Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 550 BOXFORD STREET 4/30/2018 (2)
=- 550 box fOit ST. _ a _ o X TOWN OF NORTH ANDOVER • Office of COMMUNITY DEVELOPMENT AND SERVICES -�` HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer,REHS/RS 978.688.9540 a "IL � b Public Health Director 978.688.8476- J �� healthde t a,tow, ' www.townollnortl Well and/or Pump Application (Please print) DATE: LOCATION to Drill Well or install a pump: �� t 60-" F-Ug0 ' Licensed Well Contractor Name and Company Name: AS 04 (� �c ►yrs s N c' &OX f094D, &\A , (Geop-ce W. Contact Phone Numbers: Homeowner: Address: oL l 7 of A 11 l Wert a j sc' l_?ey V-2 L&+ u4 Contact Phone Numbers: Q-7 — 3 7' 95 ?3 WELLS(to be completed at time of pump test) Typeofwell- Use: Dp $�`C. Diameter of well: Size of Casing: Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water-bearing rock: Depth of water: Delivers: GPM for: (how long) Drawdown: feet after pumping: hours at: 7 GP31 Date of Completion: T- _w . Signature o cll Contractor PUMPS(To be filled in before installation) Name&size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis report submitted to Health Department: Plumbing Wiring Inspector Health Department Representative S:\Health\Permit ApplicationslWell Application.doc TOWN OF NORTH ANDOVER .- Office of COMMUNITY DEVELOPMENT AND SERVICES sEt � HEALTH DEPARTMENT ' 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER,MASSACHUSETTS 01845 Susan Y.Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-FAX healthdept@townofnorthandover com www.townofnorthandover.com Well and/or Pump Application (Please print) DATE: 1 LOCATION to Drill Well or install a pump: La t ��� F:090 Licensed Well Contractor Name and Company Name: C P e-S 04, /2v L,(-,'us Cz. S N C- Contact Phone Numbers: O87- Z3Z� 7 R- 375- �s� S7 Homeowner: I°l�S'S t P-e '/ Address: 'L1 -7 LJ RTI(i Wo"n�l sr-; 64 V'2 C4-fJ,0 vu Contact Phone Numbers: -7 3 7 `l S Y 3 WELLS(to be completed at time of pump test) Type of well: t✓�D/�� Use: Do M+--S'n'G Diameter of well: lP Size of Casing: & N Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water-bearing rock: Depth of water: Delivers: GPM for: Drawdown: feet after pumping: (how long) hours at: GP Date of Completion: Signature o ell Contractor PUMPS(To be filled in before installation) Name&size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron_ Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis report submitted to Health Department: Plumbing Wiring Inspector Health Department Representative S:\Health\Permit Applications\Well Application.doc TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES " HEALTH DEPARTMENT 1600 OSGOOD STREET;SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 -- Susan Y.Sawyer,RENS,RS 978.688.9540-Phone Public Health Director 978.688.8476-FAX healthdent&torvnofnorthandover.com wnvw.townofnorthandover.c �- RECEIV90 APPLICATION FOR SOIL TESTS DATE: 11/24/2014 MAP&PARCEL: 105C.22 NOV �.6 2014 602 Boxford St NA Lot T R LOCATION OF SOIL TESTS: HEALTH DEPARTMENT� OWNER: Gorton Family Trust Contact#: APPLICANT:Messina Development Contact#:978-837-9553X3 ADDRESS: 277 Washington St, Groveland; MA 01834 ENGINEER: Christiansen &-Sergi,Inc - Contact 4: 978=373-0310- CERTIFIED SOIL EVALUATOR: Philip Christiansen Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing: X Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) ➢ 8.5"x I]"Plot plan&Location of Testing(please indicate test nit sites on the plan) ➢ Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: \ 1 Signature ofConsery ation Agent:, IN Date back to Health Department:(stamp in): Blackburn, Lisa From: Isaac Rowe <irowe@millriverconsulting.com> Sent: Wednesday,January 14,2015 2:33 PM To: Blackburn, Lisa;'Pam Lally';Grant, Michele Cc: Isaac Rowe Subject: RE:602 Boxford St. Attachments: 602 Boxford Street-Soil testing results Jan 9-14 2015.PDF Lisa, Attached are the soil testing results for the above referenced property. This was for(9) new construction lots. Phil Christiansen will be survey locating all the deep observation holes and percolation tests. Let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone:978-282-0014 ext.804 Fax:978-282-1318 irowe@millriverconsulting.com www.milIriverconsulting.com -----Original Message----- From: Blackburn, Lisa [mailto:LBlackburn@townofnorthandover.com] Sent:Wednesday, December 03,2014 8:45 AM To: Dan Ottenheimer; Isaac Rowe; Pam Lally Subject: 602 Boxford St. Good Morning, Please call Phil Christiansen at 978-837-9583 for soil testing. -----Original Message----- From: noreply@townofnorthandover.com [mailto:noreply@townofnorthandover.com] Sent:Wednesday, December 03,2014 8:53 AM To: Blackburn, Lisa Subject: Message from "ComDev-Health-Ricoh" This E-mail was sent from "ComDev-Health-Ricoh" (Aficio MP C3002). i , y A_&OV/ PicI i i I /1P TM if ri 61d VA - ' � I i I � � ✓� i I i I _ 1. fff.,,»> 1 1 I t � f , I i ( I i , [3 I I 4 , Oft 77 I '�)-5- i-!UYI ' � '»w ir- Nar j If 1 -�_ - . -- P � I �� I M413 F , . I td 1 I tNl i , I ! , 4 I ' a I ' I - - -. z. : - C 2 ,5 q4 1 -; - - i t I , 1 I 1 I , +, r '"r,.'Pww-...rt .. . . -.: * ^^� :• •tr R.. .. r .1%t Y,4 >«'�w..;*xtks••�ida!�h=.:+r��.. ='.-4 .1% .a.rz , _ _• ,.Mme^ s , t OkPACi f` . : µ v r .. I r IV - ---- - • -�, - +� i -lo5 /O'Z7 , I 1 t � I/ x'-56 . . ,. --._ ... _..- _. ._ .. _..- (} '�,--�7� - - . ' I �I� - �FiST . i- _ I i 1 i 5(� _ ........ _ I , � A I I i f - - - - I �Z s �* ^ s j i I i , ................_ _... ---- - -- - , i r� �� .. -- - - - -' ` 4 : O f I 1 t , , 1 , - �-,- -- T --------- (AA --- f 1 ' � r I • _ - - 1 � — -- - - --- --- -- - --- - — "- � I , 7 I �Q '�j C O C •L a- ' t IIIY I w .-�.xV`33�.s.'v^.,: ��....`.., 8^.r„�� - t,.`,'wiiw5vi dv".aa:�;.e wa 'r .. A . �S'iyi �-'.•^y,..�.+,t '4' „s..A 'F- �.."" ""'n'. - _Tr+Z+r `xw. •...a':+*,ut !Y.'vr.+.+tis xa -~ ..af ."^ $ Na..r.,.^.7..r-_4 ay..�..:.,t�......o y. ...v,►,i..y..a...�... . .....F.i.ail�.S_.r.. Yr.S.L.:.1L:ntw.....o.,,_...wnx.,,r..'.ii.w.r.w+,....r..w._+..i.. ...,a,.�,7i..,.,�..�.. i n a, x �7- L �. -- / 71 42 >•ra l r� J�N�jdiV �" v/1 cz SW , i 4 x%y(.v �19 %�, - 'z S to cl 071 , t. s r _ r K � 1 296.0, i N LOT Z EXISTING FOUNDATION TOF EL:130.9` 100'BUFFER s � M f I 621 \ I N \ �-11l orAA��`� 115 R �O GI FoNo.33 i 1 CERTIFY THAT THE PRIMARY STRUCTURE SHOWN CONFORMS TO THE CAL FOUNDATION LOCATION APPLICABLEIZONINGONTAL YALAWS NCK EFFECCTWHEN CONSTRUCTED- (THISREMENTS OF THE CERTIFICATION DOES NOT CONSIDER ANY OTHER CLIENT: S & L HOMES LLC RESTRICTIONSSUL�HASCOVENANTS.WETLANDS,FASEMENTS, ORDERS OF CONDITIONS,ETC_)THIS DRAWING SHALL NOT BE USED THIS CERTIFICATIONISMADE AND LIMITED TOTHE ABOVE CLIENT BYTHECLIENTFORANY PURPOSE OTHER THAN THAT OUTLINED BOVE,EXCEPT WITH THE WRITTEN PERMISSION OF CHRISTIANSEN LOCATION: NORTH ANDOVER,MA. &SERGIINC.FURTHERMORE THIS DRAWING iS THE COPYRIGHTED PROPERTYOF CHRISTIANSEN&SERGI INC.AND ANY DATE: 7127115 SCALE: 1"=89 UNAUTHORIZED USE IS PROHIBITED.CHRISTIANSEN&SERGITAKES NO RESPONSIBILITY FORTHE UNAUTHORIZED USE OF THIS INFORMATIONDRAWING OR ANY PROFESSIONAL ENGINEERS & LAND SURVEYORS CHRISTIANSEN & SERGI, INC. 160 SUMMER STREET, HAVERHILL, MASSACHUSETTS 01830 WWW_CSI-ENGR.COM TEL.978-373-0310 FAX.978-372-3960 D W G.N O.:14036.001.017 �N1 � �- GV� �vu�.Q �� - '� - -�- ��� . �S�'�Tti�D�6gc • k PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 12/28/15 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Construction of an On-Site Sewage Disposal System By: Jesse Warren At: 550 Boxford Street Map105C Lot 0083 North Andover, MA 01845 The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Thomas Trowbridge,DDS, MD BOH Chairman 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 1 i PUBLIC HEALTH DEPARTMENT Community Development Division RECLINED, TOWN OF NORTH ANDOVER SEP 16 2015 SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION TOWN OF NOP.TH ANDOVER The undersigned hereby certify that the Sewage Disposal System�<constructed;( )repaired; HEALTH DEPARTMENT By: J S —T WO l'r 1'1 F i.NAJ- r-)(cn it n0 fi7be'v,C0)r p. (Print Name) L Located at: 6o2 Ras4ryt 94 - LD± (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated and last revised on (0/23�Z�/.5� ,with a design flow of �7 V gallons per day. The materials used were in conformance with thosApecified on the approved plan;the system was installed in accordance with the provisions of 310.CMR 15.000,Title 5 and local I i regulations,and the final grading agrees substantially with the approved plan.All work is accurately represented on the As-built which has been submitted to the Board of Health. Bottom of Bed Inspection Date: Engineer Representative(Signature) And—Print Name " Final Construction Inspection Date: C—/®'/S /I ) En eer Representative(Signature) pig i`i l0 ��1 i°I Sf 1 Cvva:S-Prt'1 And—Print Name Installer: nature) Date:_ `��/(�h V And—Print Name Engineer:4Z' nature) Date: GJ —// - Z O/Y- 1+ jZ I s-- S— /+ iZIS--1 /j, /c f= K L And—Print Name 1600 Osgood Street, North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com Town of North Andover - Septic System - AS-BUI CHECKLIST 1) All changes to the design plan have been reflected and noted on the as-built plan 2) i" As-built plan has a suitable scale; (1 inch=40 feet or fewer for plot plans) 3) Street Address,Assessor's Map and Lot Number 4) Lot Lines and Location of Dwellings served by the system 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 7) Setback distances are shown on the as-built plan from system components to: Subsurface,interceptor&foundation drains Catch basins Property lines N A Dwellings or other structures ✓ Private water supply or irrigation wells — Watercourses or wetlands g) Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) Location of water,gas,electric lines,cable,control panel (if applicable) 0 T )-t) y f / 1 10) J Location of Structures within 6 Inches of Finished Grade 11) Original Stamp&Signature 12) k N Location and holder of any easements which could impact the system 13) Impervious Areas;Driveways,etc ROT y4� 14) North Arrow 15) ✓ Location&Elevation of Benchmark used 16) STATEMENT ON PLAN (NA 5.3) a. "I 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 breakout elevations,if applicable,have been met." Signature of Designer Date b. "If a STUCTURAL WALL IS PRESENT(NA 4.9I a Letter or statement on the as-built indicating the wall- was or was not constructed in accordance with the intended design and any manufacturer's specifications." Signature of Designer Date \ As of:Thursday,September 17,2015 North Andover Health Department Community and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 602 Boxford St— Lot 2 MAP: 105C LOT: 22 INSTALLER: Jesse Warren DESIGNER: Phil Christiansen PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: 9/1/15 DATE OF BED BOTTOM INSPECTION: 9/1/15 DATE OF FINAL CONSTRUCTION INSPECTION:?11/15 DATE OF FINAL GRADE INSPECTION: A71 ) SITE CONDITIONS ® Contractor reports any changesto design plan ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Raised the septic tank and building sewer slightly SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ® Cleanouts per plan ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port Z Outlet tee installed, centered under access port (gas baffle) ® 24" inch cover to finish grade installed over inlet and outlet access ports ® Neoprene boots around inlet & outlet Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box N/A Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: SOIL ABSORPTION SYSTEM (General) ® Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder/concrete /timber/block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: High Capacity Standard Quick 4 Infiltrator Chambers ® Number of chambers per row: 10 ® Number of rows (trenches): 2 Comments: Total Chambers = 20 FINAL GRADE X Loamed X Seeded X Cover per plan Comments: DOCUMENTS NEEDED X Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer X As-Built Plan BM = 122.71 HR = 3.58 HI = 126.29 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 2.06 123.88 123.55 Septic Tank IN 2.74 123.20 123.09 Septic Tank OUT 3.00 122.94 122.84 Distribution Box IN 3.19 122.75 122.69 Distribution Box OUT 3.38 122.56 122.52 Lateral 1 TOP 3.50 1 Lateral 1 INVERT 122.44 122.52 Lateral 2 TOP 4.39 Lateral 2 INVERT 121.55 121.55 Top of Chamber Bottom of Bed/Chamber 121.48 / 120.59 121.56 / 120.59 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck,on footings,etc 5 10 -- ® Waterline 10 10 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh,Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib.to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot.Area ® Reservoirs 400 400 ® Drains(wat. supply/trib.) 50 100 ® Drains(intercept g.w.) 25 50 ® Drains(Other)Foundation 10(5) 20(10) ® Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws N ashoba Analytical, LLC Tel:978-391-4428 Fax:978-391-4643 LabNumber: 162383 31A Willow Road,Ayer MA 01432 Websitc:http://www.NashobaAnalytical.com Use this number with all correspondence Client: Well Water Connection John Larsen ReportDate: 12/22/2015 PO Box 158 Tewksbury, MA 01876 Certificate of Analysis 550 Boxford Street(Lot#2), North Andover, MA Parameter Method Result MCL MRL Date of Analysis Analyst -Sink Sampled:12/18201510:00.00 AM by Roland Total Coliform Bacteria,/100ml ENZ.SUB.SM9223 Absent Absent Absent 12/18/2015 3:15:00 PM M-MA1118 Arsenic,Total,MG/L SM 3113B ND 0.01 0.001 12/2112015 M-MA1118 Calcium,MG/L EPA 200.7 18.6 Not Spec 0.2 12/21/2015 M-MA1118 Copper,MG/L EPA 200.7 0.012 1.3 0.003 12/21/2015 M-MA1118 Iron,MG/L EPA 200.7 ND 0.3 0.003 12/2112015 M-MA1118 Lead,MG/L SM 31138 0.001 0.015 0.001 12/21/2015 M-MA1118 Magnesium,MG/L EPA 200.7 2.5 Not Spec 0.1 12/2112015 M-MA1118 Manganese,MG/L EPA 200.7 0.003 0.05 0.002 12/21/2015 M-MA1118 Potassium,MG/L EPA 200.7 0.5 Not Spec 0.1 12/2112015 M-MA1118 Sodium,MG/L EPA 200.7 16.2 See Note 0.2 12/21/2015 M-MA1118 Alkalinity,MG/L SM 2320B 77 Not Spec 1 12/18/2015 M-MA1118 Ammonia as N,MG/L SM 4500-NH3-D 0.11 Not Spec 0.1 12/21/2015 M-MA1118 Chloride,MG/L EPA 300.0 12 250 1 12/18/2015 M-MA1118 Chlorine,Free Residual,MG/L SM 4500-CL-G ND Not Spec 0.02 12/1812015 M-MA1118 Color Apparent,CU SM 21208 0 15 0 12/1812015 M-MA1118 Conductivity,UMHOS/CM SM 2510B 230 Not Spec 1 12/18/2015 M-MA1118 Fluoride,MG/L EPA 300.0 0.2 4 0.1 12/18/2015 M-MA1118 Hardness,Total,MG/L SM 2340B 57 Not Spec 1 12/21/2015 M-MA1118 Nitrate as N,MG/L EPA 300.0 ND 10 0.05 12/18/2015 M-MA1118 Nitrite as N,MG/L EPA 300.0 ND 1 0.02 12/18/2015 M-MAI118 Odor,TON SM 2150B 0 3 0 12/1812015 PN pH,PH AT 25C SM 4500-H-B 7.6 6.5-8.5 NA 12/1812015 M-MA1118 Sediment,pos/neg -------------- NEG -- NEG 12/18/2015 PN Sulfate,MG/L EPA 300.0 10.4 250 1 12/18/2015 M-MA1118 Turbidity,NTU EPA 180.1 0.2 Not Spec 0.1 12/18/2015 M-MA1118 MCL=Maximum Contaminant Level(EPA Limit),MRL=Minimum Reporting Level Sodium Guidelines-Mass 20,EPA 250, #=Result Exceeds Limit or Guideline ND=None Detected(<MRL), *=Background Bacteria Noted Massachusetts Certified David L.Knowlton Laboratory#M-MA1118 Laboratory Director Page 1 of 1 Grant, Michele To: tat.boh@comcast.net Cc: Hadge, Lisa Subject: 550 Boxford street Lotf Attachments: 201511161127.pdf Hi Tom, I have a Deed Restriction for 550 Boxford Street.They have a 4 Bedroom,9 room home.They want to add an additional room bringing it to a total of 10 rooms. It's a brand new house and brand new system,that is compliant and has already been inspected.They have a buyer and the sale is contingent on finishing the Attic. They have two choices, 1. Upgrade the system,or 2. Put a deed restriction on the 4 bedrooms. (Limiting it to a 4 bedroom home). Is this something you want to come in front of the board???Susan has always done this in the past, I can sign it and have it notarized here or you could stop by and it signed it and have it notarized here. Please see the attached Deed Restriction Michele E.Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email merant@townofnorthandover.com Web www.TownofNorthAndover.com tx. k 1 Grant, Michele From: Grant, Michele Sent: Tuesday, November 17, 2015 7:55 AM To: 'tat.boh@comcast.net' Subject: RE: 550 Boxford street Lot 1 Good morning, Yes, It's a family room...... I will start the deed and notarizing process today.Thanks very much!! Michele From: tat.boh*comcast.net[mailto:tat.boh@comcast.net] Sent: Monday, November 16, 2015 11:53 PM To: Grant, Michele Subject: Re: 550 Boxford street Lot 1 Michelle-When you say'finishing the attic,' I presume this means a playroom or some usage that will not add to the burden on the system. Given the deed restriction offer you have, if this is the case, I would be ok with you handling the signature on behalf of the department. Tom From: "Michele Grant" <MGrant(a)townofnorthandover.com> To: "tat.bohCa)-comcast.net" <tat.boh(�comcast.net> Cc: "Lisa Hadge" <Ihadge(cDtownofnorthandover.com> Sent: Monday, November 16, 2015 11:41:05 AM Subject: 550 Boxford street Lot 1 Hi Tom, I have a Deed Restriction for 550 Boxford Street.They have a 4 Bedroom,9 room home.They want to add an additional room bringing it to a total of 10 rooms. It's a brand new house and brand new system,that is compliant and has already been inspected.They have a buyer and the sale is contingent on finishing the Attic. They have two choices, 1. Upgrade the system,or 2. Put a deed restriction on the 4 bedrooms.(Limiting it to a 4 bedroom home). Is this something you want to come in front of the board???Susan has always done this in the past, I can sign it and have it notarized here or you could stop by and it signed it and have it notarized here. Please see the attached Deed Restriction Michele E.Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant@townofnorthandover.com Web www.TownofNorthAndover.com 1 RECEIPT ' Printed: November 18, 2015 13:21:0 Essex North Registry M. Paul Iannuccillo Register Trans#: 24230 Oper:KAIF BILL LOMBARD ------------------------------------- ------------------------------------- Book: 14449 Page: 252 Inst#: 30051 Ctl#: 84 Rec:11-18-2015 ® 1:20:57p NAND 550 BOXFORD ST DOC DESCRIPTION TRANS AMT --- ----------- --------- RESTRICTION Surcharge CPA $20.00 20.00 50.00 recording fee 50.00 5.00 TECH FEE 5.00 Total fees: 75.00 , *** Total charges: 75.00 CHECK PM 1123 75.00 R'.k 4-9 P:u 2 5 21 -2 97 J RETURN TO: Department of Environmental Protection Bureau of Resource Protection,Wastewater Management (Applicable Regional Office or Boston Office address) Above for Registry Recording Data GRANT OF TITLE 5 BEDROOM COUNT DEED RESTRICTION PROPERTY DESCRIPTION: 550 BOXFORD STREET,NORTH ANDOVER,MA 01845 This Grant of Title 5 Bedroom Count Deed Restriction is made as of this 121`day of November,2015,by S&L HOMES,LLC,a Massachusetts Limited Liability Company with a business address of 10-1 Middlesex Avenue, Wilmington, MA 01887 ("Grantor) pursuant to M.G.L. c.21A, §13 and 310 CMR 15.000 (collectively, "Title 5"). WITNESSETH WHEREAS, Grantor, being the owner(s) in fee simple of that certain parcel of land located in North Andover, Essex County, Massachusetts, with the buildings and improvements thereon,pursuant to a deed from Messina Development Company, Inc. to S & L Homes, LLC dated 5/13/2015 and recorded with the Essex North Registry of Deeds at Book 14223, Page 282, said parcel of land known and identified as 550 Boxford Street North Andover MA, and being more particularly bounded and described in Exhibit A, attached hereto and made a part hereof, and being shown as Lot 2 on a plan entitled, "Plan of Land, located in North Andover, MA, Record Owners Gorton Family Trust, 624 Boxford Street, North Andover, MA & Applicants Messina Dev, Co., 277 Washington Street, Groveland, MA" dated March 5, 2015, scale 1" = 40' prepared by Christiansen & Sergi, Inc., recorded with the Essex North District Registry of Deeds as Plan No. 17252 ("Property"); and WHEREAS, Grantor desires to restrict the number of bedrooms, as the term bedroom is defined at 310 CMR 15.002 ("Bedroom"), through the granting of this Title 5 Bedroom Count Deed Restriction; NOW, THEREFORE, Grantor does hereby GRANT to the Town of North Andover, Essex County, Massachusetts, a municipal corporation located in Essex County,having a mailing address of 120 Main Street,North Andover,Massachusetts, and acting by and through its Board of Health ("Local Approving Authority"), for nominal and non-monetary consideration, the sufficiency and receipt of which are hereby acknowledged, with QUITCLAIM COVENANTS, a TITLE 5 BEDROOM COUNT 1 DEED RESTRICTION ("Restriction") in, on, upon, through, over and under the Property. Said Restriction operates to restrict the Property as follows: 1. Restriction. Grantor hereby restricts the total number of Bedrooms in, on, upon, through, over and under the Property to four (4) Bedrooms, such that at no time shall there exist more than four (4) Bedrooms in, on, upon, through, over and under said Property. 2. Severability. Grantor hereby agrees that, in the event that a court or other tribunal determines that any provision of this instrument is invalid or unenforceable: (i) That such provision shall be deemed automatically modified to conform to the requirements for validity and enforceability as determined by such court or tribunal; or (ii) That any such provision,by its nature, cannot be so modified, shall be deemed deleted from this instrument as though it had never been included herein. In either case, the remaining provisions of this instrument shall remain in full force and effect. 3. Enforcement. Grantor expressly acknowledges that a violation of the terms of this Restriction could result in the following: (i) upon determination by a court of competent jurisdiction, in the issuance of criminal and civil penalties, and/or equitable remedies, including, but not limited to, injunctive relief, such injunctive relief could include the issuance of an order to modify or remove any improvements constructed upon the Property in violation of the terms of this Restriction; and (ii) in the initiation of an enforcement action and/or assessment of penalties by the Local Approving Authority and/or the Massachusetts Department of Environmental Protection, a duly constituted agency with a principal office located at One Winter Street, Boston, MA 02108 (DEP),to enforce the terms of this Restriction pursuant to Title 5; M.G.L. c.l 11, §§ 2C, 17, 31, 122, 123, 125, 127A-0, inclusive, and 129; and M.G.L c. 83, §11. 4. Provisions to Run with the Land. The rights, liabilities, agreements and obligations created under this Restriction shall run with the Property and any portion thereof for the term of this Restriction. Grantor hereby covenants for [himself/herself/itselfl and his/her/its executors,administrators,heirs, successors and assigns, to stand seized and to hold title to the Property and any portion thereof subject to this Restriction. 2 The rights granted to the Local Approving Authority, its successors and assigns, do not provide, however, that a violation of this Restriction shall result in a forfeiture or reversion of Grantor's title to the Property. 5. Concurrence Presumed. It is agreed that: (i) Grantor and all parties claiming by, through, or under Grantor agree to and shall be subject to the provisions of this Restriction; and (ii) Grantor and all parties claiming by, through, or under Grantor, and their respective agents, contractors, sub-contractors and employees, agree that the Restriction herein established shall be adhered to and shall not be violated, 'and that their respective interests in the Property shall be subject to the provisions herein set forth. 6. Incorporation into Deeds, Mortgages Leases and Instruments of Transfer. Grantor hereby agrees to incorporate this Restriction, in full or by reference, into all deeds, easements, mortgages, leases, licenses, occupancy agreements or any other instrument of transfer by which an interest and/or a right to use the Property, or any portion thereof, is conveyed. 7. Recordation. Grantor shall record and/or register this Restriction with the appropriate Registry of Deeds and/or Land Registration Office within 30 days of receiving the approved Restriction from the Local Approving Authority. Grantor shall file with the Local Approving Authority and the DEP a certified Registry copy of this Restriction as recorded and/or registered within 30 days of its date of recordation and/or registration. 8. Amendment and Release. This Restriction may be amended only upon the approval and acceptance of such amendment by the Local Approving Authority. Release of this Restriction shall be granted by the Local Approving Authority upon(i)Grantor's request of such release; and (ii)the Property being connected to a municipal sewer system and the septic system serving the Property being abandoned in accordance with 310 CMR 15.354. Any such amendment or release shall be recorded and/or registered with the appropriate Registry of Deeds and/or Land Registration Office and a certified Registry copy of said amendment or release shall be filed with the Local Approving Authority and the DEP within 30 days of its date of recordation and/or registration. 9. Term. This Restriction shall run in perpetuity and is intended to conform to M.G.L. c.184, §26, as amended. 10.Rights Reserved. This Restriction is granted to the Local Approving Authority. It is expressly agreed that acceptance of this Restriction by the Local Approving Authority shall not operate to bar, diminish, or in any way affect any legal or 3 equitable right of the Local Approving Authority or of DEP to issue any future order with respect to the Property or in any way affect any other claim, action, suit, cause of action, or demand which the Local Approving Authority or DEP may have with respect thereto. Nor shall acceptance of the Restriction serve to impose any obligations, liabilities, or any other duties upon the Local Approving Authority. 11. Effective Date. This Restriction shall become effective upon its recordation and/or registration with the appropriate Registry of Deeds and/or Land Registration Office. IN WITNESS WHEREOF,the said S &L HOMES,LLC has caused its seal to be hereto affixed and these presents to be signed,acknowledged and delivered in its name and behalf,this 12th day of November,2015,by: S&L HOMES,LLC Richard W.Stuart,Jr.,Manager William H.Lumbard,Manager 4 COMMONWEALTH OF MASSACHUSETTS MIDDLESEX,SS. On this 12th day of November,2015, before me,the undersigned notary public,personally appeared Richard W. Stuart,Jr.Manager of S&L Homes,LLC,proved to me through satisfactory evidence of identification, which were a MA Driver's License, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose,in such capacity. Notary Public Theresa M.ManpaneRl Cammmweakh01�t /Notary Public: . My Commission Expires: 3�gh 1 COMMONWEALTH OF MASSACHUSETTS MIDDLESEX,SS. On this 12th day of November,2015, before me,the undersigned notary public,personally appeared William H.Lumbard,Manager of S&L Homes,LLC, proved to me through satisfactory evidence of identification, which were a MA Driver's License, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose,in such capacity. EV*=BNotary Public 0"0nM1"19-202l Theresa M.Mangar*lllc m wftsbof use 14otaryPublic- My Commission Expires: Approved and Accepted By: Date: Local Approving Au rit DONNA M.WEDGE .^ NOTARY PUBLIC /do 0` COMMONWEALTHEALTHOFMASSACHUSEiTS // �! f°' My Comm.Expires Jury 15,2016 5 EXHIBIT "A" PROPERTY DESCRIPTION: 540&550 BOXFORD STREET,NORTH ANDOVER,MA 01845 PARCEL 1: That certain parcel of land situate in North Andover, Essex County, Commonwealth of Massachusetts, located off Boxford Street and being shown as "Lot V on that certain plan entitled "Plan of Land, Located in North Andover, MA, Record Owners Gorton Family Trust, 624 Boxford Street, North Andover, MA & Applicants Messina Dev. Co., 277 Washington Street, Grovelarid, MA" dated March 5, 2015, scale 1" = 40' is Prepared by Christiansen & Sergi, Inc.,recorded with the Essex North District Registry try of Deeds as Plan No. 17252. Said parcel contains approximately 87,274 square feet (or approximately 2.0035 acres), more or less,of land as shown on said plan. Subject to and with the benefit of easements, rights, restrictions, covenants, conditions, takings and other in of record,insofar as the same are now in force and applicable. PARCEL 2: That certain parcel of land situate in North Andover, Essex County, Commonwealth of Massachusetts, located off Boxford Street and being shown as "Lot 2" on that certain plan entitled "Plan of Land, Located in North Andover, MA, Record Owners Gorton Family Trust, 624 Boxford Street, North Andover, MA & Applicants Messina Dev, Co., 277 Washington Street, Groveland, MA" dated March 5, 2015, scale 1" = 40' prepared by Christiansen & Sergi, Inc.,recorded with the Essex North District Registry of Deeds as Plan No. 17252. Said parcel contains approximately 87,120 square feetor approximately Pproxtmately 2. 0000 acres), more or less, of land as shown on said plan. Subject to and with the benefit of easements, rights, restrictions, covenants, conditions, takings and other matters of record,insofar as the same are now in force and applicable. For title reference see deed from Messina Development Company, Inc.-to S & L Homes, LLC dated 5/13/2015 and recorded with the Essex North Registry of Deeds at Book 14223,Page 282. t t1 V RECEIPT t Printed: November 18, 2015 Q 13:21:0 t Essex North Registry M. Paul Iannuccillo Register Trans#: 24230 Oper:KAIF BILL LOMBARD Book:Y14449sPage: 252 Inst#: 30051 Ctl#: 84 Rec:11-18-2015 ® 1:20:57p NAND 550 BOKFORD ST DOC DESCRIPTION TRANS RMT --- ----------- --------- RESTRICTION Surcharge CPA $20.00 20.00 50.00 recording fee 50.00 5.00 TECH FEE 5.00 Total fees: 75.00 *** Total charges: 75.00 CHECK PM 1123 75.00 • V:> Commonwealth of Massachusetts Map-Block-Lot µ1 , BOARD OF HEALTH Permit No North Andover BHP-2015-0363 • R FEE $250.00 -------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Jesse T. Warren to(Construct)an Individual Sewage Disposal System. at No 550 BOXFORD STREET i-,a as shown on the application for Disposal Works Construction Permit No. BHP-2015-036 Dated August 27,2015 Issued On:Aug-27-2015 LT i � U • Application for Septic Disposal System TOD Y'S DAT Construction Permit - TOWN OF $250.0 —Full Repair NORTH ANDOVER, MA 01845 $125.00-Component Important: Application IS hereby made fora permit to: When filling out onstruct a new on-site sewage disposal system* forms on the computer,use ❑Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component—What? cursor-do not use the return A. Facility Information key. (pr72 BOb)C- Y-a ShOER-4' Address or Lot# rob NDY4b AndOyQ✓ City/Town 2.-*TYPE OF SEPTIC SYSTEM*: ➢ ❑ Pump Gravity(choose one) ***If pump system, attach copy of electrical permit to application"* 2 2015 conventional System(pipe and stone system) �uV ➢ ❑Infiltrator or Biodiff user(Gravel-Less) (Attach a copy of your certification to install hi t�pt;Fo�system.) ❑ Pressure Distribution S.A.S.(No D-Box) SOWN OF NOR �t�EN1 ❑Pressure Dosed(D-Box Present)S.A.S. 00"0)ErN ❑Does the system require an effluent filter? Yes No If yes, does plan specify make and model of filter? YES =(no further info. needed) NO=(installer must specify brand of filter before DWC issuance) What is the Make? What is the Model? 2. Owner Information S L CvKsfyl�•� i-Lc Name lDU�- Address(if different from above) City/Town State ✓� Ye Email address Telephon6 Kun%er 3. Installer Information Jesse -v- yoa im n 7MA aMld cxfi CoName Name of Company —T- 103PnX FOYZ3- 141 Address City/Town State Zip Code 9 75 G19 Telephone Number(Cell Phone#ifpossible please) a. Designer Information T Namev M Name of Company f 16� 5 Address �( rttc,elt,-t rm -1 A O I �� b City/Town State Zip Code Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 4 r _•. Application for Septic Disposal System Construction Permit — TOWN OF TODAY'S DATE NORTH ANDOVER, MA 01845 $250.00-Full Repair $125.00-Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Building: WResidential 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 Andov r. I understand that until a final Certificate of Complian a has been issued by this Boar5hl Health, the installed system is not approved. Name Date Application Approved By: (Board of Health Representative) Name Date Application Disapproved for the following reasons: For Office Use Only: 1. Fee Attached? Yes No 2. Project Manager Obligation Form Attached? Yes No 3. Pump System? Ifso,Attach copy of ElectricalPermit Yes No Applicant received copy of "Electrical Inspection Notes for Septic Systems" Yes No Handout. 4. Reviewed approval letter, all paperwork received? Yes No MISSing: 5. Foundation As-Built?(new construction only): Yes No (Same scale as approved plan) G. Floor Plans?(new construction only): Yes No Application for Disposal System Construction Permit•Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: 6&Z /,, T ti Z /3,,x�� 5 y (14(Address of septic system) For plans by / (Engineer) Relative to the application of J 1e (Installer's name) And dated Dated l/Zo j`J rigtna ate �Z 20! (today's ate With revisions dated y (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 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 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 company. a. Bottom of Bed—Generally,this is the first(1') inspection unless there is a retaining wall,which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection—Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OK (or e-mail to: healthdept(@townofnorthandover.corn) from the engineer must be submitted to the Board of Health,after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system,all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade—Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer,I understand that only I may perform the work(other than simple excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover, significant fines to all persons involved are also possible. 5. As the installer,I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board 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 appr�plans. No instructions by the homeowner,general contractor_or any other persons shall absolve me of this obligation. 1 Undersigned Licensed Septic Installer: O l2'7 l Zc (Today's Date) (Name— Tint) (Mame igne ' • SF;STGEII7�' . E:I�Ej C err/PY ; -•r� • North Andover Health Department Community and Economic Development Division June 23,2015 S&L Homes LLC William Lombard 10 Middleton Ave, Suite 1 Wilmington,MA. 01887 Re: Subsurface Sewage Disposal System Plan for 602 Boxford Street—Lot 2 (Map 105C,Lot 22) Dear Mr. Lombard, The proposed wastewater system design plan for the above site dated June 9, 2015 with a final revision date of June 23, 2015 and received on June 23, 2015 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 Quick 4 High Capacity Infiltrator Chamber system.This design plan approval is valid until June 23,2018. During this time, a licensed septic system installer must obtain a permit and complete this work, and a, Installation Certification 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 Installers 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 Installer's Permit,the applicant must submit the floor plans of the proposed dwelling showing no greater than 4 bedrooms or a total of 9 rooms. 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(310 CMR 15.020(1)): Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 602 Boxford Street—Lot 2 June 23,2015 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. Si7erely, Michele Grant Health Inspector Encl. Installers list cc: Philip Christiansen,P.E. File Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 �---� f %40RTFf q O �t..eo ,e •�. BUILDING PERMIT °OL TOWN OF NORTH ANDOVER ° _- p / ��` APPLICATION FOR PLAN EXAMINATION o H Permit NO: Date Received � 9ssgc►+us Date Issued: 5 EffORTANT:Apphcant must complete all items on this page LOCATION4,5y-SoArA S4h-e_� (Lot *a-) fI Print Ave, 1 PROPERTY OWNER J- 1 L 1'lorvies io l id d/esty Atd)141k ll urs}'ll= bW 2 Print MAP NO:/05-C PARCEL:-?-a ZONING DISTRICT: 'e T Historic District t yes no Machine Shop Village yes no. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential H New Building X One family U Addition u Two or more family U Industrial X Alteration No. of units: U Commercial U Repair, replacement U Assessory Bldg U Others: U Demolition Ll Other U Septic U Well U Floodplain U Wetlands U Watershed District U Water/Sewer 1 �ubYL It Q �Sq 0 S w 'X J I _'�;e c_ Le 40- C� Identification ease Type or Print Clearly) OWNER: Name: J' L tjorvyS Phone:g1W,gYY,a3J3 Address: I01"( iar-sc), Ave-. U11L+ f'_., WU 1M1) Y1 0)119 CONTRACTOR Name- Phone: `P`1R-gq`�.a3y3 Homos d L�5es 11 Lum c�-d G►_'iFT 2-WI; SO 2. Address: 1 Aye-, 1 � ) .L A )c seal AVB. V i i t 3- W' )nti 4fft lea. d W? Supervisor's Construction License: Exp. Date: CS a 4`i (.0 1 a4 Home Improvement License: Exp. Date. 8Ig5ill� laol ARCHITECT/ENGINEER Lac r V_ Phone:9'1'b' 35 a- X31 Address: M �(LsSlLe&i (,)V* 0rCktJowt N4 Reg. No.Q'I O U FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000 D OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ Cl , Oo'_ 0 o FEE: $ I Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/OwnerwJ. L` ' igna.ure of contractor, \ r Plans S ubmitted ❑ -.- dans Waived.[] Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Public Sewer ❑ Tanning/Massage/Body Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE E®LL®WING SECTIONS L. IGN OFFOFFICEHFORME ONLY INTERDEPARTMENT PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Si nature COMMENTS HEALTH Reviewed on I " Sf Signature cOMMENli, V�xvut ii5D a� - hLk oning Decisionlreceipt submitted yes Zoning Board of Appeals:Variance, Petition No: Z Planning Board Decision: Comments Conservation Decision: Comments Water &Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FrIRE DEP�AR NT T� me p D mp tpgntsi te yes rno� Located at �?4 Main Streeta � r 1,qre ®eparfinen£s�gnature/date j C.,OMM --���---- 1 + trr hey . s' 4,� .. tni1 1•¢ta�� -A-rT., z: ltai� y�itt�7� t7� t u t.E i;rC_5 T49LE Vi a , -1 L t.,! 5 f3 4 r + ._. .o o., I..-t. „_. -»�i PO Z-p 1X�k Ata R4 t L-!. OQ. Ls1t°;Lf4.. _,._-..�.� Tt► C�°0af>fw4Tf- 14t 64( t;T .04 42 t 12. �.. - l - vw of,y TdaTRlc_. r2ie } _.. �r�i•` t . _ IR _ N _ _ _-._ �-►� r�� � Lawrence H. Ogden-P.E.. - _- � Eg`��� 198 ast Main St �YAL Et► ��f]IC '�t3Vstf1, MA 011533 -- __ � x (17 ifs 14_-- _ N,Plrs,1 R: P FLQO NEICp4r_ w. ACTT C_ S pERGdC Car _ tN OF{yjs, M Lawrence H.Ogden PS 3 :�► #7,�i T � � ;: 1'�8 East Main St . _ . __ _�:.- Georgetown;-MA-0-1833... ._ i CHRISTIANSEN & SERGI, INC C. S PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET,HAVERHILL,MA 01830 tel:978-373-0310 www.csi-engr.com fax 978-372-3960 June 22, 2015 North Andover Health Department 1600 Osgood Street, Suite 2035 North Andover,MA 01845 RE: Subsurface Sewage Disposal System for 602 Boxford Street—Lot 2 Revised Dear Ms. Grant: I have reviewed your comments on the above referenced Sewage Disposal System and offer the following responses: For ease in review,my comments are printed in blue. 1 / The proposed grading provides more than 3' of cover over the septic tank and one portion of the soil absorption system(3 10 CMR 15.221(7)). The grading has been reduced to 3' or less. ✓2. Cleanouts are required at all bends in the building sewer line (3 10 CMR 15.222(8)). Cleanouts have been provided. 3. Clarification is needed for the design intent and soil removal. It appears the design is proposing removal of the A soil layer and retention of the B soil layer. The B soil layer is a Class II soil but the design calculations are based on a Class I soil (3 10 CMR 15.220). This design was previously approved. Percolation testing was conducted in both B and C Horizons. Rates reflect this. 4. Please label the proposed finished grade over each disposal trench to provide clarity for the installer. Spot elevations have been added to the design over the trench area. Should-you have any questions,please do not hesitate to call me. Sincerely, Philip G. Christiansen. Cc: S&L Homes I • North Andover Health Department (ommunity and Economic Development Division June 22,2015 Philip Christiansen,P.E. Christiansen and Sergi,Inc. 160 Summer Street Haverhill,MA 01830 Re: Subsurface Sewage Disposal System Plan for 602 Boxford Street,Lot 2(Map 105C,Lot22) Dear Mr. Christiansen, The proposed wastewater system design plan for the above site dated June 9,2015 and received on June 10,2015 has been reviewed. Unfortunately,the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000,or North Andover regulation that is not met by this design follows each item. 1. The proposed grading provides more than 3' of cover over the septic tank and one portion of the soil absorption system(3 10 CMR 15.221(7)). 2. Cleanouts are required at all bends in the building sewer line(3 10 CMR 15.222(8)). 3. Clarification is needed for the design intent and soil removal. It appears the design is proposing removal of the A soil layer and retention of the B soil layer. The B soil layer is a Class I1 soil but the design calculations are based on a Class I soil(3 10 CMR 15.220). 4. Please label the proposed finished grade over each disposal trench to provide clarity for the installer. 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. e'erelly Michele Grant Health Inspector cc: S&L Homes File Page 1 of 1 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 TOWN OF NORTH ANDOVER 7-1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER,MASSACHUSETTS 01845 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthde (otoxvnofnorthandover.com WEBSITE: http://wNvw.townofnorthandover.coin SEPTIC PLAN SUBMITTAL FORM Date of Submission: � '/C ` I Q Site Location: 602 Boxford Street Lot 2 Engineer: Christiansen & Sergi, Inc. New Plans? Yes $225/Plan Check# (includes I"submission and one re- review only) Revised Plans?Yes x $75/Plan Check# Site Evaluation Forms Included? Yes No x Local Upgrade Form Included? Yes No x Telephone#: 978-373-0310 Fax#: E-mail: Phil@csi-engr.com Homeowner Name: S&L Homes LLC ��r\\ �, -Gas a OFFICE USE ONLY When the submi Sion is complete(including check): ➢ Date stamp plans and letter ➢ l/ Complete and attach Receipt ➢ _Copy File;Forward to Consultant ➢ L,,,"" Enter on Log Sheet and Database S* CHRISTIANSEN & SERGI, INC 1 PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET, HAVERHILL, MA 01830 Owner's Certification for 602 Boston Street Lot 2 I,William Lombard,the owner of record of 602 Boston Street Lot 2,hereby certify to the following: 1. 1 have been provided a copy of the Title 5 Innovative Alternative Technology Approval for General use dated 2/19/2015 ,the Owner's Manual with maintenance, and I agree to comply with all terms and conditions; 2. The design does not provide for the use of garbage grinders. This restriction is understood and accepted; 3. Whether or not covered by warranty, I understand the requirement to repair, replace,modify or take any other action as required by the Department or the North Andover Board of Health (NABOH),if the Department or the NABOH determines the system to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. Acknowledged: j William Lombard S&L Homes, LLC CHRISTIANSEN & SERGI, INC CS'l PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET,HAVERHILL,MA 01830 tel:978-373-0310 www.csi-engr.com fax 978-372-3960 June 10 2015 North Andover Health Department 1600 Osgood Street, Suite 2035 North Andover,MA 01845 RE: Subsurface Sewage Disposal System for 602 Boxford Street—Lot 2 (Map 105C, Lot 22) Dear Ms. Grant: The above referenced Septic System Design was approved April 13,2015. The lot has been sold and the new owner has changed the house design and location. The septic system design has been modified to reflect the same. Should you have any questions,please do not hesitate to call me. Si er , P ' hristiansen. Blackburn Lisa From: Blackburn, Lisa Sent: Thursday,June 11,2015 2:15 PM To: Dan Ottenheimer;Isaac Rowe; Pam Lally Cc: Grant, Michele Subject: FW: BOXFORD STREET IOT 2 Attachments: LOT 2 PROOF PLAN.pdf 602 Boxford St. lot 2 correct plans. Michele, Stamped copies are in the file. From: Lois Christiansen f mailto:lois@&csi-engr.com] Sent:Thursday,June 11, 2015 8:15 AM To: Blackburn, Lisa Subject: BOXFORD STREET IOT 2 Good morning, Michele requested the proof plan be corrected for Lot 2. 1 will deliver 3 original stamped copies later today. Thanks, Lois Lois Christiansen Christiansen & Sergi, Inc 160 Summer Street Haverhill, MA 01830 978-373-0310 ext. 11 FAX:978-372-3960 www.csi-engr.com 1 t j CHRISTIANSEN & SERGI, INC PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET,HAVERHILL,MA 01830 tel:978-373-0310 www.csi-engr.com fax 978-372-3960 Gil April 8, 2015 e c North Andover Health Department 1600 Osgood Street, Suite 2035 km 092015 � North Andover, MA 01845 70�t RE: Subsurface Sewage Disposal System for 602 Boxford Street—Lot 2 Dear Ms. Grant: I have reviewed your comments on the above referenced Sewage Disposal System and offer the following responses: For ease in review,my comments are printed in blue. 1. Until the new address is provided by the Assessor's office please indicate the address as "602 Boxford Street-Lot 2". This same numbering system should be used for all proposed lots in the subdivision. The new address ID has been added to the plan. 2. The design plan was not stamped and signed by the designer (3 10 CMR 15.220(2)). A stamped original was provided to the NABOH with the original submittal. 3. On sheet 1 of 2, the survey statement was not signed (NA 3.2). A signed original was provided to the NABOH with the original submittal. 4. Itis unclear iftheproposed driveway will be an impervious area(3 10 CMR 15.220(4)(d)). The note"asphalt"has been added to the site plan. 5. On sheet 1 of 2, the conventional system (proof plan) should be shown on the site plan to confirm the location meets the required setback distances. Proof plan has been put on a site plan. 6. A manhole is required at the 90 degree bend in the building sewer line (3 10 CMR 15.222(8)). The design has been revised to omit the 90°turn. 7. On sheet 1 of 2, the depiction of the pipe going through the septic tank should be removed. Pipe has been removed. 8. The manufacturer was not indicated for the septic tank (NA 3.2). However, if it is assumed that the manufacturer is SHEA concrete, the model number indicated on the design plan does not reference a monolithic septic tank. The proper model number has been added to the plan. 9. On sheet 1 of 2, the water line from the well to the proposed dwelling should be depicted. The line has been added. 10.On sheet 2 of 2, the distribution box detail depicts a 2" sump. A minimum 6" sump is required (3 10 CMR 15.232(3)(e)). The 6" sump is noted on the plan. 11.On sheet 2 of 2, the schedule of elevations and the profile indicate c no slope from the outlet of the distribution box to the inlet of the Infiltrator Chamber trenches. That is correct, It is the designer's intent. 12.The breakout elevation should be indicated clearly on the design plan to assist the installer. The breakout elevation is shown on the cross section. 13.Indicate the material of the proposed manhole covers above the septic tank and indicate the material and size of the manhole cover proposed above the distribution box.The material and size is given on sheet 2. 14.Since the Infiltrator Chamber system is proposed as an alternative soil absorption system the "Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for Remedial Use" will apply. Please provide the following as required by the approval conditions Certifications added to plan and copies of Owners documents attached. Section 11(18): a) proof that the Designer has satisfactorily completed any required training by the Company/or the design and installation of the Technology; No training is required. c) certification by the Designer that the design conforms to the Approval, any Company Design Guidance, and 310 CMR 15.000; and Certification is on sheet 2. d) a certification, signed by the Owner of record for theproperty to be senled by the Technology, stating that theproperty Owner: 1. has been provided a copy of the Title 511A technology Approval, the Owner's Manual, and the Operation and Maintenance Manual, and the Owner agrees to comply with all terms and conditions; 2. for Systems installed under a Remedial Use Approval, the owner agrees toful sill his responsibilities toprovide a Deed Notice as required by 310 CMR 15.287(10)and the Approval; 3. for Systems installed under-a Remedial Use Approval, the owner agrees tof rlfrll his responsibilities toprovide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5); 4. if the design does notprovide for the use of garbage grinders, the restriction is understood and accepted; and 5. whether or not covered by a warranty, the System Owner understands the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, If the Department or the LAA determines the System to befalling to protect public health and safety and the environment, as defined in 310 CMR .15.303. Copies of above are attached. Should you have any questions,please do not hesitate to call me. Sin ly L- Christiansen. i S*CHRISTIANSEN & SERGI, INC 1 PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET, HAVERHILL, MA 01830 Owner's Certification for 602 Boston Street Lot 2 I,Robert Messina,the owner of record of 602 Boston Street Lot 2,hereby certify to the following: 1. I have been provided a copy of the Title 5 Innovative Alternative Technology Approval for General use dated 2/19/2015 ,the Owner's Manual with maintenance, and I agree to comply with all terms and conditions; 2. The design does not provide for the use of garbage grinders. This restriction is understood and accepted; 3. Whether or not covered by warranty, I understand the requirement to repair, replace,modify or take any other action as required by the Department or the North Andover Board of Health (NABOH), if the Department or the NABOH determines the system to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. Acknowledged: Robert Messina Messina Development Corp. Commonwealth of Massachusetts Executive Office of Energy&Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 Charles D.Baker Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner APPROVAL FOR GENERAL USE Pursuant to Title 5,310 CMR 15.000 Name and Address of Applicant: Infiltrator Systems,Inc. P.O.Box 768 6 Business Park Road Old Saybrook,CT 06475 Trade name of technology and model: High Capacity chamber, High Capacity H-20 chamber', Quick4 High Capacity chamber, Quick4 High Capacity HD chamber, Quick4 Plus High Capacity chamber (fl- inch invert), Quick4 Plus High Capacity chamber (13-inch invert), Standard chamber, Quick4 Standard chamber, Quick4 Standard HD chamber, Quick4 Plus Standard chamber (5.3-inch invert), Quick4 Plus Standard chamber (8.0-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (3.3-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (8-inch invert), Infiltrator 3050 (Storm Tech SC-740) chamber, Equalizer 24 chamber,Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, Quick4 Equalizer 24 LP(Low Profile)chamber(6 inch invert),and Quick4 Equalizer 24 LP (Low Profile) chamber(2 inch invert) (hereinafter the"System"). Schematic drawings of the System and a design and installation manual are a part of this Certification. This approval allows the installation of the above identified chambers without aggregate. Transmittal Number: X259183 Date of Revision: February 19,2015 Authority for Issuance Pursuant to Title 5 of the State Environmental Code,310 CMR 15.000,the Department of Environmental Protection hereby issues this Certification to: Infiltrator Systems, Inc., P.O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein. The sale, design, installation, and use of the System are conditioned on compliance by the Company, the Designer, the Installer and the System Owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000. February 19,2015 David Ferris,Director Date Wastewater Management Program Bureau of Water Resources This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617.292-5751.TTY#MassRelay Service 1-800-439-2370 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper Infiltrator Chamber,Infiltrator Inc. Page 2 of 6 Approval for General Use—February 19,2015 I. Design Standards 1. The models listed in Table 1 are covered under this Certification. Table 1: Chamber Dimensions Dimensions Invert Model W x L x H Height Inches Inches Equalizer 24 15 x 100 x 11 6 Quick4 Equalizer 24 16 x 48 x 11 6 Quick4 Equalizer 24 LP(6-inch invert) 16 x 48 x 8 6z Quick4 Equalizer 24 LP(2-inch invert) 16 x 48 x 8 2 Equalizer 36 22 x 100 x 13.5 6 Quick4 Equalizer 36 22 x 48 x 12 6 Standard Chamber 34 x 75 x 12 6.5 Quick4 Standard 34 x 48 x 12 8 Quick4 Standard HD 34 x 48 x 12 8 Quick4 Plus Standard 5.3-inch invert34 x 48 x 12 5.3 Quick4 Plus Standard(8-inch invert) 34 x 48 x 12 8 Quick4 Plus Standard LP(3.3-inch invert) 34 x 48 x 8 3.3 Qu1ck4 Plus Standard LP(8-inch invert) 34 x 48 x 8 83 Infiltrator 3050 or StormTech SC-740 51 x 85.4 x 30 22.254 High Capacity Chamber 34 x 75 x 16 11 High Capacity H-20`Chamber 34 x 75 x 16 11 Quick4 High Capacity 34 x 48 x 16 11.5 Quick4 High Capacity HD 34 x 48 x 16 11.5 Quick4 Plus High Capacity(8-inch invert) 34 x 48 x 14 8 Quick4 Plus High Capacity(13-inch invert) 34 x 48 x 14 135 1 This approval allows the use of the high capacity H-20 chambers but makes no determination as to the chambers meeting the H-20 loading requirements. 2 Includes Infiltrator MultiportTM invert adapter attached to the side of the end cap. 3 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in-One 8 Endcap. 4 Only systems installed with this invert height shall be allowed to use the effective leaching area associated with this model in Table 2. 5 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in-One 12 Endcap. 2. The System is an open-bottom leaching unit molded from polyolefin resin. It can be installed without aggregate or distribution pipe as an absorption trench or as a bed or field. If the System is installed with stone aggregate then the "Effective Leaching Area" in Tables 2 and 3 is not applicable, and must be designed in accordance with the provisions of 310 CMR 15.000. Infiltrator Chamber,Infiltrator Inc. Page 3 of 6 Approval for General Use-February 19,2015 3. The total effective leaching area for any Chamber Model shall be calculated by multiplying the Effective Leaching Area per square foot of chamber times the total length of chamber from end cap to end cap including end caps. 4. For new construction or upgrades,the applicant can size the System in a trench configuration,using the effective leaching areas presented in Table 2. Table 2: Effective Leaching Area in Trench Configuration for New Construction and Remedial Sites' Effective Effective Model Leaching' Leachings Area Area SF/LF SF/LF Equalizer 24 3.76 N/A Quick4 Equalizer 24 3.90 N/A Quick4 Equalizer 24 LP (6-inch invert) 3.90 N/A Quick4 Equalizer 24 LP(2-inch invert) 2.78 N/A Equalizer 36 4.73 NIA Quick4 Equalizer 36 4.73 N/A Standard Chamber 6.53 N/A Quick4 Standard 6.96 N/A Quick4 Standard HD 6.96 N/A Quick4 Plus Standard(5.3-inch invert) 6.20 N/A Quick4 Plus Standard(8-inch invert) 6.96 N/A Quick4 Plus Standard LP(3.3-inch invert) 5.65 N/A Quick4 Plus Standard LP (8-inch invert) 6.96 N/A Infiltrator 3050 or StormTech SC-740 N/A 6.71 High Capacity Chamber 7.79 N/A High Capacity H-20 Chamber' 7.79 NIA Quick4 High Capacity 7.93 N/A Quick4 High Capacity HD 7.93 N/A Quick4 Plus High Capacity(8-inch invert) 6.96 N/A Quick4 Plus High Capacity(13-inch invert) 7.93 N/A '. Effective April 21,2006,310 CMR 15.251(1)(b)maximum trench width is 3 feet. '.Effective leaching area is equal to 1.67(bottom width+(2x invert height))for Systems 3 feet or less in width. 8.Effective leaching area is equal to 1.0(3 +(2x invert Height))for Systems with a width greater than 3 feet. 9.The maximum trench width allowed to calculate effective leaching area is 3 feet. 5. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Tables 2 or 3,or additional reductions in soil absorption system may be allowed. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. y Infiltrator Chamber,Infiltrator Inc. Page 4 of 6 Approval for General Use—February 19,2015 6. For new construction or an upgrade,the applicant can size the System in bed or field configuration,using the effective leaching areas presented in Table 3. Table 3: Effective Leaching Area for Bed or Field Configuration New Construction and Remedial Sites Effective Model Leaching10 Area SF/LF Equalizer 24 2.09 Quick4 Equalizer 24 2.23 Quick4 Equalizer 24 LP(6-inch invert) 2.23 Quick4 Equalizer 24 LP(2-inch invert) 2.23 Equalizer 36 3.06 Quick4 Equalizer 36 3.06 Standard Chamber 4.73 Quick4 Standard 4.73 Quick4 Standard HD 4.73 Quick4 Plus Standard(5.3-inch invert) 4.73 Quick4 Plus Standard(8-inch invert) 4.73 Quick4 Plus Standard LP (3.3-inch invert) 4.73 Quick4 Plus Standard LP(8-inch invert) 4.73 Infiltrator 3050 or StormTech SC-740 7.10 High Capacity Chamber 4.73 High Capacity H-20 Chamber' 4.73 Quick4 High Capacity 4.73 Quick4 High Capacity HD 4.73 Quick4 Plus High Capacity(8-inch invert) 4.73 Quick4 Plus High Capacity(13-inch invert) 4.73 10.Effective Leaching area is equal to 1.67 times bottom width only. 7. When the System is used with a secondary treatment unit approved in accordance with 310 CMR 15.284 or 15.288,additional reductions in soil absorption system may be allowed. In these situations the reduction in the SAS cannot exceed the maximum allowed under the secondary treatment units approval. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. II. Special Conditions 1. The System is an approved Alternative Chamber for use as an Alternative Soil Absorption System. In addition to the Special Conditions contained in this Approval, the System shall comply with the"Standard Conditions for Alternative SAS with General Use Certification and/or Approved for Remedial Use"(the Infiltrator Chamber,Infiltrator Inc. Page 5 of 6 Approval for General Use—February 19,2015 'Standard Conditions'), except where stated otherwise in these Special Conditions, 2. New Construction This Certification is for the installation of a System to serve new construction or an existing facility with a proposed increase in flow, for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction,as provided in Paragraph 6 in section II Design and Installation Requirements of the Standard Conditions. 3. Remedial Site This General Use Certification also applies to the installation of a System for the upgrade or replacement of an existing failed or nonconforming system,provided that the facility meets the siting requirements for upgrades,as provided in Paragraph 7 in section II Design and Installation Requirements of the Standard Conditions 4. The System shall be exempt from the minimum inlet spacing requirements of 310 CMR15.253. 5. The System shall have a minimum of one inspection port through the top of one of the chambers. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. 6. When the System is installed in trench configuration,then the system shall comply with these requirements: a) Length(each trench) 100 feet maximum(3 10 CMR 15.251(1)(a)); b) Width(each trench)2 feet minimum to 3 feet maximum(3 10 CMR 15.251(1)(b)). -Chambers greater than 3 feet wide,when specifically approved, are subject to other Special Conditions and limitations; c) The minimum separation distance between any two trenches shall be two times the effective width or depth of each trench,whichever is greater, or where the area between trenches is designated as reserve area,three times the effective width or depth of each trench,whichever is greater(3 10 CMR 15.251(1)(d)); d) The effective leaching area shall be calculated using the bottom area and a maximum of two feet(per side)of side wall area for each trench(3 10 CMR 15.251(1)(e)); e) Trenches shall be situated,where possible,with their long dimension perpendicular to the slope of the natural soil. Where possible they shall follow the contour lines(3 10 CMR 15.251(2)); f) Trenches constructed at different elevations shall be designed to prevent effluent from the higher trench(es) flowing into the lower trench(es)(3 10 CMR 15.251(3)); g) The area between trenches may be designated as system reserve area only where the separation distance between the excavation sidewalls of the primary trenches is at least three times the effective width or depth of each trench, whichever is greater(3 10 CMR 15.251(4))-Chambers greater than 3 feet i Infiltrator Chamber,Infiltrator Inc. Page 6 of 6 Approval for General Use—February 19,2015 wide,when specifically approved, shall be separated by three times the actual width and are subject to other Special Conditions and limitations; and h) Effluent distribution lines exceeding 50 feet in length shall be connected and venting provided in accordance with 310 CMR 15.241 (3 10 CMR 15.251(11)). 7. When installed in trench configuration,approved Alternative Chambers greater than 3 feet wide: a) shall be installed with a minimum separation distance between any two trenches of two times the actual width of the chamber,or where the area between trenches is designated as reserve area,three times the actual width of the chamber; and b) shall only be entitled to a maximum effective width of 3 feet for the purposes of calculating total effective leaching area. 8. When installed in a bed or field configuration,the System may be installed without distribution piping,but must comply with the following requirements in 310 CMR 15.252: a) the use of leaching beds or fields is restricted to systems with a calculated design flow of less than 5,000 gpd per leaching bed or field(3 10 CMR 15.252(1)); b) the maximum length of chambers in series shall be 100 feet(3 10 CMR 15.252(2)(b)); c) separation distance between adjacent beds/fields shall be ten feet(3 10 CMR 15.252(2)(0); and d) the effective leaching area shall include only the bottom area,not the sidewalls(3 10 CMR 15.252(2)(1)). 9. For Systems constructed in fill and installed,the System shall be installed as specified in 310 CMR 15.255 Construction in Fill,except the minimum 15 foot horizontal separation distance to be provided between the soil absorption area and the adjacent side slope shall be measured horizontally from the top of the chamber. 10. The System is exempt from 310 CMR 15.287, specifically items: (5)requiring written notification of alternative system prior to property transfer, (6)need for a certified operator, (9)need for an operation and maintenance contract with an operator and(10) deed notice requirement. o- �. .y ��21�i ►r.4�J V Ll�:./ r u, r » e 1 l l t e r y Yr � ` � • �xt� ' t. i► ' `1 t ti a ' » 9 1 A Guide to the Proper Care and Maintenance oflour Onsite Wastewater Treatment System COURTESY OF INFILTRATOR,SYSTEMS, INC. Deer Septic system Owner, A RESIDENTIAL SEPTIC SYSTEM: What's Inside Clean water is our heritage—it§also our rospoWlWity.As the population # _ grows andmore/arid isdeveloped,wemust all find new ways tosafeguard Your onsite wastewater treatment plant r Page 3 ourenvironment for future generations. The Residential Septic System: At Infiltrator were doing our part by using science to design better What is a Septic System? Your Onsite Wastewater performing septic systems.We manufacture ratable Products from Phvmwrq vW Treatment Plant primarity recycled materials.Our reduced footprint minim&e's disruption A septic system is an onsite wastewater Page 7 o1 the environment AB of this provides septic system owners with treatment system that processes and purifies I ' � ..� The Infiltrator Product System: products they can trust for superiorpedormance,ease ofmaintenance, household waste(effluent).The effluent consists ti Today's Modern Solution and long-term value. r , of blackwater(toilet wastes)and graywater 4- �- What started over26years ago asanidea for abetter ieachfiefd,isnow - (kitchen sink,bathtub and laundry wastes).testi :' Page t0 a worldwide company with a broad range ofproducts in service in North L' Care and Maintenance of Your Infiltrator System day,America and around the world.Toone in every three systems installed in North America is an Infiltrator system.This Septic System Owner's Manual A Septic System has 1W0 components: explains how septic systems work describes the buts of the Infiltrator a septic tank and a leachfield or drainfield. system,and provides valuable tips forpropersystem maintenance.This Primary treatment occurs in the septic tank, is part of our commitment to making sure that clean wafer is where bacteria digest organic materials in the CONGRATULATIONS ... eve yorreSbus ess wastewater.The effluent then flows into the x,� ___ .= �. . . . _•' Your leachfletd system Is constructed with Infiltrator products. leachfield for secondary treatment.Here,bacteria Infiltrator products,manufactured of recycled materials,Interlock complete the digestion and purification process together to form a continuous drainage area.These state-of-the-art Mme. A standard septic system has two components:a septic tank and a leachfield, 9 �� as the wastewater slowly leaches or infiltrates G systema offer many advantages over old-fashioned stone and pipe President&CEO 1 into the soil. systems.They treat more effluent,more efficiently,In a smaller area. Irifiitrator Systems Ino. . r .. AW y 71 n 9 wawAdNetl0.gy7ftm�,ram � ♦ a++�.. `�� � ^�.. � � SYSTEM COMPONENTS:THE SEPTIC TANK SYSTEM COMPONENTS:THE LEACHRELD The septic tank is a watertight underground box,about eight feet Found in all three of these layers are billions of bacteria that live From the septic tank,partially treated effluent flows Into a leachfield, long,four feet wide,and five feet deep.It typically has at least a naturally in the tank and perform the first phase of treatment to which typically has two or more trenches.This is where effluent is 1,000-gallon capacity for retaining,storing,and treating solids,in break down solid matter.The bacteria digests the solid materials. naturally purified as it percolates down through the soil. addition to releasing effluent into the leachfield,sometimes called In the process,gases are produced,which are vented from the a drainfield. septic tank through the plumbing vent on your rooftop. For proper effluent purification,the distance between the trench As wastewater flows into the tank,heavy solids settle to the bottom and the water table should be equal to or greater than the bottom into a sludge layer,while grease and fats float to the top minimum distance allowed by your local health department.The soil - forming a layer of scum.Between these two layers is a clear zone acts as a biological filter,removing harmful substances before the of liquid called the clarified zone. effluent reaches the groundwater. Infiltrator Systems manufactures chamber systems and Wow Access port Scum layer Battle Access port Geosynthetic Aggregate systems which are both used In leaeh0eld installations. J: Inlet pipe - - .—Outlet Clarified zone y e ' Effluent flows into the leachfield where it is naturally purified as it percolates Sludge layer w' down through the soil. cutaway of an infiltrator Septic Tank The naptic tank retsina,stores and treats solids before releasing effluent into the leachfleld. +wawArAglrgM,yeNme,axn Wow goosynthenc leachfield. soft sy t..own.,e Mwwl s OLD-FASHIONED SYSTEMS: TODAY'S MODERN SOLUTION: STONE AND PIPE SYSTEMS INFILTRATOR CHAMBER SYSTEMS. Old-fashioned systems use gravel or crushed stone in the Infiltrator Chamber Systems E2flow Systems leaching trenches to create void space to store the effluent and Infiltrator chambers are hollow structures that attach end-to-end. EV/ow Is an environmentally friendly replacement to traditional release it slowly.However,such systems are prone to eventual They are installed in trenches or beds without gravel(except stone In septic dralnfields using an engineered geosynthetic t? failure as the voids(empty spaces)around the gravel become where local codes require the use of gravel).The entire bottom of aggregate modular design.The Uflow system is designed plugged.This phenomenon occurs over time as solids build-up the trench is open for unobstructed infiltration of water.The large to improve infiltrative performance by eliminating the fines and between the stones,limiting infiltration of water into the soil, storage volume within the hollow chambers accommodates peak reducing compaction and embedment associated with crushed As the gravel settles,it also tends to compact and accumulate flows of effluent from the home.Infiltrator chambers also feature stone. fines(small soil particles),further reducing the infiltration rate. patented sidewall louvers that allow lateral leaching of effluent into the soil. (i q S Infiltrator chamber to. EZtlow geosynthetic U: ►Stone and pipe systems can fail " systems'design s systems replace stone because solid matter clogs the eliminates the need in a traditional system 4 space between the stones. f- for stone.The $ reducing compaction ` entire trench r and fines. { bottom is open > for unobstructed ' rA t- infiltration. x Stone bbcka a reduces infiltration rate. 't, e�anao-Pcmmromscam LioPtk AYPIam OwnwR Mnnud 7 4 = ADVANTAGES OF INFILTRATOR PRODUCTS ADVANTAGES OF SEPTIC SYSTEMS OVER STONE AND PIPE OVER SEWER SYSTEMS isr r.� Infiltrator products are today's superior alternative to The alternative to septic treatment technology are sewer systems, old-fashioned stone and pipe because they: which pipe waste to a centralized treatment plant,typically near a y Provide long-term savings due to longer life and greater river or other body of water for disposal after treatment.In addition to being a cost effective alternative to expensive sewer lines, operating efficiency 9 P Offer worry-free,free,Ion -term service with on simple, septic systems are environmentally superior to sewers because they: _ � ,�• rry- 9 N P r; routine maintenance —Provide simple,effective onsite wastewater treatment —Allow the groundwater to be recharged onsite, Protect landscape from damage caused by heavy equipment 9 nJ which makes more clean water available for use —Provide greater treatment area to handle more wastewater -71 T + with higher efficiency —Avoid contamination of local groundwater caused by ageing which leak untreated effluent into the soil —Offer a"greener"approach utilizing recycled plastic resins sewer lines, to manufacture the roducts —Avoid environmental disasters of raw sewage discharges from f * P accidentsrocessin floods or plants during processing - Are backed by a minimum 1-year warranty and a reputable, treatment p ~ V service oriented company 0- Infiltrator products can be installed in curved, •. —Can be installed in tight,sloped and curved areas creating sloped and small areas allowing for optimal land use, less site disruption ~ ►Infiltrator systems are designed to safeguard our environment for future generations, LY;" . Y�a ar ,r xtr t Fh`s. .�°r lo, Pollution from sewage. M, samk °tLmd�t Y *' - y ._ _.�^� sc .... �. a CARE AND MAINTENANCE OF YOUR INFILTRATOR SYSTEM LOCATING THE SEPTIC TANK SEPTIC SYSTEM MAINTENANCE RECORD A septic system may be out of sight,but it definitely should not be Whythe Tank Needs Pumping Periodical) It's very Use the chart below to record standard system maintenance such out of mind,With proper standard maintenance and b being more p 9 Y ry important to know where the tank is in order to have it as the dates the tank was pumped P P Y 9 inspected and pumped.Here are three different ways to find your aware of our daily livinghabits,you will greatly improve the life About 95 percent of the sludge and scum that is in your septic y g Y p tank is broken down by bacteria.The other 5 percent remains in septic tank. 1 •i and health your system.Here are some guidelines to help you the tank and builds up in the sludge layer.Consequently,your 1. Ask to see the septic system permit for your property protect yourr septic system Investment septic tank must be pumped out regularly.Otherwise,solids would at your local health department,town or city hall. eventually fill the tank and wash-out into the leachfield.This is It will have a diagram of your system on it. detrimental to the overall health and longevity of your system. p. See where the sewer line leaves your house,the tank CAUTION:If solids do overflow from the septic tank into the should be about 10 feet outside the foundation wall. leachfield,they will prematurely clog the soil pores(openings). 3. Have your septic contractor probe with a steel rod, Pumping out the septic tank at that point will not restore the taking care to avoid damaging the tank or underground utilities. system.The most likely solution would be installing a new leachfield in a different area,which can be very expensive and disruptive to your property. Have your tank checked by a septic system contractor every two to three years.If you have high water usage or a garbage disposal, the inspections should be more frequent.Use the septic system maintenance record on page 11 to enter and date each inspection Infiltrator Septic Tank and pumping. 10 wwx.lefiRretasyetmmmm BapNe byelam Ownaft Mwwsi 11 DIAGRAMMING THE LOCATION THE DAILY INS AND OUTS OF A HEALTHY SEPTIC SYSTEM Once you know where the septic tank is,use the septic system on the layout equal 5 feet x 5 feet or 10 feet x 10 feet.Measure THE INSIDE STORY ✓No paints,oils,chemical drain cleaners,thinners,solvents, layout below to sketch the location of your house,driveway,septic and record the exact footage from the house to each septic tank poisons,or pesticides.These toxic chemicals not only tank,and leachfleld.Depending on your lot size,let each square access port or cleanout spot. You can protect the performance and life of your system by kW helpful bacteria,they may also contaminate the controlling what goes into and through your septic system. Here's how: groundwater. Contractor, 0 Conserve water.Large volumes of water over a short period ✓No grease or cooking oils.Grease may harden in the septic of time will flush untreated solids out of the septic tank into the tank's scum layer and build up until it blocks the inlet or leachfieid. outlet.If you mail grease and pour it down the drain,it may run through the septic tank and then harden,clogging the Contact Info: ✓Practice conservation every day.For example,turn off soil pores in your leachfield. the faucet while brushing your teeth. ✓Go easy with your garbage disposal.Using a garbage ✓Space out heavy water-using activities such as washing disposal typically doubles the rate of solids buildup In the clothes and taking showers. septic tank.To avoid frequent pumpouts,compost your ✓Repair leaky faucets and valves.Consider replacing old garbage or put it in the trash. toilets that use 3.5 to 5 gallons per flush with J 1.1new 1.6 gallon fixtures. 0 Be cautious with household chemicals.Disinfectants, ammonia,bathroom cleaners,bleach,etc.can kill the bacteria ® Keep your drains clean.Remember your system needs in order to operate properly.Allow the Permit Number: that a septic system uses natural system to dilute and neutralize them a little at a time. r tIE �1 biological processes,so only ✓Infiltrator doesn't recommend the use of additives that claim biodegradable waste should go in it, to boost the bacteria count or extend septic system life, Your septic system layout r= f ✓No cigarette butts,tissues, Bacteria are already present by the billions,and additives sanitary napkins,disposable won't affect the need for periodic pumping, 1 diapers,catbox litter,coffee grounds or cotton swabs. tR vww.IMRmtaeyMamo-mm %ptio so-0-6 M-1 13 THE DAILY INS AND OUTS OF A HEALTHY SEPTIC SYSTEM INFILTRATOR'S FAMILY OF PRODUCTS NOWYOU'RE AN INFORMED QuiCk•f Quick4&Quick4 Plus Chamber Systems THE OUTSIDE STORY Infiltrator chamber systems are a direct replacement for old-fashioned }fr yr Here's how you can control what happens outside your septic INFILTRATOR SEPTIC SYSTEM OPERATOR Quick.-stone and pipe leachfields.Infiltrator chambers give designers,engineers, installers and homeowners great flexibility in placement of the septic leachfield, system. Most problems with septic systems are due to lack of proper care. x 0 Keep surface water away.Divert downspouts,roof drainage, With a little attention,your Infiltrator chamber or EZflow septic EZflown driveway runoff,and sump pump discharge away from the system can be a valuable asset to your property.It all comes I'down EZ&w lly lly friendly en modular design.The EZflow system is aggregate m leachfield.Landscape your yard to channel rainwater away. to knowing where your system is,protecting it from internal and using an engineered gens EZflow is an environmentadly replacement to traditional stone and pipe drainflelds designed to improve infiltration performance m eliminating the fines associated with ® Encourage the right plants.Remove trees such as willows external problems,giving it regular maintenance,and calling a crushed stone,and reducing compaction and embedment associated with stone. that like"wet feet."Their roots may penetrate and damage the professional septic contractor when you need help.If you follow leachfield.Grow grass or ground cover over the septic system these simple guidelines,it will benefit the environment,as well as Septic Tanks to prevent soil erosion.Plant beneficial trees such as pines yourself.Infiltrator chamber and EZflow septic systems are theNFf LruA-row infiltrator septic tanks provide a revolutionary improvement in plastic septic near the leachfield to absorb water. premier onsite wastewater systems and,now,you're an informed "'`"°` tank design,offering exceptional strength comparable to concrete tanks. ® Avoid physical damage.Don't drive over the system or septic system operator, There's a full range of tank sizes to best suit your needs. compact the soil with heavy equipment,Don't dig in the EZset Risers and Lids ' leachfield or build anything over it.Don't cover the tank or 4=EZSet EZset risers and lids are made from glass reinforced polypropylene, leachfield with concrete or blacktop. f """''n` providing superior strength and durability.Ideal for use with any For more information on septic products, concrete or plastic tank.The slip resistant lids are fastened using Call Infiltrator Systems: stainless steel screws and can be further secured by installing locking rings. 1-800-221-4436 Aquaworx IPC Panels Or visit our website: ;�AGUAwor x Aquaworx IPC Panels provide an innovative approach to pump control where a pump N www.infittratorsystems.com is required.These panels use a floatless pressure transducer technology,monitors t liquid levels,controls pumping time intervals and logs events in real-time.Panels are available in simplex or duplex. f1 wxw.iMMrafaryelnme.aem 9eptk Syefem OwmY�Mawel 10 , i 4 l INFILTRATOR a 4Busines 7p Park olad 18 P.O. .5 x7 68 1 Old Saybrook,CT 06475 S`! --31-7 l". 1-800-221-4436 1 www.infiltratorsystems.com U.S.Patents:4,759,661;5,017,041;5,156,488;5,336,017;5,401,116;5,401,459;5,511,903;5,716,163;5,588,778;5,839,844 Canadian Patents:1,329,959;2,004,564 Other patents pending, Infiltrator,Equalizer,Quick4 and Sidewinder are registered trademarks of Infiltrator Systems Inc.Infiltrator is a registered trademark in France.Infiltrator Systems Inc.is a registered trademark in Mexico.Contour,Contour Swivel Connection,Microl-eaching,MultiPort,PolyTuff,SnapLock,ChamberSpacer,Posil-ock,QuickPlay and QuickCut are trademarks of Infiltrator Systems Inc. 0 2013 Infiltrator Systems Inc. Not responsible for any typographic errors.Printed in U.S.A. A50 0613 ti f' �.0M� I Tzar 1 l L�� North Andover Health Department Community Development Division April 13,2015 Messina Development Corp 277 Washington Street Groveland,MA 01834 Re: Subsurface Sewage Disposal System Plan for 602 Boxford Street—Lot 2 (Map 105C,Lot 22) To Whom It May Concern: The proposed wastewater system design plan for the above site dated March 25,2015 with a final revision date April 9,2015 received on April 9,2015 has been approved. Please note that the designer has chosen to provide no slope in the pipe from the outlet of the distribution box to the inlet of line#2 of the leaching facility. Although not a requirement by Title 5 or the North Andover Board of Health it is strongly recommended that all distribution pipes from a distribution box to a leaching facility meet a minimum slope of 0.01 (1/8 inch per foot). 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 Quick 4 High Capactiy Infiltrator Chamber system. This design plan is valid for 3-years from the date of approval. 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. 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 Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035 North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 602 Boxford Street—Lot 2 April 13, 2015 Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission,Zoning Board, Planning Board,Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. 3. Cleanouts to finish grade will be required at all bends in the building sewer pipe in accordance with 310 CMR 15.222(8)). 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. erely, Michele Grant Health Inspector Encl. Installers list cc: Philip Christiansen,P.E. File Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 BUILDING PERMIT NEORTHp ,bgti TOWN OF NORTH ANDOVER or yrr.' Y,'•,n.se APPLICATION FOR PLAN EXAMINATION 0 Permit No#: Date Received �RwTED 9SSgCHUS�� Date Issued: Il"ORTANT:Applicant must complete all items on this page 1. `RROP.,.ERTtY,'OWNER i'�/IE� .• �. n ,Pant 100 Yeaf Structure . : yes n ,PARCEL. ZONING DISTRICT: ' Historic,District yes no Maehnop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential flew Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ 7 •e Pt� Uxl/ell��- '�'�'; o iri, i�tWetlantls� �� �� ❑ �1lUat��rsle e��'`t'r`i>t� T' �` 321 Waw/ we i v P DESCRIPTION OF WORK TO BE PERFORMED: N t S►J�)1e TAM �Lq2 t I [ � l c � Sq +Ertl Wei Identification- Please Type or Print Clearly 7 � + OWNER: Name: k L �-AunGG L-LC Phone: 9�S 6/6, A Address: 01 i rsb 1 p F! U N -� 91 �r,o ®/8&7 ..`:� ,., i 5��`" �.� gi..- 7 yr.t s ..1.. -�A, ytt: - �u Y•,w r' ,,.r,^ ... ' Supervisor�sConstructioriLicerise}`�C:r5 �! r ExpDate .. iY�.,� � .�r.a r "'C r w ) �'" '�t,fi,�'ai ;+i.la+.yY+ ^^_ x�:•r ,� 'tiY r �r.��3c,� '••` $r�cy.4 �:y c;y+h. � +.:.. Home:Improvement License ARCHITECT/ENGINEER R(Zq�DE� �� Phone: AddressMEMAQ S+�&© ✓t1 M 10 ?Reg. No.*� 77 6 FEE SCHEDULE;BOLDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No,: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund , r. Plans Subrri�ted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL, Public Sewer ❑ TanningWassage/Body Art ❑ Swimming Pools ❑ Well A30eTobacco Sales ❑ Food Packaging/Sales 0 Private(septic tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS 4EALTH Reviewed on Si nature CV COMMENTS'Da Y) UAW A VW ova, ..oning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Tanning Board Decision: Comments :onservation Decision: Comme Vater&Sewer Connection/sl nate ° t Driveway Permk( LPW Town Engineer: Signature: Located S8 Osgo d Street I .,DEPAR1rjt ERITTem ®p gP&itey oratedat,1a24 Main Street artmen si, ate Y t • North Andover Health Department (ommunity Development Division March 31, 2015 Philip Christiansen,P.E. Christiansen and Sergi, Inc. 160 Summer Street Haverhill,MA 01830 Re: Subsurface Sewage Disposal System Plan for 602 Boxford Street—Lot 2 (Map 105C,Lot 22) Dear Mr. Christiansen, The proposed wastewater system design plan for the above site dated March 25,2015 and received on March 26,2015 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. Until the new address is provided by the Assessor's office please indicate the address as "602 Boxford Street—Lot 2". This same numbering system should be used for all proposed lots in the subdivision. 2. The design plan was not stamped and signed by the designer(3 10 CMR 15.220(2)). 3. On sheet 1 of 2,the survey statement was not signed(NA 3.2). 4. It is unclear if the proposed driveway will be an impervious area(3 10 CMR 15.220(4)(d)). 5. On sheet 1 of 2,the conventional system(proof plan) should be shown on the site plan to confirm the location meets the required setback distances. 6. A manhole is required at the 90 degree bend in the building sewer line(3 10 CMR 15.222(8)). 7. On sheet 1 of 2,the depiction of the pipe going through the septic tank should be removed. Page 1 of 3 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 r 8. The manufacturer was not indicated for the septic tank(NA 3.2). However, if it is assumed that the manufacturer is SHEA concrete,the model number indicated on the design plan does not reference a monolithic septic tank. 9. On sheet 1 of 2,the water line from the well to the proposed dwelling should be depicted. 10. On sheet 2 of 2,the distribution box detail depicts a 2"sump. A minimum 6"sump is required(3 10 CMR 15.232(3)(e)). 11. On sheet 2 of 2,the schedule of elevations and the profile indicate no slope from the outlet of the distribution box to the inlet of the Infiltrator Chamber trenches. 12. The breakout elevation should be indicated clearly on the design plan to assist the installer. 13. Indicate the material of the proposed manhole covers above the septic tank and indicate the material and size of the manhole cover proposed above the distribution box. 14. Since the Infiltrator Chamber system is proposed as an alternative soil absorption system the"Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for Remedial Use"will apply. Please provide the following as required by the approval conditions Section II(18): a) proof that the Designer has satisfactorily completed any required training by the Company for the design and installation of the Technology; c) certification by the Designer that the design conforms to the Approval, any Company Design Guidance, and 310 CMR 15.000; and d) a certification, signed by the Owner of record for the property to be served by the Technology, stating that the property Owner: 1. has been provided a copy of the Title 5 IIA technology Approval, the Owner's Manual, and the Operation and Maintenance Manual, and the Owner agrees to comply with all terms and conditions; 2. for Systems installed under a Remedial Use Approval, the owner agrees to fuNll his responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10)and the Approval; 3. for Systems installed under a Remedial Use Approval, the owner agrees to fulfill his responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5); 4. if the design does not provide for the use of garbage grinders, the restriction is understood and accepted; and 5. whether or not covered by a warranty, the System Owner understands the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. Page 2 of 3 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 sop, . u 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 �- LI hele Grant Health Inspector cc: Messina Development Corp File Page 3 of 3 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 �R a TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES '' HEALTH DEPARTMENT ' 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX }lea Ithdeptotownofnorthandover.cotn www.townofnortliando ver.com Well and/or Puma ADplic_ ation �_ /5 (Please print) DATE: LOCATION to Drill Well or install a pump:Lot#2 Boxford Road Licensed Well Contractor Name and Company Name: George W. Rollins Charles M. Rollins Co., Inc. Contact Phone Numbers: Homeowner: ! `'e J1 N ��- "r'�G Address: �7 p��(r ►f S'7'. Je�,4�✓D Contact Phone Numbers: i _7� $3� WELLS(to be completed at time of pump test) Type of well: Bedrock Use: Domestic Diameter of well: 6" Size of Casing 6" Depth of bedrock: 19' Depth of casing into bedrock: 31' RECEIVED Seal been tested? Yes(Y) No( ) Date of test: q—*-I —t S APR 3 0 2015' Depth of well:500 C4,,,gtt.i t-r�e Water-bearing rock: TOWN OF NORTH ANDOVER Depth of water: 11. Delivers:6'3 GPM for: Z— HEALTH DEPARTMENT t (how long) Drawdown: �Qt� feet after pumping: hours at: Cot 3 GPM Date of Completion: Signature fjAVell Contractor PUMPS(To be filled in before installation)),/ 'j n L , Name&size of Pump: (��$t1LDrj `�H'i Type: j�Ilk,/'3.1 Size of Tank: '76 V) Pump delivers: GPM n Pipe used in well: Cast Iron_ Galvanized Plastic Zc9 rJ f 5 t Sleeve used to protect pipe? Yes No Type well seal: te: t'.1 l "I _j, Signature of p Installer ter analysis report submitted to Health Department: Wiring Inspector Health Department Representative '\HEALTMWebUpdates\WordForms\Well Application.doc Massachusetts Department of Environmental Protection Bureau of Resource Protection Well Completion Reports Well Driller Please specify work performed: Address at well location: New Well Street Number. Street Name: LOT#2 BOXFORD ROAD Please specify well type: Building Lot#: Assessor's Map#: Assessor's Lot#: ZIP Code: Number Of Wells: F -_.. I J City/Town: Well Location NORTH ANDOVER In public right-of-way: GPS �w # Yes r North: West: 42.66818 71.04703 Subdivision/Property/Description: Mailing Address: f click here if same as well location address Property Owner: Street Number: Street Name: MESSINA DEVELOPMENT CO.,INC. 277 WASHINGTON STREET City/Town: State: Engineering Firm: GROVELAND MASSACHUSETTS ZIP Code: 01834 Board of health permit obtained: F�' Y ' Not Requi ` esred]lj Permit Number: Date Issued: BHP 2015 0082 03/31!2015 i, Massachusetts Department of Environmental Protection Bureau of Resource Protection–Well Driller Program t Well Completion Reports(General) s Well Driller - General Well Form DRILLING METHOD Overburden Bedrock wudRotary Lr Hammer WELL LOG OVERBURDEN LITHOLOGY Drop in drill Extra fast or Loss or addition From(ft) To(ft) Code Color Comment stem slow drill rate fluid Silty Send And Gr Brown YES r l0 E �` Fast f: Slow i I r' Loss r Addi rT WELL LOG BEDROCK LITHOLOGY Drop in drill Extra fast or Loss or addition of Visible Extra From(ft) To(ft) Code Comment stem slow drill rate fluid Rust Large Staining Chips (1'"9 100 Granite # C YES t: pp G � _(' --_l � t y �..�._ II Fast C' Siow Loss Addition Ye Ye _ t ...-,. --t j 100^0200 Granite YES r N01 Fast Ir Slow i.l Loss r Addition r Yes? Ye ,200 7 3 Granite < YES G NO s r Fast Slow < Loss t" Addition r YeYe r30D �—� 400__.. Granite � � _ � YES N0i Fast C' Slow; loss C Addition Yes Ye i _ 1 v" 400 X500 Granite �� .H__� .+ �ES NJ Fast Slow; Loss C Addition Yes J F Ye ADDITIONAL WELL INFORMATION Developedf' Yes r No Disinfected i Yes f No I- ----._-...1 L_._,_._...- —_ Total Well Depth 500 Depth to Bedrock 19 Fracture - Surface Seal Type gone Enhancement i C' Yes CASING r is Casing above ground?, From: 1 To: 0 From To Type Thickness Diameter Driveshoe Steel 17# i° i (v Yes SCREEN 1,r No Screen From To Type Wot Size Diameter Massachusetts Department of Environmental Protection Bureau of Resource Protection—Well Drifter Program Lill' Well Completion Repoi�ts(Genewl) -Choose Screen Type--- V. WATER-BEARING ZONES 1 DRY WEi_I; From To Yield(gpm) i 150---� 1`5 I482 rl [4- j3.7 PERMANENT PUMP(IF AVAILABLE) °3 Wire Constant Speed Pump Description Horsepower ;submersible q Pump Intake Depth(ft) 400 Nominal Pump Capacity(gpm) 5 ANNULAR SEAL/FILTER PACK From To Material 1 Weight Material 2 Weight Water Batches Method Of (gal) (count) Placement 0 Ii9 Native Material Choose Material Gravity 19 —1131.17—,�i Bentonite Grout Choose Material X24 1 Tremie WELL TEST DATA Date Method Yield(gpm) Time Pumped Pumping Level(ft Time To Recover Recovery(ft (HH:MM) BGS) (HH:MM) BGS) 104082015Air Blow With Drill Stem 16.3 j02 00 500 01:56 11 �_.S _.a WATER LEVEL Date Measured Static Depth BGS(ft) Flowing Rate(gpm) COMMENTS _j Massachusetts Department of Environmental Protection I Bureau of Resource Protection—Well Driller Program ' Well Completion Reports(General) WELL DRILLERS STATEMENT This well was drilled or altered under my direct supervision,according to the applicable rules and regulations,and this report is complete and accurate to the best of my knowledge, Supervising Driller ROLLINS, JEFF Monitoring[M] Signature GEORGE, Driller ROLLINS 307 Registration# 305 W CHARLES M. Firm ROLLINS CO.,INC. Rig Permit# 0208 Date Job Complete 04082015 NOTE:Well Completion Reports must be filed by the registered well driller within 30 days of well completion. Nashoba analytical, LLC Tel:978-391-4428 Fax.978.391-4643 LabNumber: 15"98 a PA Willow Road,Ayer MA 01432 Website:http://aww.NashobaAnalytical.com Use this number with all correspondence Client: Charles M.Rollins Co.,Inc. ReportDate: 4/17/2015 126 Depot Road Boxford,MA 01921 Certificate of Analysis Lot#2 Boxford Rd, Notch Andover, MA - M e;a c n e. -0 e I l c,lm e Parameter Method Result MCL MRL Date of Analysis, Analyst -Well Head Sampled,41142015 4:15:00 PM by Client Total Coliform Bacteria,I100ml ENZ.SUB.SM9223 Absent Absent Absent 4/151201511:40:00 AM M-MA1118 Arsenic,Total,MG/L SM 31136 0.007 0.01 0.001 4/16/2015 M-MA1118 Calcium,MG/L EPA 200.7 10.5 Not Spec 0.2 4/17/2015 M-MA1118 Copper,MG/L EPA 200.7 0.003 1.3 0.003 4/17/2015 M-MA1118 Iron,MG/L EPA 200.7 # 0.95 0.3 0.003 4/1712015 M-MA1118 Lead,MG/L SM 31138 NO 0.015 0.001 4/16/2015 M-MA1118 Magnesium,MG/L EPA 200.7 1.6 Not Spec 0.1 4/17/2015 M-MA1118 Manganese,MG/L EPA 200.7 0.038 0.05 0.002 4/17/2015 M-MA1118 Potassium,MG/L EPA 200.7 0.6 Not Spec 0.1 4/17/2015 M-MA1118 Sodium,MG/L EPA 200.7 23.1 See Note 0.2 4/17/2015 M-MA11 i8 Alkalinity,MGIL SM 23208 83 Not Spec. 1 4/15/2015 M-MA1118 Ammonia as N,MG/L SM 4500-NH3-D NO Not Spec 0.1 4/1512015 M-MA1116 Chloride,MGIL EPA 300.0 8.1 250 1 4/15/2015 M-MA1118 Chlorine,Free Residual,MG/L SM 4500-CL-G NO Not Spec 0.02 4/15/2015 M-MA1118 Color Apparent,CU SM 21208 # 25 15 0 4/1512015 M-MA1118 Conductivity,UMHOS/CM SM 2510B 206 Not Spec 1 4/15/2015 M-MA1118 Fluoride,MG/L EPA 300.0 0.8 4 0.1 4/15/2015 M-MA1118 Hardness,Total,MG/L SM 23406 33 Not Spec 1 4/17/2015 M-MA1118 Nitrate as N,MG/L EPA 300.0 NO 10 0.05 4/15/2015 M-MA1118 Nitrite as N,MGIL EPA 300.0 NO 1 0.02 4/15/2015 M-MA1118 Odor,TON SM 21508 0 3 0 4/15/2015 RPM pH,PH AT 25C SM 4500=H-B 8.1 6.5-8.5 NA 4/1512015 M-MA1118 Sediment,pos/neg --------------- NEG ------ NEG 4/15/2015 RPM Sulfate,MG/L EPA 300.0 11.2 250 1 4/1512015 M-MA1118 Turbidity,NTLI EPA 180.1 12.5 Not Spec 0.1 4/15/2015 M-MA1118 MCL=Maximum Contaminant Level(EPA Limit),MRL=Minimum Reporting Level Sodium Guidelines-Mass 20,EPA 250, #=Result Exceeds Limit or Guideline NO=None Detected(<MRL), '=Background Bacteria Noted Massachusetts Certified David L.Knowlton Laboratory#M-MA1118 Laboratory Director Page 1 of 1 04/27/15 09:54AN ROLLINS YELL 978-352-8236 p.01 N ohoba Anal tical, LLC 7'�I:978.391.4428 Fax:939.391.4643 LabNumber: 154498 3 t A Willow Road.Ayer MA 01432 Wehsile:hu r1lr�ww.NashobMnal ticnl.corn Use this number with nit correspondence Client: Charles M.Rollins Co„Inc. ReporlDate: 4117/2015 126 Depot Road Boxford, MA 01921 Certificate of Analysis Lot#2 Boxfor Rd, North Andover. MA N\t a,r\e,,, 'O t U Y'NC. arameter Method Result MC1" MRL Date of Analysis Analyst Well Heed Sampled:411412016 4:15.'00 PM by Clianr Total Coliform Bacteria,/100ml ENZ.SUB.SM9223 Absent Absent Absent 4/1612015 1111:40:00 AM M-MA1118 Arsenic,Total,MOIL, SM 31136 0.007 0.01 0.001 4/16/2015 M-MA1118 Calcium,MOIL CPA 200.7 10,5 Not Spec 0.2 4117/2015 M-MA1116 Copper,MOIL E=PA 200.7 0.003 1.3 0.003 4/1712015 M-MA1110 Iron,MG/L EPA 200.7 # 0.06 0.3 01003 4/17/2015 M-MA1118 Lead,MOIL SM 311313 NO 0,016 0,001 4/16/2015 M-MA1118 Magnesium,MG/L EPA 200.7 1,8 Not Spec 0.1 4/17/2015 M-MA1116 Manganese,MG/L EPA 200.7 0,038 0.05 0.002 4/17/2015 M-MA1118 Potassium,MOIL EPA 200,7 0.6 Not Spec 0.1 4/17/2015 M-MA1118 Sodium,MG/L EPA 200.7 23.1 See Note 0.2 4/17/2015 M-MA1116 Alkalinity,MG/L SM 23208 83 Not Spec 1 4/15/2015 M-MA1118 Ammonia as N.MOIL SM 4500-NH3-0 NO Not Spec 0.1 4/15/2015 M-MA1118 Chloride,MG/L EPA 300.0 8.1 250 1 411512.015 M•MA1118 Chlorine,Free Residual,MG/L SM 4500•CI.,G NO Not Spec 0.02 4/1512015 M•MA1118 Color Apparent,CU SM 212.08 # 25 15 0 4/15/2015 M-MA1118 Conductivity,UMHOS/CM SM 26108 206 Not Spec 1 411512015 M-MA1118 rluorldo,MC/l, EPA 300.0 0.8 4 0.1 4/1512015 M•MA1118 Hardness,Total,MG/L SM 23408 33 No(Spec 1 4/1712015 M-MAt 118 Nitrate as N,MOIL FPA 300.0 NO 10 0.05 411512015 M-MA1118 Nitrile as N.MG/L EPA 300.0 NO 1 0.02 4115/2015 M-MA1118 Odor,TON SM 21509 0 3 0 4/15/2015 RPM pH.PH AT 25C SM 4800-H•8 13,1 616-8.6 NA 4/15/2015 M-MA1118 $ediment,paslneg -•-••••••--.-.• NEG --•-- NEG 4/1 51201 5 RPM Sulfate,MG/L EPA 300.0 11,2 250 1 4/1512015 M-MA1118 Turbidity,NTU EPA 180,1 12,5 No(Spec 0.1 4/15/2015 M-MA1116 MCLMMaxlmum Contaminant Level(EPA Limit),MRL=Minimum Reporting level Sodium Guidelines.Mass 20,EPA 260. Om Result Exceeds Limit or Guideline, ND=None Detected(<MRI.), 'a Background Becteda Noted Massachusetts Csrtlfled David L.Knowlton page 1 of 1 Laboratory#M-MA1113 Laboratory Director '° „FReceived✓Time,4Apr. 27.,`i2015'010:03AMLNo, 1194 COMMONWEALTH OF MASSACHUSETTS NUMBER • .w �=Nn jr,�' BHP-2015-0082 -._ North Andover FEE $135.00 BOARD OF HEALTH ,rKh14k '�� Charles M. Rollins, Inc. • ---------------------------------------------------------------_----------________________________ NAME BOXFORD STREET ------------------------------------------------------------------ ADDRESS IS HEREBY GRANTED A PERMIT Well Construction Well-Lot 2 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires June 30, 2015 unless sooner suspended or revoked. March 31, 2015 -- -------------------------------------- - ------- BOARD OF --------------r'.`=._r-- �. �--------------------- HEALTH ----------- L L ----------------------------- BOARD OF HEALTH CHAIRMAN i i TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER; MASSACHUSETTS 01845 Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX healthdeptntownofnorthandover.com www.townoftiorthandover.com Well and/or Pump Application -5�- (Please print) r DATE: J LOCATION to Drill Well or install a pump: Lai 430.7' FoQD / IJC- Licensed Well Contractor Name and Company Name: C hA 12�S t�` Rei t_ir"� '' S Contact Phone Numbers: f 7 ?5- (a L41- ` -i g- 29-7- Z 3 Zv C i✓i Homeowner Address: oZ 1 -7 Ld)t SW l W6--n wi sc-; 020y'Q cq 61 r9j vu 4 - Contact Phone Numbers: q-7 V 1 ?3 7 95 g WELLS(to be completed at time of pump test) Type of well: 1J4 � Use: Diameter of well: Size of Casing: Depth of bedrock: Depth of casing into bedrock: Seal been tested? Yes( ) No( ) Date of test: Depth of well: Water-bearing rock: Depth of water: Delivers: GPM for: (how long) Drawdown: feet after pumping: hours at: GP Date of Completion: Signature o ell Contractor PUMPS(To be filled in before installation) Name&size of Pump: Type: Size of Tank: Pump delivers: GPM Pipe used in well: Cast Iron_ Galvanized Plastic Sleeve used to protect pipe? Yes No Type of well seal: Date: Signature of Pump Installer Date water analysis report submitted to Health Department: Plumbing Wiring Inspector Health Department Representative S:\Health\Permit Applications\Well Application.doc a 7058 Town of North Andover 5� HEALTH DEPARTMENT K#: DATE: CATION: f H/O NAMEA, - 6 �i CONTRACTOR NAME: Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC S.s�� tems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ .❑ Title 5 inspector $ ❑ Title 5 Report $ 11 Other(Indicate) $ slA1 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer MESSINA DEVELOPMENT COMPANY,INC. 277 Washington Street Groveland,MA 01834 978-891-3190 March 31, 2015 Dear Michelle, I understand that the septic designs have not yet been approved by the BOH and I accept full responsibility for the location and installation of the wells on lot 1 &2,Boxford St. Sincerely, Bob Messina ti TOWN OF NORTH ANDOVER Office of CObIMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET;SUITE 2035 NORTH ANDOVER,MASSACHUSETTS 01845 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: 3 Site Location: xfi � Engineer: New Plans?-:Yes_C$225/Plan Check#1d Z (includes-1 submission and one re- _._ review on1Y)__ Revised Plans'Nes W/Plan Check# Site Evaluation Forms Included? Yesy No Local Upgrade Form Included? Yes No Telephone#:_ 75�-373-.b3 Ili Fax#: E-mail: p ► 1&d CSG — en�r .co m Name: AA c56 i,n q. DCV C�O jo rrle nt — cmdo d iwoedJoram. /6� F n;l4 T lust 1 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 hAK Z D 2015 TOL M. Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information Gorton Family Trust Owner Name 602 Boxford Street LOT 2 Map 105C Lot 22-2 Street Address Map/Lot# North Andover MA 01845 City State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 2. Soil Survey Available? ® Yes ❑ No If yes: NRCS 421 B&C Source Soil Map Unit CANTON LARGE STONES Soil Name Soil Limitations 3. Surficial Geological Report Available? ❑ Yes ® No If yes: Year Published/Source Publication Scale Map Unit Geologic/Parent Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ❑ No Within the 500-year flood boundary? ❑ Yes ❑ No Within a velocity zone? ❑ Yes ❑ No 5. Wetland Area: Wetlands Conservancy Program Map Map Unit Name 6. Current Water Resource Conditions(USGS): Month/Year Range: ❑ Above Normal ❑ Normal ❑ Below Normal 7. Other references reviewed: tp lot 2•rev.3/13 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts lugCity/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 2-A 1/14/2015 15 CLOUDY Date Time Weather 1. Location Ground Elevation at Surface of Hole: 120.41 Location(identify on plan): WOODS NO 0-3 2. Land Use (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) OAK, W PINE OUTWASH PLAIN MIDDLE Vegetation Landform Position on Landscape(attach sheet) >100 >100 >100 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line >50feet Drinking Water Well eet00 Other feet 4. Parent Material: ALLUVIAL Unsuitable Materials Present: ❑ Yes No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation tp lot 2•rev.3/13 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2-A Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist Munsell USDA Structure Consistence Other (Munsell) (USDA) Cobbles 8 Moist Depth Color Percent Gravel Stones (Moist) 0-13 A 10YR3/2 FSL 13-30 BW 1 10YR 3/6 FLS 30-80 C1 2.5Y6/4 M SAND REFUSAL Additional Notes: tp lot 2•rev.3/13 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of - - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2-B 1/14/2015 15 CLOUDY Date Time Weather 1. Location Ground Elevation at Surface of Hole: 121.34 Location (identify on plan): WOODS NO 0-3 2. Land Use (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) OAK, W PINE OUTWASH PLAIN MIDDLE Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body >100 Drainage Way >100 Possible Wet Area >100 feet feet feet Property Line >50 feetDrinking Water Well f 100 Other feet 4. Parent Material: ALLUVIAL Unsuitable Materials Present: ❑ Yes No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation tp lot 2•rev.3/13 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F _ Y C. On-Site Review (continued) Deep Observation Hole Number: 2-B Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) (Munsell)Moist Layer (USDA) StoneStructure Consistence Other y ) )Depth Color Percent ravel Cobbles as (Moist) 0-8 A 10YR3/2 FSL 8-19 BW 1 10YR3/6 FLS 19-69 C 2.5Y6/3 C SAND REFUSAL Additional Notes: tp lot 2•rev.3/13 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of North Andover = Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 2-C 1/14/2015 8- 19 OVERCAST Date Time Weather 1. Location Ground Elevation at Surface of Hole: 123.23 Location (identify on plan): 2. Land Use WOODS NO 0-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) OAK, W PINE OUTWASH PLAIN MIDDLE Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body >100 Drainage Way >100 Possible Wet Area >100 feet feet feet Property Line >50 0 Drinking Water Well >10Otherfeet feet 4. Parent Material: ALLUVIAL Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation tp lot 2C•rev.3/13 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal r C. On-Site Review (continued) Deep Observation Hole Number: 2-C Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Consistence Other Layer Moist(Munsell) (USDA) Cobbles& Structure Depth Color Percent Gravel (Moist) Stones 0-10 A 10YR3/2 FSL 10-26 BW 1 10YR 3/6 FLS 26-53 C1 10YR6/6 M SAND 53-80 C2 2.5Y6/3 C SAND REFUSAL Additional Notes: tp lot 2C•rev.3/13 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 _TZ\_ Commonwealth of Massachusetts City/Town of x - Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Cf D. Determination of High Groundwater Elevation 1. Method Used: ❑ Depth observed standing water in observation hole A. B. C: inches inches ❑ Depth weeping from side of observation hole A. B. C: inches inches ® Depth to soil redoximorphic features (mottles) A. Ref @ 80" B. Ref @ 69" C: Ref @ 80" inches inches ❑ Groundwater adjustment(USGS methodology) A. B. C: inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No " b. If yes, at what depth was it observed? Upper boundary: 10"inches Lower boundary: 6 699" tp lot 2-rev.3113 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate d in acc a with 310 CMR 15.100 through 15.107. 1/14/2015 Si nature of it uator Date hili Ch stiansen #378 11/1994 Typed or rinted Name of Soil Evaluator/License# Date of Soil Evaluator Exam Isaac Rowe North Andover Name of Board of Health Witness Board of Health Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. tp Tot 2•rev.3/13 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts City/Town of North Andover Percolation Test Form 12 �M 'V•y`•v IIS Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important:When filling out forms A. Site Information on the computer, use only the tab Gordon Family Trust key to move your Owner Name cursor-do not 602 Boxford St LOT 2 use the return Street Address or Lot# key. North Andover MA 0 � City/Town State Zipp Code Philip Christiansen 978.373.0310 Contact Person(if different from Owner) Telephone Number B. Test Results 1/14/2015 10:45 1/1412015 10:50 Date Time Date Time Observation Hole# 2-C 2-B Depth of Perc 6+ 16=22 20 + 18=38 Start Pre-Soak 10:45 10:50 End Pre-Soak 11:00 11:05 Time at 12" 11:00 would not Time at 9" 11:03 maintain Time at 6" 11:07 water level Time(9"-6") min - Rate(Min./Inch) <2 min/inch <2 minlinch Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Philip Christiansen Test Performed By: Isaac Rowe Witnessed By: Comments: e 1 of-1 Perc Test•Pa t5fomt12.doc•06/03 g } 'I ; Il! IIIIIII. IIII�'III , a l l j l ill i IIII II F II I III � I I . z Illilllil II 1111111 � ► IIII ►,,II.�,. IIIIIII III II!. {` i I I' ,I 1111111 IIIIIII► II IIII I I D I ! 1111111 111L1111111 IIIIIII Illlliiii!lil II Z I ► I I I� III' i. III I I I I III III III IIII 'I INII'l 11 !I'' IIILII 11!11 I ► I ! I II I,I I; Illllii!Illil" Iffilllil.il,!II j�i 1 I I ' 111111!i111111 IIIDIIIIIII I I I I ' !'I I II iIIlllll I� I II � 11 Illl.�ili!I�111►1.1i IIII I II'iil�llllllll I' Il i�'' I I�IIII II I!I I � 1_1711 I I I ® II !IIII II I ►l I ©� III �{i!I I �IIIIII : I I i ! I I I I IIII ! I Ii {I II IIIIIIIIIIIIIV!II � ;' I ;!�II+i I I I II I I I i l � I i! �I 11 II I �IIIIIIII!I IIIIIII {�,' ;iill'jl1 i I IIII II :� I ..I II II' il�'I .I 1111i11!lilll 11► illll! III!;I!Ikii �IIIIIIIIIIIII I I I I o I l l�!III i I I!Illllllllli I IIII!Illllllq ! I I I I l i' I I I ► I I , I i Illlall, IIILIIIIIII: ;ll illi; I: il � I I I III � j I I I I 1�11!II II 11' �' IIMEN ;II 1111 I "1111 � , IIII I IIIIII IIII IIIII 111!11111 i I I I,I IIII I II.I hill .II.(IIII l i I I 111 I I I III III Il dill 11 IIII ii'!liilllllll!.I 'li I i l I l 'Illi lll!!Ili l Jiilllll�l�l 9 I ! I I II I,I I I I � , II , � I I, II I II I IN I { I I III 1 �I!ill it III 111!Ilii'� t 354 AVERAGE WIDING IIEIG!II Pfio,ECT NuIE NEW CONSTRUCTION - �� ;. Archi- IATIONS INGLE FAMILY RESIDENCE �, M A LOT 2 BOXFORD STREET 3 Four @XAawsys-nbptite101,N�I E ir!fi��.IMAarcfetec>s�rlbplcom T NORTH ANDOVER, MA 01845 �� r SWE: y+_ -0- S-2 S-Y a'r li➢R 2-2x 2'x12."viceP ZJwGl:S lt„uG Proetnwe> -1--4 I --------------------- . TYPKRt_. --- -- .------ °_..� 4c K 4'-9" ——— 7-1 X 4'-9 I — 2-10 X4-9_— J Z- t.7Sw 9.2S LVL p2. -t-or 2KIO. .lo1sT I I � tst6 ma "oI S-T /4 To P T v PIGe L I I pe` $ I UG I w Aoo x PEmoao m s Fa n4x1 NaTEs I , I gI FACE OFva"PERM& 5EFEET 3 0 J�vf T Eu II SSFP SORET D-1 - i t 0.0 II � All 41 r-d' � g-I�' '1 lad' g-�}• r-� Ir-�' loI N I 3-I-75rn•zsLut 3'/t°.6 LALLN COtuMN 41iab ALL.It towMu I L _ �l IeL ISM S1MPcOu kc GAp I - - w1n4 51MOSou 1-CC,GAP -1 tY PtCI11- UON 2' I _ -- 21 W 1Dli X l 2. '� I I 1 ct I I -DBL ® vsc Focrla,c. �� 3-1-76x11.25 I I Bfntn NFL. AT Lut GtRDBR POK C DR I LAME OF 5 X GOD _ 2^1 7S A 9.2 5 LUL PfA/E AT F USN TOP 1 I LAV OF 5 X G* _ �4' � I b i i i e Co caeTH grmamu lois? SDAM w�k wnH IL 20 WK J5 x 9.25 W L W-e It _ _ ----=------- 1 a --- Ft t11 M wM W 4 IC-0 tY-IO 17 f 17-10' cue ylw�to ITHOD IIAp� •H 44 8 en .vn tE E T •Z l':. P EM FOUNDATION /BASEMENT FLOOR PLAN ;RST-nooR ilaG--_ CGRTIF-AT,o� Lf To .Fx. - '2 3 i4ck.5 ► W vG id-f S K f-I' S4 C-t S4 f-5 1/r 7-7t 5-9'X 4'-9 Y, 7-6 X X 3-5 r 7-6 X X 3-5 X 11-0' M.LG BATH M. BATH W.1. BEDROOM 2 11' X 13' 511�! SD 3DX90 ® 2x12 elf,"oc 5?,1LZ5 LUL SD XT><301ST 30X90 3_2x4 / /5-2x4 � A S-a T�l — . -r m=BEDR�3 aoscr SD D.N 13'X 18' 3-N � aosEr m BEDROOM 3 SOD sa- 13'6" X 11' ,p& Qj N BEDROOM 4 so N — 11'-5'X 12'5- -1.75 2'5- -1.75 u1l•8'75 LVL • 7-10 Y X 4'-9 X r-10/C X 4'-9 X AV-3 2'-10 X X f-9 X 2'-10 X X -9 y r" 'T4P1cAL 14EAVEm - 2-7-A 45 1 Jock ►K14pe vluo-ti1F. 0T14E.la i.n E N ergo f 9 64 is-IV 17 4' ,S-W CpFT QuD ,1f-10 31znw5 of a1.x.t-wc `- ;YIMPSoa 2.11.8►8 Lu us SECOND FLOOR PLANATTIC r—P Am14 PLNt4 _. o n � '4 Id 1 19'-9' L S t-4 5 a r r-21/t d-d 7-5 K X 3-5 Yi — t7ol _ Yi X 3-5 Y, 54 X 4'-9 Y LDALl 164 F,, ,'_exz4_9x 1 1641 ,-eX z,'-9 Y, BREAKFA KITCHEN STUDY .\2-2X to O Z-2xlo 13'--rX 22 ZJACFs 16 9 X 84" IT zJAGK9 1 K1 V& z-1.75x7.25' I IC,ax O 2-I-75x 7-ZS L•uL LVL — LjAcps t Jew& k _ � 2JAtKS I XI),IJo FAMILY ROOM ;;wk —— VAULTED CEILING n K'u` 3-I 75x 9•zs 16' X 24' I I wt 6-2x+ 37X6 C ADD /2 SHEJCt'MIUL ToTNts WNL 17-0. �Y PER Dmm IL sweEr ON z r P-1 W'" "ps uns 2-1.75x 7.25 L VL 5p 90AR0 OVL'R ZJACKS I V-IAJ6 _ DINING 2--Zx1D LIMN XROOM Z zX,o s� 13• X 14 IJ,cK I krrJC 2JAZ�S 2-1.75r t1:B)S L 11 T � 1 KIuG I I -Ttf MAL HEADER vuLEss o�erWlsE b I LV6il0-L II iipTED ENTRY FOYER ® 2 Irg 2J,cks 1 ICIdt 56-G II 2-1.75x9.25tVLSO �s i t-�N t-I0YX,'-9Y Z-I0)rXr-9Y Ir se_S tJX44- fAK t-10KXf-9K 1 se 5 pEti71C 9 C I 1 R6 COALS y; COATS A2I -id T 9 r-Id d d r-0 WALL 134Ac1UL d-0 _ d-0 tr-Xf tt r -10 SpAceo WAu-LI. ALL E,teAjok l Aup LINE 2A g 2-?X10 Ao t, LiIue -Z 1 2JAGKS To $E r%cmwoD FIRST FLOOR PLAN A-2 1 KINL 5ECONP FRAMING P(—a 3 C5_�SP SEE DErA I SNE: m P B* 0 Z � z o n -- cn CD 0 1—u A G7 rrt A I Q $ $ 119.25 MED BY 15=7.95 PROECT NMF- NEW AMENEW CONSTRUCTION - �, SINGLE FAMILY RESIDENCE J M A Architects, In LOT #2 BOXFORD STREET $ Farr New Street,SA 101,NewWr porgy NA 01950 NORTH ANDOVER, MA 01845 yn E do@JNAardlitecUbpt.= T 978.465,7163