. System Owner: a Name Teton Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record L 1. Date of Pumping C 7 - 1560 p g Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) ( Septic Tank ❑ Tight Tank 9 ❑ Grease Trap �I ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: cXJ 6. System Pumped By: Name Vehicle License Number Stewa Service Company 7. Location wher ontents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signature of Hauler Date Signature of Receiving Facility Date t5fonn4.doc-03/06 System Pumping Record•Page 1 of 1 LAW OFFICE OF PETER J. RADULSKI Licensed in Massachusetts and New Hampshire 112 MIDDLE STREET TELEPHONE: (978)458-2111 SECOND FLOOR FAX: (978)459-7728 LOWELL,MASSACHUSETTS 01852 WWW.PETERRADULSKILAW.COM FRECEIVEO.*]DFebruary 25, 2011 120 Mr. John Soucy Soucy's Sewer Service, Inc. 78 North Broadway Rte. 28 Salem, NH 03079 Re: Matthew Savory 42 Penni Lane, North Andover, MA 01845 Dear Mr. Soucy: The following constitutes a Demand Letter pursuant to M.G.L. c.93A, the Consumer Protection Statute. As you know, my office has been consulted and retained by Matthew Savory ("Savory") with regard to the above-captioned claim. Based on m review of documents related to this claim and y by discussions with my client, I have been made aware of the following facts: On or about August 31, 2004, Savory purchased the property at 42 Penni Lane, North Andover, MA 01845 (the "property"). I As a condition to the purchase of the property the sellers (Michael and Jo Elizabeth Tagaras) were required to install a new septic system for the home. The sellers hired Soucy's Sewer Service, Inc. ("Soucy") to complete the installation. On or around August 25, 2004, Soucy completed the installation of the septic system on the property and sought approval from the Town of North Andover's Public Health Director. On or About April 12, 2010, Savory applied for a building permit to build a two story addition to the current home. As part of the approval process Savory was required to submit a subsurface sewage disposal system plan to the North Andover Health Department. After review by the Health Department Savory was informed that he needed to increase the size of the present Mr.John Soucy Soucy's Sewer Service, Inc. February 25,2011 Page 2 septic system by adding a third trench. The cost for this work was estimated at approximately $8,800.00. However, as work began on the installation of the third trench, it became apparent that there were problems with the present septic system that was installed by Soucy back in August of 2004. First, Savory was made aware of the fact that the second trench had been broken and never worked since the date of installation back in August of 2004. Further, the second trench was not buried to the correct depth. Second, the sand that was used by Soucy for the soil absorption system back in August of 2004 was not compliant with the requirements set forth under the Code of Massachusetts Regulations. Based on an investigation and testing of the sand it appeared that Soucy filled most of the soil absorption system with non-compliant sand and added a finished layer of a few inches of compliant sand on top for purposes of concealing the non-compliant sand below. As a result of the above listed problems and actions by Soucy, Savory was required to excavate and remove the entire septic system, including but not limited to the soil used for the absorption system that was installed by Soucy back in 2004. Savory was then required to install an entirely new system incurring costs in excess of$34,500.00, which was over and above the original estimate of$8,800.00 On or around July, 2010, my office contacted Soucy via telephone and spoke with a representative and informed her of the situation. During the conversation this office requested that Soucy contact us to further discuss the matter and/or provide this office with a contact for Soucy's legal representative and/or insurance carrier. On July 19 2010 after no response, this office sent a letter to Soucy memorializing Savory's notice of the alleged problems again requesting the Soucy refer this matter to his counsel and/or insurance company for further handling. To date, there has been no response from Soucy and/or its representatives. Based on the above-mentioned, it is our position that the actions of Soucy's Sewer Services, Inc. and/or its representatives, agents, servants or employees, were willful and knowing actions and constitute unfair and deceptive acts or practices under M.G.L. c.93A, §2. As a result of Soucy's and/or its representatives, agents, servants or employees, willful and knowing violations, Savory has been caused to suffer considerable damages, including, but not limited to, actual monetary damages and attorney's fees. Savory is willing to resolve this matter in a reasonable manner, and has authorized my office to present you with a demand in the amount of$34,500.00, as full and final settlement of all claims he may have against Soucy. Mr.John Soucy Soucy's Sewer Service, Inc. February 25,2011 Page 3 Massachusetts General Law, Chapter 93A gives you the opportunity to make a good-faith s response to this letter within thirty (30) days. Should a good faith response not be forthcoming within the next thirty (30) days, it is our intention to file a Complaint in this matter to include a claim against Soucy for unfair and deceptive acts in violation of M.G.L. c.93A. Thank you for your immediate attention to this matter. Very ly yrs, Pete . Radulski PJR/km CERTIFIED MAIL R/R/R 7008 0500 0000 6842 4363 /cc: Susan Y. Sawyer, Public Health Director I HEREBY CERTIFY THAT THE SUBSURFACE SEPTIC DISPOSAL SYSTEM INSPECTION HAS BEEN CONSTRUCTED IN GENERAL CONFORMANCE WITH THE PORT (TYP.) +91.0 APPROVED PLAN LISTED BELOW. CERTIFICATION IS FOR THE HORIZONTAL 3 TRENLCNES_O_F__1�QUICK4 AND VERTICAL LOCATION OF SYSTEM COMPONENTS AS SHOWN ONLY. �91.z__ - as- _ STANDARD INFILTRATOR CHAMBERS vs- 40mi1. fMPERVIOUS TITLE: SUBSURFACE SEPTIC DISPOSAL SYSTEM REPLACEMENT +96.3 LINER. 42 PENNI LANE VENT �-- -96 NORTH ANDOVER, MA RISER / +97.8 \ -a6- PREPARED BY: O'NEILL ASSOCIATES +93.2 / � +99.0 \ +98. +99.4 +95.2\ / / \ DATE: JULY 28, 2010 - REVISED AUGUST 13, 2010 6 OUTLET H-20 +96.8 / 5 DISTRIB. BOX 98. 6 � 9.0 99. + '''1 ' •'�,;u 2j Luke J. Roy, P.E. W i HOFM '- ss.s �Sgss9 o -- 8 G cn --- _-_._.�o � � I I `� LUKE.t.fiOY m , CIVIL No.47s56 g 3 +99.9 +97j +100.4T (D 2 DO t NA +98.8 1 2 4" SCH40 / 4.2 +100.4 0 / PVG'(TYP.)/ °s 4 7 d i EXIST. 1500ga1 BM#1 SEPTIC TANK l, +97.9/ 17h T" SCHEDULE ®F INVERTS PROPOSED As-IBuiLT 99.9 9 B DECK I �. SEPTIC TANK INVERT (OUT) EL.=98.86 EL.=98.80 .I .. i,�i � r� r; -� -' DISTRIBUTION BOX INVERT (IN) EL.=98.50 EL.=98.60 �' DISTRIBUTION BOX INVERT (OUT) EL.=98.33 EL.=98.42 ' CHAMBERS INVERT EL.=98.27 EL.=98.31 BOTTOM OF CHAMBERS EL.=97.6 EL.=97.66 NEW i�A V ADDITION x' 2 STORY WOOD FRAME AS-BUILT TIES ; NOTE: AS-BUILT FIELD MEASUREMENTS TAKEN 11-1-10 �c 12-6-10 #42 FIELD BOOK 119, PAGES 89-90 POINT NO. A B 1 33.8' 30.2' - - - 0 'NEILL A a5" CIA TE 2 37.0' 55.0' 3 37.8' 52.8' -4 Civil Engineers and Land Surveyors r� 234 Park Street 4 75.0' 42.2' North Reading, MA 01864 5 90.3' 65.6' PENNI LAN E SUBSURFACE SEPTIC SYSTEM g 63.5' 73.0' 7 78.2' 46.6' BENCHMARKS (ASSUMED DATUM) 2 P BUILT 8 70.0' 37.6' PLA NO. DESCRIPTION ELEVATION 42 ENNI LANE 9 62.7' 26.6' NOT TO SCALE BM#1 TOP RT. COR. STAIR FTG. 100.00 NORTH ANDOVER, MASSACHUSETTS ASSESSORS MAP 107® PARCEL 60 10017ASB.DWG DECEMBER 7, 2010 1 r DelleChiaie, Pamela From: Isaac Rowe[irowe@millriverconsulting.com] Sent: Monday, November 08, 2010 9:27 AM To: 'Daniel Ottenheimer; Grant, Michele; irowe@millriverconsulting.com; 'Marianne Peters'; DelleChiaie, Pamela; 'Randy Burley'; Sawyer, Susan Subject: 42 Penni Lane Attachments: 42 Penni Lane- Final Construction Inspection 11-4-10.doc Susan, Please find attached the final construction inspection form for the above referenced property. As you know, this was a repair for a system that was not very old. It was installed about 2002 1 believe. They reused the existing tank. Please let me know if you have any questions. Thank you, Isaac Isaac M. Rowe R.S. Project Manager Mill River Consulting 6 Sargent Street 'I 1 r- li North Andover Health Department Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 42 Penni Lane MAP: 107D LOT: 60 INSTALLER: Craig Waelty DESIGNER: Luke Roy PLAN DATE: 7/28/10 BOH APPROVAL DATE ON PLAN: 8/25/10 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: lc� DATE OF FINAL CONSTRUCTION INSPECTION: 11/4/10 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS NA Contractor reports any changes to design plan NA Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: SEPTIC TANK Comments: Existing tank being reused. DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box NA Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution NA Speed levelers provided (not required) .-- f Comments: SOIL ABSORPTION SYSTEM (General) J Bottom of SAS excavated down to C soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan NA Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ® Number of chambers per row: 15 ® Number of rows (trenches): 3 Comments: Total Chambers = 45 BM = 100.00 HR = 1.84 HI = 101.84 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark 1.84 100.00 Building Sewer OUT 99.78 Septic Tank IN 99.08 Septic Tank OUT 2.72 98.77 98.86 Distribution Box IN 2.89 98.60 98.50 Distribution Box OUT 3.07 98.42 98.33 Lateral 1 TOP 3.20 Lateral 1 INVERT 98.29 98.27 Lateral 2 TOP 3.20 Lateral 2 INVERT 98.29 98.27 Lateral 3 TOP 98.29 Lateral 3 INVERT 98.29 98.27 Top of Chamber 3.24 98.6 98.6 Bottom of Bed/Chamber 4.24 97.6 97.6 P 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 10 101 ® 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 s I HEREBY CERTIFY THAT THE SUBSURFACE SEPTIC DISPOSAL SYSTEM HAS BEEN CONSTRUCTED IN GENERAL CONFORMANCE WITH THE A05 Woo INSPECTION +91.0 APPROVED PLAN LISTED BELOW. CERTIFICATION IS FOR THE HORIZONTAL PORT (TYP.) AND VERTICAL LOCATION OF SYSTEM COMPONENTS AS SHOWN ONLY. 3 TRENCHES_f1=15--QUUICK4 STANDARD INFILTRATOR CHAMBERS --i6 40mil. I PERVIOUS TITLE: SUBSURFACE SEPTIC DISPOSAL SYSTEM REPLACEMENT +965.3 LINER. 42 PENNI LANE VENT / -6565 NORTH ANDOVER, MA --� � RISER / +97.8 ---865-- PREPARED BY: O'NEILL ASSOCIATES +ss.o � +93.2 +9 +99.4 \ +95.2\ / �-\ 6 OUTLET H-20 DATE: JULY 28, 2010 - REVISED AUGUST 13, 2010 g4--"+96.8 / / cJ DISTRIB. BOX L 9.0 +99. Luke J. Roy, P.E. o I I V,tH OF Mqs 00 gas $ �� `boy R♦ 1 '0 Ln �o ' LUKE J.ROY -4 CIVIL y Olin-� ZOtO N0.47356 g 3 +965.65 �'� 9�G� T �� �c`cQ T HEA OF NORTH ANDOVER +100.4 2 H DEPARTMENT +98.8 I 1 � 4" SC�140 / 4.2 +100.4 0 PV (TYP.) ��� 7 0� EXIST. 1500gal \ BM#1 SEPTIC TANK ` +97. SCHEDULE OF INVERTS PROPOSED AS-BUILT 99.9 9 . B DECK 1 SEPTIC TANK INVERT (OUT) EL.=98.86 EL.=98.80 65.8 DISTRIBUTION BOX INVERT (IN) EL.=98.50 EL.=98.60 9 .1 DISTRIBUTION BOX INVERT (OUT) EL.=98.33 EL.=98.42 CHAMBERS INVERT EL.=98.27 EL.=98.31 NEW BOTTOM OF CHAMBERS EL.=97.6 EL.=97.66 ADDITION 2 STORY WOOD FRAME BIT. DRIVE AS-BUILT TIES NOTE: AS-BUILT FIELD MEASUREMENTS TAKEN 11-1-10 & 12-6-10 POINT NO. A B ' #42 FIELD BOOK 119, PAGES 89-90 1 33.8' 30.2' ► O 'NE'ILL ASSOCIATES 2 37.0' SS.o' ^, ^, 0 Civil Engineers and Land Surveyors 3 37.8' 52.8' , 234 Park Street 4 75.0' 42.2' North Reading, MA 01864 5 90.3' 65.6' PENNI LANE SUBSURFACE SEPTIC SYSTEM g 63.5' 73.0' 7 78.2' 46.6' BENCHMARKS (ASSUMED DATUM) AS-BUILT 8 70.0' 37.6' PLAN NO. DESCRIPTION ELEVATION 42 PENNI LANE 9 62.7 26.6 NOT TO SCALE BM#1 TOP RT. COR. STAIR FTG. 100.00 NORTH ANDOVER, MASSACHUSETTS ASSESSORS MAP 107D PARCEL 60 10017ASB.DWG DECEMBER 7, 2010 -� - o f �RTNq Application for Septic Disposal System -Construction Permit — TOWN OF TODAY'S DATE i''°" = •�'' MA 01845 $250.00—Full Repair ORTH ANDOVER 4.;b,,„°.•��� . $125.00-Component SgACHUSt Important: Application is hereby made for a permit to: When filling out ❑ Construct a new on-site sewage disposal system* forms on the computer,use ❑ Repair or replace an existing on-site sewage disposal system* only the tab key // to move your [G- epair or replace an existing system component—What? ( t2 1 DAA cursor-do not use the return key. A. Facility Information k( Z t��,/Lq ry i L twos 1K tL t v 7 D Pbwa C k6 rm5 Address or Lot# 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 UVl t+-t`T C-4�-'l v 5 /41/U 12 Name S Address(if differe t from above) T41 � GUI��C�l��2 City/Town State Zip Code Telephone Number 3. Installer Information 0_QU416 W 6� ,, 196� & CoIeVST .CIO Name , nLf Name of Company (P 1 0 Address too -Cron lig City/Town State Zip Code -S-0'5 7 z4) 1304, Telephone Number(Cell Phone#if possible please) 4. Designer Information LU t'_'e Name Name of Company Address City/Town State Zip Code Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 o O, ►ORTM, Application for Septic Disposal System 0 k `AConstruction Permit - TOWN OF TODAY'S DATE ''�' • ��'+ ORTH ANDOVER MA 01845 $250.00-Full Repair °•,... �� $125.00-Component �SSACHuS°t PAGE 2 OF 2 A. Facility Information continued.... 5. Type of Building: [residential 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 issued by this Board of Health. �QP�A_16 (Aj LI Z Name Date Applicati ti Approved By: (Bo d of Health Representative) NNaa, e Date `Application Disappred for th following reasons: For Office Use Only: 1. Fee Attached. Yes_/ No V 2. Protect Manager Obhgatron Form Attached. Yes No 3. Pump S9ystem? If so,Attach coj%v of Electrical Permit Yes No 4. Foundation As-Built?(new construction ronly): Yes No (Same scale as approved plan) 5. Floor Plans?(new construction only): Yes No Application for Disposal System Construction Permit•Page 2 of 2 SE..�PTIC SYSTEM INSTAQER PROJECT MANAGEMENT OQ'IGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: 2- (Address of septic system) For plans by (Engineer) Relative to the application of (f�1141 t/ (Installer's name) And dated -3122210 ngma ate Dated /to o ay s ate With revisions dated �2�/ (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the a1212roved 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 manager, 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 Title 5 and the Board of Health Regulations may result in a$50.00 fine being levied against me and/or MY compan' a. Bottom of Bed—Generally, this is the first (1'� inspection unless there is a retaining wall,which should be done first. The installer must request the inspection but does not have to.be present. b. Final Construction Inspection—Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OK (or e-mail to: healthdel2tQtownofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade—Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simile excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board 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. Undersigned Licensed Septic Installer: b (Today's Date 06 L-1` J ame—Print) ame--Signed) �—L\ Commonwealth0Massachusetts r - 0. w `City/Towwo" f NORTH ANDOVER, MASSACHUSETTS System Pumping Record ` Form 4 DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving au ECEIVED A. Facility Information Important: SEP 11 2007 When filling out 1. System Location: • ,. � TOWN OF NORTH ANDOVER forms on the HEALTH DEPA RTNAFbIT computer,use only the tab key Addre to move your cursor-do not Cit !Town State Zip Code use the return y key. 2. System Owner: Name �1�'16 Nf Y ' Address(if differe from ocation) City/Town State Zip Code Telephone Number B. Pumping Record i 1. Date of Pumping 2. Quantity Pumped: Date Gallons 3. Type of system: ❑ Cesspooi(s) �Oeptfc Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes *--No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of system: 0 IA- 6. System Pumped By: 7? 40'a N <7 n Vehicle License Number 1G/ Company 7. Locatio where contents were disp ed: L , Signa r of Haul Date http://www.mass.gov/depY'water/a""pprovals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Y •• • North Andover Health Department (ommunity Development Division August 25, 2010 Matthew and Gail Savory 42 Penni Lane North Andover, MA 01845 RE: Septic System Design, 42 Penni Lane Map 107D Lot 60 Dear Mr. and Mrs. Savory, 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 O'Neill Associates dated July 28, 2010, last revised August 13, 2010 and received August 19, 2010. This plan has been approved. The design has been approved for use in the fully compliant construction of an onsite septic system for a 6-bedroom house (maximum 13-room). In accordance with state subsurface disposal regulations plans shall expire three years from the date approved unless construction on the lot has begun. 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. The-previously issued disposal works construction permit has been rendered void. The contractor must apply and receive the current approved plan. There will be no charge for this since no inspections had occurred. Please notify your contractor. 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. 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 or imply 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com J compliance with any of the aforementioned requirement. �VV 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 may have. Sincerel Susan Y. Sawyer, HS/RS Public Health Director Cc: Luke O'Neill, O'Neill Assoc. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com LE COPY North Andover Health Department (ommunity Development Division August 10, 2010 O'Neill Associates Attn: Luke Roy,P.E. 234 Park Street North Reading, MA 01864 Re: Subsurface Sewame Disposal System Plan for 42 Penni Lane Map 107D lot 60 Dear Mr. Roy: The proposed wastewater system design plan for the above site dated July 28,2010 and received on August 9,2010 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. Depiction of the distances from all tanks, and primary, and reserve soil absorption areas to subsurface, interceptor and foundation drains, catch basins, property lines, dwelling so other structures etc(NA 11 3.2 Design req.)Please add distances to plan. :✓a. house to tank b. house to field /c. field and lot lines d. deck to tank Shed noted on the plan over a portion of the area to be excavated. Please note where shed shall be relocated. May not be over any portion of the leaching area. Should be at least 10 feet from leach area,but must also meet other pertinent setbacks in regards to the building and zoning departments. Owner noted verbally to the Health Dept. his concern over the lack of cover over the septic tank. It is understood that the plan does not call for a new tank,however, if this is an issue of concern please note on plan that work may need to be done in this area and the description of the required outcome to comply with Title V. V114. Impervious barrier shown on plan, but not on the system profile or leach area plan. Please add to be consistent. / 5. Please add note that the installer shall be trained and certified by the manufacturer to ` install infiltrators and other pertinent information. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorth andoversom 0 42 Penni Lane Septic Plan Disapproval August 10, 2010 Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincerely S san Y. Sawyer, REH S Public Health Director cc: Matthew and Gail Savory, owners File 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townofnorthandover.com (D 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 15.255: continued . (f) where a retaining wall to stabilize the slope is required and also is proposed as an impervious barrier,in addition to meeting the requirements in 310 CMR 15.255(2),it shall be constructed of suitable structural material and be designed by a Massachusetts Registered Professional Engineer. (3) Fill material for systems constructed in fill shall consist of select on-site or imported soil material. The fill shall be comprised of clean granular sand,be free from organic matter and deleterious substances, and shall notcontain Remediation Waste as that term is defined in 310 CMR 40.0000. Mixtures and layers of different classes of soil shall not be used. The fill shall not contain any material larger than two inches.A sieve analysis,using a#4 sieve,shall be performed on a representative sample of the fill.Up to 45%by weight of the fill sample may be retained on the#4 sieve. Sieve analyses also shall be performed on the fraction of the fill sample passing the #4 sieve, such analyses must demonstrate that the material meets each of the following specifications: SIEVE SIZE EFFECTIVE %THAT MUST PARTICLE SIZE PASS SIEVE # 4 4.75 mm 100% #50 0.30 mm 10%- 100% #100 0.15 mm 0%- 20% #200 0.075 mm 0%- 5% A plot of the sieve analyses of the portion of the sample passing the#4 sieve shall fall on or between the lines on the following graph: PARTICLE SIZE DISTRIBUTION #200 #100 #50 #4 Sieve Size 100 90 80 0 70 cr 60 Q 0 a_ 0 CW7 50 4 O ' W40 W iL 30 _ 20 10 01 100 0 Micron 60 200, 600 2 6 10 mm 4/21/06 310 CMR-534 Of NORT//, • 4 4 3? �?° c I•ti00t Town of North Andover fibs;„`e4,'s HEALTH DEPARTMENT,,' CHECK#: DATE: 9D/ LOCATION: Z. H/O NAME: ' r CONTRACTOR NA E: Type of Permit or License: (Check bvx)'I ❑ 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 $ ❑ Tras4lSolid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑❑ Septic-Soil Testing $ 0- Septic-Design Approval $� ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ / K Health Agent Initials E White-Applicant Yellow-Health Pink-Treasurer o TOWN OF NORTH ANDOVER _ �. Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ° 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36s"° « �-• �a NORTH ANDOVER, MASSACHUSETTS 01845 #�$ACH� 978.688.9540—Phone Susan Y. Sawyer, REHS/RS 978.688.8476—FAX Public Health Director E-MAIL: healthdeptgtownofnorthandover.com WEBSITE: http:Hwww.townofiiorthandover.com SEPTIC PLAN SUBMITTAL FORM wl Date of Submission: -7 ( 7- 5 4 6 0 p ql� ►� 10 � 2- 1 Site Location: e ►�Vt I l– -N � T OR NOM DOVER HEALTH Off PARTM2NT Engineer: L-�e Py New Plans? Yes J $225/Plan Check# (includes l st submission and one re- review only) Revised Plans?Yes $75/Plan Check # Site Evaluation Forms Included? Yes No J N/A Local Upgrade Form Included? Yes No �j/)P, Telephone#: 01 Fax #: -7� - k� � 1 " g � Lf Z E-mail: Homeowner Name: Ma- e W OFFICE USE ONLY When the submission is complete (including check) o�19e ➢ / Date stamp plans and letter eA-V4 5 ➢ Complete and attach Receipt a� d ➢ Copy File; Forward to Consulta '` - ➢ —Enter on Log Sheet and Databas `-0 O y TOWN OF NORTH ANDOVER NOWT Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ° 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 CHU 978.688.9540—Phone Susan Y.Sawyer, REHS/RS 978.688.8476—FAX Public Health Director E-MAIL: healthdept(Atownofnorthandover.com WEBSITE: http://www.townofiortliandover.com SEPTIC PLAN SUBMITTAL FORM Date of Submission: -7 Z S 10 Hio Site Location: Z 1 yl Vt 1 Lo-N -Fn9 TOWN OF NOIFFM DOS HEA L H DffpAR'PItNT Engineer: New Plans? Yes J $225/Plan Check # (includes Is' submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes No N� Local Upgrade Form Included? Yes No ►`f Telephone#: Fax E-mail: Homeowner Name: M 6t��'ti VU 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 . o o AO arm coftsmflon Testing ftow YBWN OF 4§W�AN HgR►6Tt�q@� LETTER OF M4.NSWTTAL—SOIL T—FSTINGkLSL.,I.. V S"PLE NO LOCAtION: PROJECT NO. Sam le Submitted By 0 UT Representative: Date Submitted: � �... ether: C of Ca _ ` A . SOURCE Nt A ,�. 917 el 444 �r l q - Oa-Site Existing @a Location- 0 0if-5iie UrTow from- PROPOW)USE: MATERIAL SLTBND AS REOY-TESTED TESTII�G a SmeuraUGran.uiar Fill: Aceradadon Analysis m Ordinary Bormv MHD.W.01.d(ShaU be approved by the Aruhi Q 'W '00 Particle Size Distribution Report zd TOWN OP NORTH ANDD r HEALTH DEPARTMENT 00 — _ -- t ` — Spacr.Cn110n'.. 9070 I Uj I' 80 j... .. LU I: • II 0LU i 20 I I ' 20 10 _....� I � •I Ii i I 1 p Ij i I ! i1 300 +.00c,r� 0.0a� GRAIN SIZE- Ir m +o CpEpl.wg I %GRAVEL SAN /o° D n i °fa 0.0 .o SILT CLAY o. 84.5 _ IO.� ' SIEVE PERCENT BPHC," PASS? Material Description SIZE FINER I PERCENT (x=Na) SEPTIC SAND #20 i 90.0 B:IQ 78,0 #50 I 67.2 10 i 00 Atterberg LImIts A-100 30.5 0.20 ! x PL 4 LL= PI= #200 10.5 0-5 x c a officiants i D95= 0.564 D30= 0.259 D50== 0,2 16D30= 0.148 015= u.0925 010_ CLI= G-= j USCS- Classification AASHTO= I Remarks 1.9%-BY WEIGHT OF THE S:MPLF RETAINED ON THE I I S'1;'TF.1-:NV1RONh.4F'W'i':%1, v Sample No,: :';x Source of Sample: ON S1'1'r Date: 71H/MO Location: Elev,/Depth: UTS OF MASSACHUSETTS, INC, Client: ONEILL ASSOCIATES 5 Richardson Lane I Project: 42 PENhI LANE,NORTH ANDOVER,i to LLI _ StonehT, MA 02180 PEoject No: Figure 2i.8 � 7M -=1"A c i n -- .-„-.,, — 00 00 l De''w"_Chiaie, Pamela From: Sawyer, Susan Sent: Monday, April 05, 2010 3:00 PM To: 'matsavory@verizpn.net' Cc: DelleChiaie, Pamela; Grant, Michele Subject: 42 Penni Lane Attachments: SKM BT_60010040514390.pdf Mat, Please find the attached approval letter. We will send you a hard copy in the regular mail. I have signed your building permit as well, so your contractor can get that permit moving as well. Thank you, Susan Sawyer Health Director 1 ED 1 _ 6� 4® Q a .i'a 6e if 6 0 f it , _ oR4 Coewi.i..■ 0 R'4TED 77SS�iCaB19`''�416`9 PUBLIC HEALTH DEPARTMENT Community Development Division April 5, 2010 Matthew and Gail Savory 42 Penni Lane North Andover,MA 01845 RE: Septic System Design,Trench addition, 42 Penni Lane Map 107D Lot 60 Dear Mr. and Mrs. Savory, The North Andover Board of Health has completed the review of the septic system design plans for the addition of a single trench and associated pipe,for the above referenced property, submitted on your behalf by O'Neill Associates dated February 3,2010, last revised March 22, 2010. This plan has been approved. The design has been approved for use in the fully compliant construction of an onsite septic system for a 6-bedroom house(maximum 13-room). In accordance with local subsurface disposal regulations"Acceptable plans and any variances shall expire two years from the date approved unless construction on the lot has begun". During this time, a licensed septic system installer must obtain a permit and complete this work,and a Certificate of Compliance be endorsed by the installer,designer and the Town of North Andover. This approval is 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. 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 or imply compliance with any of the aforementioned requirement. `fib: Lan 2 Penni � O 0 q 4 e S.A.S sin le'1 rench a raval letter 415/2010 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 may have. Since r y, Ausan Y. Sa" er REM9 RS �'Y Public Health Director Cc: Luke O'Neill, O'Neill Assoc. II TOWN OF NORTH ANDOVER °f N�RTN Office of COMMUNITY DEVELOPMENT AND SERVICES o`'F+��a`�-•�°°} HEALTH DEPARTMENT , 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 :�e • ��'� NORTH ANDOVER,MASSACHUSETTS 01845sAC 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdept@townofnorthandover.com WEBSITE:http://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM Date of Submission: Site Location: �{ 2 NAS, L_o_,.t2 Engineer: L-J New Plans? Yes $225/Plan Check# (includes Ist submission and one re- review only) ECEIVEI� Revised Plans?Yes $75/Plan Check# f�1,4 2 4 2 10 Site Evaluation Forms Included? Yes No ✓ NIA TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Local Upgrade Form Included? Yes No /v /9 Telephone#: $' G(0 9 IT/y f (I)Fax#: �f 7 8 — G C-Lf — g 1 '-k k E-mail: Homeowner Name: c' )Co-� OFFICE USE ONLY When the submiss�'on is complete (including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ Enter on Log Sheet and Database I I i 4� r /� .., � `� '�/) f1 lam- � /nx\ ., Lr 0 Town of North Andover a°RTN Office of the Health Department Community Development and Services Division 27 Charles Street +O�4t.° North Andover,Massachusetts 01845 CH Susan Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax C'E1R�II FICA�I'E O F C01V11�'�IAYCE As of: August 25, 2004 '7fiis is to cert that the individual su6surface disposal system repaired(v — Full System by ,john Soucy at 42 Penni .Gane NorthAndover, -%,A 01845 has been installed in accordance with the provisions of Iztfe v of the State Sanitary Code and with the North Andover Board of.?fealth regulations. 'The Issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. Susan T Sawyer, �,E.�fS fu6lic Yfealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 f ' TOWN"OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( )constructed; (X)repaired; b3�_ To N1�1 O UQ J .located at e tr of was installed in conformance with the North Andover Board of Health approved plan, System Design Permit.# ,plan dated ,with a design flow of gallons per day. The materials.used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR.1S.000,Title S 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: _ 94py . t, Engineer Representative Final inspection date: 8kLoy7�- Engineer Representative Installer: `- _ Lic.#: Date: w of�s� � --�— q Engineer: BE IM a�, Date: clv1� No.46899 fS'��C�C ��sroNA RECEIVED AUG. 2004 TOWN HEALTHvDEPARTMENTER d 0 Dellechiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Wednesday, August 11, 2004 2:53 PM To: pdellechiaie@townofnorthandover.com Subject: RE: 42 Penni Lane- Final Inspection Request y Cal Daniel Ottenheimer (info@millr... All set for tomorrow(8/12) at 7:30 a.m. Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com info@millriverconsulting.com -----Original Message----- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com] Sent: Wednesday, August 11, 2004 9:00 AM To: 'Daniel Ottenheimer(E-mail)'; 'McBrearty Andrew(E-mail)' Subject: 42 Penni Lane - Final Inspection Request Hi Guys, Can you put this on your schedule? Thanks. -----Original Message----- From: Sawyer, Susan Sent: Wednesday, August 11, 2004 8:53 AM To: Dellechiaie, Pamela Subject: 42 Penni Lane is ready for a final insp The engineer, Steve, from Merrimack just called Susan Sawyer, REHS/RS Public Health Director North Andover Health Department 27 Charles Street North Andover, MA 01845 i 00 O BOARD OF HEALTH NORTH ANDOVER MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: JLZ! 0 Y MAP&PARCEL:_M T -7 I L 9T GCS LOCATION OF SOIL TESTS: �U, Ren.n l Levi OWNER: /�c_In a A Q a r aS TEL.NO.: ADDRESS: ENGINEER: > �I1�vla Fn�mee�t erYice TEL.NO.:_��78I CERTIFIEDSOIL EVALUATOR: q Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No x THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$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 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write B low This Line N.A.Conservation Commission Approval: Date Received: Check Amount: Check Date: r II� Of o a 0 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at relative to the application of drn. (,vaq dated for plans by e �,��, and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer,must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersi d Licensed Septi Installer Date: Disp sal Works Construction Permit# i Commonwealth of Massachusetts Map-Block-Lot 107.D-0060- 'Board Of Health ----------------- a., Permit No North Andover BHP-2004-0564 P.1. ------ F'EE F.I. $250.00` ---------------------- Disposal Works, Construction Permit Permission is hereby granted John Soucy - -- - > --- ------- --- ----- to(Construct)an Individual Sewage Disposal System. at No 42 PENNI LANE ------------------ ------- -- -------- -- .----------------------------------------------- -------- ------ ---- - --- as shown on'the application for Disposal Works Construction Permit No. BHP-2'004-056' Dated August 02,2004 r -------------- - --'-- ----- - ----------------- -- Issued On Aug-02-2004 Board Of Health .....t.Y..././..■t...■.........t.Y.............Y..tttt■t.t...t.■.././.t.t.■.............t.t..■■f.........Y.............../.■..........t..■/.../.t........./........./.t./.... . Commonwealth of Massachusetts Map-Bio�k-rot -0060- 107.D Board Of Health ------ --- --- North Andover. Certificate o mpliance 1{ I THIS IS TO CERTIFY,Tha dividual Sewage Disposal System (Construct) I n by John Soucy ------------ - - ----- --- -- ------------------------------- Installer at No 42 PI'ZANE --------------------------------------------------------- -- ---- ,- ---- ----- ---- --=-- has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. BHP-2004-056 Dated August=02z 2004 --- -- -- --------- -------------------- Printed On:Aug-02-2004 -- -- Board OfHealth, ................. ......................... ......................................................................---........I------------ ------------------------------------- I .. , ,,,�r'i i �. <,r i � nr Y Y &x � :Y r ,; +.r 'rF �v�. t x s� ,• '04 a� ?3"� �'�t `�`'.�,atS � �'' ;+pt,1�F4,: k t �r;;•-�'�ir° s,`fi x-Ls� :':1 �`,r�At� :cy�la,...sY.� r,#+.8:,� tie,�,,'Yy�; 'v.Y xgfy��`,�,� a�t7����� P ,� A."t.� tr.. : f��a�'d°.,E t v•�„ Ir?' u ��" ? `€"rs, ��,+ ' <` "'€`` .;r r S �' r s 1 ,� x' A�`_ ;in � :q 3` '�" *.,,, � �'it + "'M�:. .� ,� �"•'�y'd8 :.`,'k a c r:"i-�d a..r " ' ?. , r`i...afi ,� ". r' ramfi ,y. 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'� ,r Y a � �4;e•.#y � ' �` r � k Y, Town of Nacth Andover Ix HealW'De'partment / Date: /4,"� Location: (Indicate Address, if Residential,or Name f Business) Check#: Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type. $ ➢ Funeral Directors $ ➢ Massage Establishment $ _ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: 0 Septic-Soil Testing $ ❑ Septic-Design Approval $ L,1,>efrVc Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) 170 7O Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer 0 TOWN OF NORTH ANDOVER Nvr+Tk w Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT } 27 CHARLES STREET >" NORTH ANDOVER,MASSACHUSETTS 01845 �9SSACHUS Kph Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdept@t6wnofnorthandover.com www.townofnorthandover.com APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT RECEIVED DATE: F� AUG 0 2 2004 TOWN OF NORTH ANDOVER LOCATION: L 1 HEALTH DEPARTMENT LICENSED INSTALLER NAME: PLEASE PRIN SIGNATURE: ® TELEPHONE# 60�j _ 1f.1 t-7S �I CHECK ONE: FULL SYSTEM REPAIR: COMPONENT REPAIR (indicate what parts): * NEW CONSTRUCTION: * If NEW CONSTRUCTION,please attach the Foundation As-Built Plan. $250.00 Fee Attached? Yes No Project Manager Obligation From Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes No Approval of Health Agent Date: f, TOWN OF NORTH ANDOVF,"n Page 1 of 4 0 Dellechiaie, Pamela From: Pamela DelleChiaie [pdellechiaie@townofnorthandover.com]on behalf of Dellechiaie, Pamela Sent: Monday, August 09, 2004 2:43 PM To: 'Daniel Ottenheimer(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: Sawyer, Susan Subject: Bottom of Bed Inspection -for 42 Penni Lane Importance: High Sensitivity: Private SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 42 Penni Lane MAR LOT: INSTALLER: John Soucy DESIGNER: NEES PLAN DATE: July 8, 2004 BOH APPROVAL DATE ON PLAN: July 23, 2004 DATE OF BED BOTTOM INSPECTION: August 6, 2004 DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION X PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1500 LOADING OF SEPTIC TANK = 440 GALLON PUMP CHAMBER = n/a LOADING OF PUMP CHAMBER = n/a TYPE OF SAS = Infiltrator DIMENSIONS AND DETAILS OF SAS: 62.5 L x 2 Rows SITE CONDITIONS ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered 8/9/2004 TOWN OF NORTH ANDOVF0 O Page 2 of 4 Comments: SEPTIC TANK D Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ 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: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Watertightness of tank has been achieved Visual or Vacuum Test or Water held for 24 h rs ❑ Hydraulic cement around inlet & outlet Comments: 8/9/2004 TOWN OF NORTH ANDOVn O Page 3 of 4 D-BOX D 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 ❑x Bottom of SAS excavated down to soil layer, as provided on plan ❑O 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: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits p ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside 8/9/2004 TOWN OF NORTH ANDOVC Page 4 of 4 0 Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV_@ TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D-Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW 8/9/2004 O , L '471 T AJ-- 4 foot cased openingEl - � C 3 foot — — ILI cased M opening a � 0 �,9 o UP — sit r A . TOWN OF NORTH ANDOVEO Page 1 of 4 Dellechiaie, Pamela From: Pamela DelleChiaie [pdellechiaie@townofnorthandover.com] on behalf of Dellechiaie, Pamela Sent: Monday, August 09, 2004 2:48 PM To: 'Daniel Ottenheimer(E-mail)'; 'McBrearty Andrew(E-mail)' Cc: Sawyer, Susan Subject: FW: Bottom of Bed Inspection -for 42 Penni.Lane Importance: High Sensitivity: Private The D-Box - installed on stable stone base should not have been checked. However, I was unable to delete it after I sent it to you. Please take this off when you add in your other inspection. Tx., P -----Original Message----- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com]On Behalf Of Dellechiaie, Pamela Sent: Monday, August 09, 2004 2:43 PM To: 'Daniel Ottenheimer (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: Sawyer, Susan Subject: Bottom of Bed Inspection -for 42 Penni Lane Importance: High Sensitivity: Private SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 42 Penni Lane MAR LOT: INSTALLER: John Soucy DESIGNER: NEES PLAN DATE: July 8, 2004 BOH APPROVAL DATE ON PLAN: July 23, 2004 DATE OF BED BOTTOM INSPECTION: August 6, 2004 DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION X PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1500 LOADING OF SEPTIC TANK = 440 GALLON PUMP CHAMBER = n/a LOADING OF PUMP CHAMBER = n/a 8/9/2004 TOWN OF NORTH ANDOVERO Page 2 of 4 TYPE OF SAS = Infiltrator DIMENSIONS AND DETAILS OF SAS: 62.5 L x 2 Rows SITE CONDITIONS ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK D Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ 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: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working 8/9/2004 TOWN OF NORTH ANDOVO Page 3 of 4 ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: D-BOX ❑x 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 D Bottom of SAS excavated down to soil layer, as provided on plan D Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: 8/9/2004 . TQWN OF NORTH ANDOVUP- Page 4 of 4 ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D-Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW 8/9/2004 TOWN OF NORTH ANDOVER of HaaTH Office of COMMUNITY DEVELOPMENT AND SERVICES or 4T'4.o HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845 �RS�ACHUSEh Susan.Y. Sawyer,R.EHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC YSTEM CONSTRUCTION-NOfiES ADDRESS: -MAP:_ LOT. INSTALLER: �.. 1 DESIGNE PLAN DATE: BOH APPROVAL DATE 09-PLAN: ILi3 ze y DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPEC I N: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION 1� PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = / Soo LOADING OF SEPTIC TANK = �© GALLON PUMP CHAMBER = LOADING OF PUMP CHAMBER = TYPE OF SAS = �—w DIMENSIONS AND DETAILS OF SAS: (oZ.s L x Z 1�4w SITE CONDITIONS ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Page 1 of 2 �J TOWN OF NORTH ANDOVER 4 NORTy Office of COMMUNITY DEVELOPMENT AND SERVICES 3r04 i(e°eb e�Q0L HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER,MASSACIIUSETTS 01845 �aSS4C1iU5Et�h Susan Y. Sawyer,REHSIRS 978.688.9540—Phone Public Health Director 978.688.9542—FAX SEPTIC TANK Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ 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: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: Page 2 of 2 TOWN OF NORTH ANDOVER k tiaORTy Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT f y 27 CHARLES STREET `►^' <: NORTH ANDOVER,MASSACHUSETTS 01845 �qS°^rro S�cNus Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-FAX 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) Q Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete / timber/ block) ❑ Final cover as per plan Comments: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals El size inch as per plan Comments: Page 3 of 3 TOWN OF NORTH ANDOVER f gORTH 9 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT . ,00v 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845 ''�s��CHUSEt�y Susan Y. Sawyer,REHSlRS 978.6889540—Phone Public Health Director 978.688.9542—FAX CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D-Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 fJ Q `T J Dellechiaie;Pamela Subject: Bottom of Bed Inspection Location: 42 Penni Lane Start: Fri 8/6/2004 1:00 PM End: Fri 8/6/2004 1:30 PM Show Time As: Out of Office Recurrence: (none) Meeting Status: Meeting organizer Required Attendees: Dellechiaie, Pamela; Sawyer, Susan Importance: High John Soucy is the Installer;NEES is the Engineer(confirmed with John) John - 603.216.7175 NEES: 508.328.4633 o Q TOWN OF NORTH ANDOVER Of ►ORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES o `�'IND HEALTH DEPARTMENT 27 CHARLES STREET • �,,.�::s:..�,, + NORTH ANDOVER, MASSACHUSETTS 01845 978.688.9540—Phone Susan Y.Sawyer, REHS/RS 978.688.9542—FAX Public Health Director healthdept@townofnorthandover.com http://www.townofnorthandover.com July 21,2004 Michael Tagaras 42 Penni Lane North Andover,MA 01845 RE: Subsurface Sewage Disposal System Plan for 42 Penni Lane,Map 107D, Lot 60,North Andover, Massachusetts Dear Mr.Tagaras, The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated July 8,2004 and received by this office on July 12,2004. The design has been approved for use in the construction of a replacement onsite septic system.This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work,and a Certificate of Compliance must be endorsed by the installer,designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection which did not meet the acceptable criteria in the state regulations. 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(l)). 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. /SincerSawyer, REHS/RS Public Health Director encl: List of licensed septic system installers cc: file New England Engineering Services V Town of North Andover Health Department Date: 7/X Location: (Indicate Address,if Residential,orNa e off B�usiness) Check#: Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ o-Septic-Design Approval ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) 145 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer o Q NEW ENGLAND ENGINEERING SERVICES INC July 12, 2004 Susan Sawyer EHEALTHI)EPAR North Andover Board of Health 27 Charles Street � North Andover, MA 01845 OV � NT Re: 42 Penni Lane, North Andover Septic System Design Dear Susan: The following plans and enclosures for the above referenced property are being submitted for approval. 1. (5) Copies of the Septic System Design Plans. 2. (1) Copy of the soil evaluator sheets. 3. (1) Check for payment of the Town approval fee. If you have any comments or questions please do not hesitate to contact this office. Sincerely, Steven E. Pouliot Project Manager 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 tt6/28/2004 . 20:'34: 17813340115 T hIG!1f?fi�' PAGE 02 O Q Feng a t SOIL EVALUATOR FORNM Page 1 of 3 Date: , /� Commonwealth of Massachusetts Massachusetts ,S it_ SgUabili xA ss ess�ne i°� r � i e `�wa a Ibis 0-141 f- �` Gy .. Date: Performed By: ....� � .. . Witnessed By: , ', 4�-� ............ Lccp+Inn R6QtCtS OF ACCtesi,i,ca /J 0 New construction C1 Repair M�J Ofi'i_ ce Revicw Published Soil Survey Available: Non Yes ` .. .... .. ... Publication Scale 1 jl i�f Soil heap Unit j��� AW Fear Publtsht:d f � Drainage Class 4-(.. ........ So:t Limitations Surficial Geologic Report Available: No R] Yes Year Published ... Publication Scale Geologic Material (Map Unit) La,,-tdfor n '" Flood Insurance Rate Asap' Above 500 year flood boundary No ❑Yes L Within 500 year flood boundary No El Yes U Within 100 year flood boundary No El Yes Wetland Area. National Wetland Inventory Map (map unit) W"etlands Conservancy Program M1 2p (snap unit) 1 Current Water Resource Conditions (U5CS)• Month Range :Above Normal 5 !Norma} lC'r Normal Chher References Reviewed, OEF APPROVED FOKM-12107'91 1 t1Di L,�; GC1C74 L�i:.GYJ !!ill 3. 407 IAN.�r;h�llt� O: NAkat,.,-LZ • PORIA. II - SOIL EVALUATOR FORM Page 2of3 Location Address or Lot No. On-site Re g—w I ' peep Hale Number -1-7104 gime: f '� WeatherRx- Deep (identify on site plana Land Use1`� .. � . 4 Slope M � Surface Stones Vegetation '1e.¢"'e,4 Landform Position on landscape d - � Distances from: Open Water Body feet Drainage way �� feet Possible Wet Area ,2 feet Property Line '¢`-. feet Drinking Water We(I /•S'a feet Other . DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil other i Surface (inch6s) (USDA) (Munsell) Mottling (Structi,ire, Stones, 8widers, Cnnsistency, % i Grave!( 4- Parent Material (geologic) / AE �_` ''� dapthtoBedrock: Depth to Groundwater; Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water.�� DEP APPROVED FORM• 12MMS - u+J; tut tvtl f:,•cu.G V 1 1 01 JJYC.:11 L y I:HIYtaYICLr°. - r Ir— ti,.t - ... O v Q FORM 1t • SOIL EVALUATOR FORM Nge2 (if I Location Address or Lot ,4o. On-side Review r Deep Hole Number Dat®: 1Time f `Weather t.1;01 '� Location (identify on site plan) . Land USe; W f�- $lope {°kl r Suriace Stones Vegetation ��. ... Position on 16ndscapeJ Distances frog: Open Water Sodyj-I�—`vw feet Drainage way-apo teet Possible Wer Area feet Propepty Lane ` .. feet Drinking Water Well,2t„17� feet Other . :.. r� DEEP OBSERVATION HOLE LOG i rUep:h from--I Saii Horizon Soil Texture Sol(valor Soil v other su"ace ;Irohes) l (USDA; (Munsal(V i Mottling (Structure. Stcnes, souiders, Consis+.erc;, `% eY All l � i I Y i i Atl- tl- Parent Matarlaf?geologic) Doth to OrOtUndwater; Swriding Water in the Holt' Weeping from Pit Estimated Seasonat High Ground DEP A.PPZUVFD F0101. 12'07195 t C.1 LC<i GUQ4.; :U:,:.4 V) . 1 f C.1 i ti FORM 1 . SOIL EVALIUATOR iFO%i9 Pa€c 3 of 3 Location, Address or Lot No. �� �N1 44�1-eFl DetertniWativn for Seasonal Hi.ai Myer _gbl� Method Used: � Depth observed standing in observation hole _ .. inches Depth weeping from side of observation role ..... inches Depth to soil mottles . .'`�., inches '�f Ell Ground water adjustment ............... feet 424-"e — �/ Index Well Number Reading Date .............. Index well level Adjustment factor Adjusted around water leve! Deoth_of Naturally Occurring Pervious Material Goes at least four feet of naturally 9 occurrin pervious material exist in 411,areas observed throughout the area for the soli absorptioncr ptions stem? If not, what is the depth of naturally occurring pervious material? Certification `�I .r I certify that on 1� (�_. (date) 6 have passed the soilo evaluator examination approved by the Cfepartment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 390 CMR 15.017. � Signator ' Date RF,P APPROITD FMI-12107'45 ,8 pORTH TOWN OF NORTH ANDOVER o HEALTH DEPARTMENT _ xi 27 CHARLES STREET _ + NORTH ANDOVER,MASSACHUSETTS 01845 ,T.°^titer SRCHU'S Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542-Fax li I FAX To: DanielOttenheimer From: Pamela Mill River Consulting 978.282.0012 Pages: Fax: 1.800.377.3044 or Date: Phone: 978.282.0014 Request for Soil Testing or CC: Re: Septic Plan Review ❑Urgent x For Review ❑Please Comment ❑ Please Reply ❑Please Recycle • Comments: Septic Plan Review Soil Tes OTHER Note: For plan reviews, this is notification only. Plans will be mailed or arrangements made to pick them up as requested. Address: y` Please call 978-688-9540 for assistance with any questions. Thank you. Cc: File-Address B,': BOAJ_ OF HEALTH NORTH-ANDOVER, MASS. 01845 978-688-9540 AKPLICA'TIQN F0-R SOIL TESTS DATE: 6 MAP&PARCEL: L gT 6y r LOCATION OF SOIL TESTS: Pei1i�v,p OWNER:A I C. ck e TA TEL.NO.: 78 ADDRESS: 46a L.cjo p ENGINEER:ALo En,-, a SerYiLe s TEL.NO.:_�g78� CERTIFIED SOIL EVALUATOR: V � Intended use of land: Residential Subdivision —Single Family Home Commercial Is This. �� Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No x THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$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 un ades. GENERAL INFORMATION 1- Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write B low This Line N.A.Conservation Commission Approval: G' p Date Received: Check Amount: Check Date: l cbqi bo:O�Ord: O, /GI.art•. �..o, W TLA/J'DS etCi1Jo'A ,-,5 ' ?A 'a O C 1 LoT '4 L a 4xs.• 1.0..sr.As `o. LoT g N ll �'9 Rid•1.07 dG,Rtf ' 4,e " j ro 144 0 7 ' I .d. Aloof � 7. O 11.00 ' V) a{ + s4 a.o� H �.. - � Page 1 of 1 r Dellechiaie, Pam From: Dan Ottenheimer[info@miliriverconsulting.com] Sent: Wednesday, July 28, 2004 2:01 PM To: Susan Sawyer; amcbrearty@miIIriverconsuIting.com; 'Pamela Dellechiaie' Subject: perc test results Sue and Pam, Attached please find the percolation test results for three properties: 545 Winter reet 42 Penni Lane 43 Mill Road. These were completed a few weeks ago and the results already faxed ove toy Scanne ages are now attached which should be clearer to read than the faxes. Dan Mill nOver< ConsuIting Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com Lnfo@mi,l,lrliverconsultinQ.com a 7/28/2004 j iF f { r I ►J�`. ��+� , Cry �#-�' �.. "° ��� � I Oj tG 6k' to; } �* -� Page 1 of 1 Dellechiaie, Pam From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Wednesday, July 28, 2004 2:08 PM To: Susan Sawyer; amcbrearty@millriverconsulting.com; 'Pamela Dellechiaie' Subject: 42 Penni Lane Sue and Pam, Several weeks ago we s you soils field information for 42 Penni Lan , however we inadvertently labeled it 43 Penni Lane (becau we were at 43 Mill Road earlier that day— ). Anyway,just so the right information makes it into the corr t files at our office, here are the ed notes for 42 Penni Lane. Thanks, Dan - Mill imer con suIting Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriv_erconsultina.cora infQ@millriverconsultina.com 7/28/2004 r IJ r it t i DID or I L,=� Vx lv)� ITW > f J/a zea �� � � ► .��:�.� _ � � ; , �. I i f i N G) W C7 a- �?f fo4 4a. Pcjjt . i tj, r +lt_ 1/7104 I MitY,, lir A. {+P. �MtL. �. r���1�2CAIT.n 1 T- LAS �JT73v tr Pau- V C . J RECEIVED �trR.�Lam'„ �G2G i��' JUL 1 2 2004 , L w TOWN OF (NORTH ANDOVER aHEALTH DEPARTMENT n�•a�., oc i�•,�.� , 40JA or 4'j" J J rr f S-Tp'-c' Pec 4L ST4jLT. ?R.3 Sop,,L : N\*�� e ��.�na $u.,C C� .t1'� I�-o� �marts �v►l< � �7`t `. j l: 5� ! - . .)t3'3b1�.'•1/��; i 6\I fY hTcrS 1 �� �4•J i l - CD 04 co qu_ �a _4q - ►�_�<< _ N i m N m m m - v , M 777 C � •.f p i N W = �_. _... ..._ .. . TO: NORTH ANDOVER, MASS /V° V 19 7S BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage j System Inspection This is to certify that I have inspected the construction of the said disposal system at '00"'�lc1 / 6A - North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated �ZN < <fAss [ \P 9 V ; Pr neer/.Reg,. Sa trlan R___ n 464 N O p10 e FG C? IgTE - •P �S�%ONAL S/ a � { 1 s 1{ .{ AZG4 ?900 •� i i �"n G'farllC t ( 70' r !9% t 4m Ul - y ��� JOS 1 _Y 12"MocToP501t. COVER ` d :gL,... 3"WAS111�OPEASTONS Ve-3le 00$�� e o d° � • LA"PERFORATEDORA"cvEOTACw n A9SOaP" om AREA ABSORPTION BED E-ND SECTION z w _ _ f in Cl 40 a q rJ C- LLON E- J .+o •`Z i�. SEPTIC �" ,! . • of f ¢ TA%W. 00 ad r • a� Qts" V r �o- � i�•�----" DISPOSAL SYSTEM PROFILE Ta Z 4V 35 ASSORVnor4 AREA= 900 5 y ABSORPTION BED PLAN 0 OBS. HOLE -49 PERC. HOLE PERC DATE TEST DA 421 7/410/oc+1 7-11 PERC TEST �4.TU RATS 16/410 Pte. oril UJ�A �" �� 4 rM.L4t, '1 'OQ r r � r yet S Yrlp+ �t r ► a� !� ice-• � 4,X14 r . r p `" rr r 13 ,.4f30` Sz 751 �L= \0010 • �I � N A4 r a Lm'1 W Joseph j. barbagallo, r.s. 1 westward circle no. reading,mass. ---��