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HomeMy WebLinkAboutMiscellaneous - 52 WELLINGTON WAY 4/30/2018 (2)I I� a m U� Z5p U N Of co O U a nm. m U N Of Z O C7 Z J J W N J N LO U) w 0 Q J w U 1 0 O 0 0 0 O J W) co O 0 Y U O J m r d Q 0 0 0 0 W) 00 0 O U L6 O r 0 N 0 JI W U d 0 0 N N U co co N N N ff c c O O N 0) N V ON O0 W O O O �' . O O O O O Z Cl) W ... rWf`:Nlt1�/•f�f��'rN"��F�'' 0 o > N Z a 0 0<� '9' l 1f `(/r rfJtjj!(jjfjJ�j( c J o m m\ J N O �O QU M M NN r Q m -mom Y °p m ani maU E -� � _ x ami o c a waU_o rnN Z �O Z { s4'tti;ti4,11� EE M OJJ OQ (n O W U u V_ Z Q O ZF— O N O LL m Z O W Z Z} O Ta Z r�� F-a� r Qmm Y •:' �n�kyt,E'"y��t'�%"��d i{p � J Z LUw 2 J _ U y Q :fi ham,,,, t�r:a"-1-1w} W O a) IL N a) a) CD c O U_ m U� 3 O U OCl) W N N m �' j tL.. � C �i' m m m ��H�in �' ... cAi PUBLIC HEALTH DEPARTMENT Town of North Andover Community and Economic Development Division CERTIFICATE OF COMPLIANCE As of: July 11, 2017 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: New Construction of an On -Site Sewage Disposal System By: Robert L. Innis, RLI Corp At: 52 Wellington Way Map lOS.0 Lot 85 North Andover, MA 01845 The uance o t s certificate shall not be construed as a guarantee that the system will function satisfactorily. Brian J La r sse, CEHT Director of Public Health 120 Main St., North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web www.northandoverma.gov A' v Town of North Andover - sa �e ll System - AS -BUILT CHF.ICKLIS7 1) / All changes to the design plan have been reflected and noted on the as -built plan 2) v As -built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans) 3) v Street Address, Assessor's Map and Lot Number 4) .Lot Lines and Location of Dwellings served by the system 7 5) Locations, Elevations and Dimensions of As -built system components, including reserve (if applicable) 6) " Ties to all tank openings, d -box, and leach area from dwelling or Permanent Structure Setback distances are shown on the as -built plan from system components to: `-� Subsurface, interceptor & foundation drains rlCatch basins ope-, lines Dwellings or other structures rivate water supply or irrigation wells /_V Watercourses or wetlands 8) J Locations of W 1 , Drains, Wetland Resource Areas within 150 feet of system 9) Location of water, gas, electric lines, cable, control panel (if applicable) 10) ZLocation of Structures within 6 Inches of Finished Grade 11) Original Stamp & Signature 12) Location and holder of any easements which could impact the system 13) `�Impervious Areas; Driveways, etc 14) ' North Arrow 15) ZLocafion & Elevation of Benchmark used 16) STATEMENT ON PLAN (NA 5.3) C�_Vko S C {fi �e -P� Y�'� `v �r�J n,l 5 a. 1 certify the locations, elevations, ties, cover material; exposed component covers etc., shown on this as -built substantially agree with the approved plan and have determined that the break out elevations, if applicable, have been met. " Signature of Designer Date b. "If a STUCTURAL WALL IS PRESENT W 4.9) a Letter or statement on the as -built indicating the wall - wasor was not constructed in accordance with the intended design and any manufacturer's specifications." Signature of Designer Date As of: Tuesday, March 17, 2015 PUBLIC HEALTH DEPARTMENT Community & Economic Development TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM — INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (constructed; ( ) repaired; By: Bob Innis (Print Name) Located at: 52 Wellington Way (Lot 2 Wellington Woods) (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan, originally dated 11/9/16 and last revised on 12/5/16 , with a design flow of 440 gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed iniaccordancewith the provisions of 310. CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bottom of Bed Inspection Date: And — Print Name Final Construction Inspection Date: 6/15/17 James Melvin, P.E. And — Print Name Insta Engi Engineer Representative (Signature) Date: 7 - % 8 e % ? Aid — Print Name Date:. Phil Christiansen, P.E. And — Print Name 120 Main Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web http:/Iwww.northandoverma.gov North Andover Health Department Community and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 52 Wellington Way Lot 2 MAP: 105.0 LOT: 85 INSTALLER: Bob Innis DESIGNER: Christiansen & Sergi, Inc PLAN DATE: 11/9/2016, Rev 12/5/2016 BOH APPROVAL DATE ON PLAN: 12/9/2016 INSPECTIONS TANK INSPECTION: 6/12/2017 DATE OF BED BOTTOM INSPECTION: 6/1/2017 DATE OF FINAL CONSTRUCTION INSPECTION: 6/20/17 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS Comments: SEPTIC TANK ❑ Contractor reports any changes to design plan ❑ Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered ❑ Building sewer in continuous grade, on compacted firm base ❑ Cleanouts per plan ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (gas baffle) ❑ inch cover to within 6" of finish grade installed over one access port ® Boots around inlet & outlet Comments: 6/12/17 1" of stone under the area of the tank- told Bob to remove dirt from under the stone and replace with 6" of stone. Brian and Michele will re- inspect. The pipe coming out of the house is angled in the wrong direction. The plan has it angled towards the tank. The plumber needs to redirect the pipe. — M. Grant 6/20/17 — Building sewer pipe was not bedded with compacted material. Instructed licensed installer on proper procedure. He assured me he would do so and I expect he will so I authorized backfill when completed. Reminded installer of minimum of 9" cover and maximum of 3' cover over septic tank. ISTRIBUTION-BOX ❑ Installed on stable stone base ® H-20 D -Box ❑ Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: 6/20/17 —.Flow exiting distribution box was not even, was about 3/4 to one arm. The licensed installer had no means available to correct this at the time. He will acquire flow leveling device and install them and then call for a re- inspection. Reminded installer of need for riser to bring cover of distribution box close to final grade once that has been determined. SOIL ABSORPTION SYSTEM (General) ® Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan (on site) ® 40 Mil HDPE barrier installed ® Laterals installed ® Elevations of laterals and chambers installed as on approved plan ® Retaining wall ( oulderq) ❑ Final cover as per plan Comments: 6/1/2017 inspection by B. LaGrasse 6/20/17 - Reminded licensed installer of minimum 1' cover and maximum 3' cover requirement. Also reviewed importance of not driving on leach trenches during backfill so as to compact soil and prevent good air exchange. FINAL GRADE ❑ Loamed ❑ Seeded ❑ Cover per plan Comments: DOCUMENTS NEEDED ❑ Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer ❑ As -Built Plan BM = 144.77 HR = 0.76 HI = 145.53 SYSTEM ELEVATIONS 6/20/17 - Benchmarks on plan were no longer present. Licensed installer reports the engineer established a new benchmark as a nut on a hydrant in the street. Hydrant was labeled with elevation 144.77 KETCH PLAN ROD ELEVATION AS -BLT INVERT ELEV DESIGN INVERT ELEV Benchmark Building Sewer OUT 7.98 137.22 137.75 Septic Tank IN 8.71 136.49 137.08 Septic Tank OUT 9.20 136.00 136.83 Distribution Box IN 11.04 134.16 134.21 Distribution Box OUT 11.25 133.95 134.04 Lateral 1 Beg 12.41 132.79 132.74 Lateral 1 End 12.64 132.56 132.50 Lateral 2 Beg 13.09 132.11 131.99 Lateral 2 End 13.38 131.82 131.75 6/20/17 - Benchmarks on plan were no longer present. Licensed installer reports the engineer established a new benchmark as a nut on a hydrant in the street. Hydrant was labeled with elevation 144.77 KETCH PLAN y4 CRITICAL SETBACK DISTANCES ' Mark those distances checked in the field against the design plan and regulatory setback Tank Property line 10 Cellar wall 10 Inground pool 10 Slab foundation 10 Deck, on footings, etc 5 Waterline 10 Private drinking well 75 Irrigation well 75 Surface Water 25 Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Bank3 ® Wetlands bordering surface 150 water supply or trib. (in Watershed) ® Trib. to surface water supply ® Public well ® Interim Wellhead Prot. Area ® Reservoirs ® Drains (wat. supply/trib.) ® Drains (intercept g.w.) ® Drains (Other) Foundation ® Drywells SAS 10 20 20 10 10 10 1002 100 50 75 100 150 150 325 325 400 400 400 50 25 10 (5) 20 400 100 50 20 (10) 25 Sewer 101 50 1 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 12/9/2016 Town of North Andover Mail - RE: 52 Wellington Lot 2 NOR s Ati z OVER Lisa Hadge <Ihadge@northandoverma.gov> Massachusts a RE: 52 Wellington Lot 2 1 message Isaac Rowe <irowe@millriverconsulting.com> Tue, Dec 6, 2016 at 11:45 AM To: Lisa Hadge <Ihadge@northandoverma.gov>, Pam Lally<plally@millriverconsulting.com> Cc: Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov>, Isaac Rowe <irowe@millriverconsulting.com> Brian/Lisa, I reviewed the revised plan for the above referenced property. The designer has proposed a boulder retaining wall to meet the 3:1 grading requirements. I would recommend approval. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager mlZ'.L RIVER COINISUL"i=lNG (.c��iit �gkt%'Stittxd`fae @:a��it fl�k"h'C�C»�,�IiCli4 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.millriverconsulting.com From: Lisa Hadge [ma iIto: Ihadge@northandoverma.gov] Sent: Tuesday, December 06, 2016 9:09 AM To: Isaac Rowe; Pam Lally Cc: Brian LaGrasse; Michele Grant Subject: 52 Wellington Lot 2 https:Hmai l.google.com/mail/u/0/?ui=2&ik=46857787dO&view=pt&q=52%2OWellington°/a2Oway&qs=true&search=query&th=l 58d506b8c5cc955&siml=... 1/2 12/5/2016 Town of North Andover Mail - RE: 52 Wellington Way lot 2 NOR R. ••Massachu 1,4;.� Lisa Hadge <Ihadge@northandoverma.gov> � RE: 52 Wellington Way lot 2 1 message Isaac Rowe <irowe@millriverconsulting.com> Mon, Dec 5, 2016 at 10:22 AM To: Lisa Hadge <Ihadge@northandoverma.gov>, Pam Lally<plally@millriverconsulting.com> Cc: Michele Grant <mgrant@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov>, Isaac Rowe <irowe@millriverconsulting.com> Brian, I reviewed the revised plan but still did not feel the designer met the 3:1 sloping requirements of Title 5. 1 confirmed this with DEP and then spoke with the designer. He will be revising the plan again to add a boulder wall in order to comply with the 3:1 sloping requirements. The other two comments on the review letter were satisfied.. I would expect you will receive the revised plan this week. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager iER �LL �dti E ONSULTING Ov:itwe" sotljilokl� for 1-1. Uld r Y tiai;�f>�tYY I%5Y7. 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0.014 ext.804 www.millriverconsulting.com https://mail.google.com/mail/ca/u/0/?ui=2&ik=46857787dO&view=pt&search=inbox&th=158cf9496165283c&sim1=158cf9496165283c 1/2 - 1 CHRISTIANSEN & SERGI, INC �::, _ PROFESSIONAL ENGINEERS AND LAND SURVEYORS :i 160 SUMMER STREET, HAVERHILL, MA 01830 ,c. - — tel: 978-373-0310 www.csi-engr.com fax 978-372-3960 i November 29, 2016 Mr. Brian LaGrasse CEHT Director of Public Health North Andover Health Department RECEIVED 120 Main Street North Andover MA 01845 NOV 3 0 101 b , TOWN OF NORTH ANDOVER Re: (Lot 2) 52 Wellington Way HEALTH DEPARTMENT �i Dear Mr. LaGrasse: 1 J Thank you for your review letter of November 23, 2016. We have made the following chap ges to the plan as a result of your comments: 1. A foundation drain has been added to the rear of the house i 2. The feature you referred.to is a deck and I have moved the septic tank location4to ensure compliance with local regulations. 3 We have in the past used 2:1 slopes and the plans were approved by the North Andover Board of Health. We have added a description of fill placement to ensure the slope will be stable. It should be recognized that the vertical fill is only about 4 feet high. The notes I have added about the fill to be used and the method of placement of the fill is in line good engineering practice. From GUIDELINES FOR DESIGN AND INSTALLATION OF IMPERVIOUS BARRIERS AND SLOPE STABILIZATION FOR TITLE 5 SYSTEMS the following phrases are important. For a system constructed in fill, 310 CMR 15.255 requires slope stabilization........, when the sideslopes to a soil absorption system are steeper than 3:1 (horizontal: vertical). Section 310 CMR 15.211(1)[4] requires slope stabilization when systems are located in an area adjacent to a naturally occurring downhill slope steeper than 3:1. When a naturally occurring downhill slope adjacent to a system is steeper than 3:1, Title 5 requires stabilization in accordance with accepted engineering practice. Slope stabilization at 2:1 does not require a retaining wall. It is my considered opinion as a Professional Engineer that the slope as shown and constructed as described will be stable. North Andover Health Department Community and Economic Development Division November 23, 2016 Philip Christiansen, P.E. Christiansen and Sergi, Inc. 160 Summer Street Haverhill, MA 01830 Re: (Lot 2) 52 Wellington Way (Map 105C, Lot 85) Dear Mr. Christiansen, The proposed wastewater system design plan for the above site dated November 14, 2016 and received on November 14, 2016 has been reviewed. Unfortunately, the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item where applicable. 1. The foundation drain is not indicated on the design plan (NA 3.2). 2. On sheet 1 of 2 in the site plan view, indicate the feature being proposed northeast of the septic tank. If it is a deck please make sure it meets the local setback requirements. 3. Explain how the proposed 2:1 side slope meets the requirements of 310 CMR 15.255 and the impervious barrier guidelines specifically figure 1. Please feel free to contact the office or Mill River Consulting at 978-282-0014 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, J G riase, CEHT Director of Public Health cc: Messina Development Company File Page 1 of 1 North Andover Health Department, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 LFII ' • SS. TOWN OF NORTH ANDOVER Offiq-e of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 SEPTIC__P_LAN S_UBMIT_T_AL FORM Date of Submission: 11011q�w Site Location VV e I 1 I nyV 041 Engineer: 0 - New Plans? Yes! $275/Plan Check # review only) Revised Plans?Yes $125/Plan Check # Site Evaluation Forms Included? Local Upgrade Form Included? 978.688.9540 — Phone 978.688.8476— FAX E-MAIL: healthdeptwnorthandovenna.gov WEBSITE: littp://wivlv.tioi-tliandovenna.gov RECEIVED NOV 7 4 `1016 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 4 110x) (includes 1St submission and one re- Yesy/ No Yes No I �/ Telephone #: q7F "373--b 3 /,6 Fax #: E-mail: Homeowner nn Name:LI1�- OFFICE USE ONLY When the submission is complete (including check): ➢ ✓ Date stamp plans and letter ➢ L-"' Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ Enter on Log Sheet and Database r No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH hUl d OF MOICT14 4J J z9rJ &-`7k APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Yermtt to t.:onstruct N Kepair � 1 upgraae k tioanuon k ) -,PS4,k VI11IJ1CLC JybM111 U 1nurv1VUH1 w111IJV11Gllw ..S2 iN&ZL / lV G 7Z)/.J W,,4 ` 1 Location o 5C - s-- Map/Parcel # Lot # Installer's Name Address Telephone # MES -S' /�.18 D&I' l , L AJC Owner's Name 2 7 7 W4S N / tiGT0 r✓ 5" i- 6 IQ j I &-ZA--U) Address 7r ED F& Telephone # F' /roc— Designer's Name Address � Telephone # Type of Building: WOnD FMIIIc E Dwelling — No. of Bedrooms Other — Type of Building No. of persons Other fixtures Lot Size -2- S feet Garbage Grinder ( )9.J Showers ( ), Cafeteria ( ) Design Flow ( 'n. required) gpd Calculated design flow gpd Design flow provided ()gpd Plan: Date /% Number of sheets_ Revision Date Ti tl P s v A XJ S2 11 r 06 Td �j t.U�l Description of Soil(s) t' Soil Evaluator Form No` Name of Soil Evaluator P 6N /41 T712WS e of Evaluation 1-13 --2-et it DESCRIPTION OF REPAIRS OR ALTERATIONS E) , C-dV �) &-7-, Z— 7-7-2-0/6 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Inspections Date FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 �3 Commonwealth of Massachusetts City/Town of North Andover w Percolation Test Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. --- Importunl:When filling out forms A. Site Information on the computer, use only the tab Gordon Family Trust key to move your Owner Name cursor - do not 602 Boxford Street LOT 4 (Wellington Way Lot 2) use the return Street Address or Lot # key. North Andover MA 01845 r� City/Town State Zip Code Philip Christiansen 978.373.0310 Contact Person (if different from Owner) Telephone Number i B. Test Results Witnessed By: Comments: t5form12.doc• 06/03 Perc Test • Page 1 of 1 1/13/2015 11:20 1/13/2015 11:53 Date Time Date Time Observation Hole # 4-A 4-B Depth of Perc 28" 34" Start Pre -Soak 11:20 11:53 End Pre -Soak 11:35 12:08 Time at 12" 11:35 12:08 Time at 9" 11:40 12:11 Time at 6" 11:48 12:14 Time (9"-6") 8 MIN 3 MIN Rate (Min./Inch) 3 MIN/INCH <2 MIN/INCH Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Philip Christiansen Test Performed By: Isaac Rowe Witnessed By: Comments: t5form12.doc• 06/03 Perc Test • Page 1 of 1 Commonwealth of Massachusetts City/Town of North Andover W Percolation Test Form 12 SV• Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. mpo an : en A. Site Information ------------- filling out forms Depth of Perc 45+17=62 on the computer, 9:28 End Pre -Soak use only the tab Messina Development 9:45 key to move your Owner Name Time at 6" cursor - do not 52 Wellington Way 18 min use the return key. Street Address or Lot # Test Passed: ® Test Passed: ❑ North Andover MA 01$5 ry Test Performed By: City/Town State Zip Code Philip Christiansen 978-373-0310 Comments: Contact Person (if different from Owner) Telephone Number B. Test Results -7/7In A4 In n.nn _.v t5form 12.doc• 06/03 Perc Test • Page 1 of 1 �v•� .•. vPIG IIIIIG Observation Hole # 1 Depth of Perc 45+17=62 Start Pre -Soak 9:28 End Pre -Soak 9:45 Time at 12" 9:45 Time at 9" 9:59 Time at 6" 10:17 Time (9"-6") 18 min Rate (Min./Inch) 6 min/inch Test Passed: ® Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Daniel O'Connell Test Performed By: Isaac Rowe Witnessed By: Comments: t5form 12.doc• 06/03 Perc Test • Page 1 of 1 N 0 Q. 0 m 3 0 I- 0 0 E cnQ N N > O Q cn 0 r— i It 0 Z Q.+- 1 r" a C r O E E t L— o U U LL U-) —_ 00 U "t o U)a 00 U O m r- a 2 O N C a� y cn Ln c O } } } 0 ❑ ❑ c ❑ ❑ ❑ D E CU co L Cl. c Z 2 Z` (tf =1 O c0 O a O C j C N O > Q CL cu CL _O 4 a CUU E C N -p C Co C Z _ Q Q .� N p Uj C O U) t v N a� f LL �OuinZ C O > > O Q w U) U C UD CL m co r _ It In cu CL U 2 w � Of 5 Z Z UO) O c El U) o W° N J iU Z) Z ❑ ❑ U) O c O U 7 c O U ani Z 0 ® '. 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C E 0 E E 1 +L 0 ._ .0 U U LL E O O = U u- cna) C _O � d � C > fII L) C W O (U = O > Ln, O L aL) C) c`o c Cr) r- 0 - > -P a) C = •U O QU nz .r 0 z c .3 0 a) CU O (D M a N > > U N G E > O E E > .0 N L C _ O) 4_ O N O O O -C E aw O cu C L6 CCu L a) Q��>+� a) cu > U ♦/ U Q U) O M L > C 47- n 0 CU > > C)- > C CU_000c9 S �mLi C (D C CO) — O E aO —cu `�:, cu L U U c0 V > -0 a> cu Li. M o v CN M y T- m r 0 T- m m 0 •o m O m O CD E m z E N 7 � w E o LL y U) 7 > E _ 4O A m O N L LO /\ m N d � L r.. y � •3 a`) � 3 UO C) M a O •3 > O 'D ons CD U = C cn> .o 0 Y 0 Z0 w 0 r > CD m EL Lom 0 O CL _N a> N U) U) c 0 0 c > E N U) m N a 0 U) I E LL co 0 n. TOWN OF NORTH ANDOVER LE"' Office of COMMUNITY DEVELOPMENT AND SERVICES �. HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 76� �&e SS//f4 060- NORTH ANDOVER, MASSACHUSETTS 01845 978.688.9540—Phone 978.688.8476 — FAX healthdept@iiorthandoverma.gov www.northandoverma.gov RECEIVED APPLICATION FOR SOIL TESTS DATE: t0 /116 LOCATION OF SOIL TESTS: Iffil JUN 2 8 2016 MAP & PARCEL: ` C. — TOWN OF NORTH ANDOVER -tiEALTH DEPARTMENT We l 1 (lot -L OWNER: Contact #: 7 3 1 APPLICANT: 6Contact #: ADDRESS: a-?? WCC S kin iu S'J'1' -ro ENGINEER: 6 ►r is h aml S- A lil Contact #: % 7Q 2 73 3 L 6 CERTIFIED SOIL EVALUATOR: P!'1 ; 1 "p C_ --'t V /S 12 a,,XS e i L Intended Use of Land: Residential Subdivision mgle Family Ho Commercial a �K Is This: Repair Testing: U developed Lot Testing: Upgrade for Addition:Qu In the Lake Cochichewick Watershed? es No ('13 12 015 THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x 11" Plot Plan & Location of Testing (please indicate test nit sites on the Plan ➢ Fee of $585.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of4$ 40.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent. Date back to Health Department: (stamp in): I i;=WA 3 �A r -S Si kn CL; 75130 low. I i;=WA 3 �A r -S Si kn CL; 75130 North Andover Health Department Community and Economic Development Division December 9, 2016 Messina Development Corp 277 Washington Street Groveland, MA 01834 Re: Subsurface Sewage Disposal System Plan for (Lot 2) 52 Wellington Way (Map 105C, Lot 85) To Whom It May Concern: The proposed wastewater system design plan for the above site dated November 9, 2016 with a final revision date of December 5, 2016 and received on December 6, 2016 has been approved. The design has been approved for use in the construction of a new on-site septic system for a 4 - bedroom (max 9 -room) home utilizing a leach trench system. This design plan approval is valid until December 9, 2019. During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer' and the Town of North Andover. This approval is also subject to the following conditions: 1. Prior to the issuance of the Disposal Works Construction Permit, the applicant must submit a foundation as -built at the same scale as the approved plan 2. Prior to the issuance of the Disposal Works Construction Permit, the applicant must submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms or a total of 9 rooms. Page 1 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 52 Wellington Way December 9, 2016 3. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). 4. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. incerely, Lq4-- chele Grant Public Health Inspector cc: Philip Christiansen, P.E. File North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Page 2 of 2 Fax: 978.688. 9542