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Miscellaneous - 62 FARNUM STREET 4/30/2018
_ 62 FARNUM STREET 210/107.A-0086-0000.0 l V 4 I I i North Andover Board of Assessors Public Access Page 1 of 1 Parcel ID: 210/107.A-0086-0000.0 Community: North Andover SKETCH PHOTO Click on Sketch to Enlarge No Picture Available Location: 62 FARNUM STREET Owner Name: GOOD,JOHN J CAROL GOOD Owner Address: 62 FARNUM STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 5 - 5 Land Area: 1.12 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 1824 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 447,100 418,200 Building Value: 264,500 249,100 Land Value: 182,600 169,100 Market Land Value: 182,600 Chapter Land Value: LATESTSALE Sale Price: 0 Sale Date: 12/31/1965 Arms Length Sale Code: N-NO-OTHER Grantor: Cert Doc: Book: 01057 Page: 0083 I http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=809303 7/11/2006 DENNIS HALLAHAN, P.E. Technical Manager dhallahan@infiltratorsystems.net 860.577.7100 INFILTRATOR® systems inc. Corporate Office 6 Business Park Road•P.O.Box 768•Old Saybrook,CT 06475 Phone 800 221.4436•Fax 860.577.7001 •www.infiltratorsystems.com septic tanks .,JAQLfAWorx- by North Andover Board of Assessors Public Access Page 1 of 2 ►ORTN North Andover Board of Assessors CHUProperty Record Click Seal To Card Return Parcel ID :210/107.A- FY:2011 Community : North 0086-0000.0 Andover Search for Parcels SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Sales 4 Summary Residence Detached Structure Condo Commercial - 62 FARNUM STREET Location: 62 FARNUM STREET Owner HICKEY, BRIAN V. Name: Owner 62 FARNUM STREET Address: City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 5 - 5 Land Area: 1.12 acres Use Code: 101-SNGL- Total Finished 2124 sqft FAM-RES Area: ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 402,500 409,300 Building Value: 2049200 2119000 Land Value: 1989300 1989300 Market Land Value: 198,300 Chapter Land Value: LATESTSALE http://csc-ma.us/PROPAPP/display.do?linkld=1708439&town=N... 1/7/2011 North Andover Board of Assessors Public Access Page 2 of 2 Sale Price: 4249350 Sale 11/27/2008 Date: Arms Length Y-YES-VALID Grantor: GATTIS Sale Code: Cert Doc: Book: 11388 Page: 339 http://csc-ma.us/PROPAPP/display.do?linkld=1708439&town=N... 1/7/2011 r 4 fir\ North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 62 Farnum Street MAP: 107.A LOT: 0086 INSTALLER: James Kellett DESIGNER: Gordon Hayes PLAN DATE: 10/10/2017 BOH APPROVAL DATE ON PLAN: 11/20/2017 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11/22/17 DATE OF FINAL GRADE INSPECTION:11/27/2017 SITE CONDITIONS N/A Contractor reports any changes to design plan N/A Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Existing septic tank/pump chamber and pump being reused. DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution N/A Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: a BM = 203.85 HR = 2.49 Hi = 206.34 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Distribution Box IN 5.00 200.99 200.90 Distribution Box OUT 5.15 200.84 200.73 Lateral 1 TOP 5.37 / 5.48 Lateral 1 INVERT 200.62 / 200.51 200.62 / 200.50 Lateral 2 TOP 5.37 / 5.48 Lateral 2 INVERT 200.62 / 200.51 200.62 / 200.50 Lateral 3 TOP 5.37 / 5.48 Lateral 3 INVERT 200.62 / 200.51 200.62 / 200.50 Lateral 4 TOP 5.37 / 5.48 Lateral 4 INVERT 200.62 /200.51 200.62 /200.50 Lateral 5 TOP Lateral 5 INVERT Lateral 6 TOP Lateral 6 INVERT Bottom of Bed 6.34 200.00 200.00 • SwKTLED j� ♦ Cie nQ,,, V_ l�� North Andover Health Department (ommunity and Economic Development Division November 20, 2017 Brian and Jessica Hickey 62 Farnum Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 62 Farnum Street (Map 107A Parcel 86) To Whom It May Concern: The proposed wastewater system design plan for the above site dated September 28, 2017 with a final revision date of October 10, 2017 has been approved. The design has been approved for use in the construction of a new on-site septic system for a three (3)bedroom dwelling with a maximum number of nine (9) rooms utilizing a gravity leach field. This design plan approval is valid until November 20, 2020. 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 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 Page 1 of 2 North Andover Health Department 120 Main Street North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 C• ED V Q D- North Andover Health Department Community and Economic Development Division November 20, 2017 Brian and Jessica Hickey 62 Farnum Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 62 Farnum Street (Map 107A Parcel 86) To Whom It May Concern: The proposed wastewater system design plan for the above site dated September 28, 2017 with a final revision date of October 10, 2017 has been approved. The design has been approved for use in the construction of a new on-site septic system for a three (3) bedroom dwelling with a maximum number of nine (9) rooms utilizing a gravity leach field. This design plan approval is valid until November 20 2020. pp , 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 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 Page I of 2 North Andover Health Department 120 Main Street North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 62 Farnum Street November 20, 2017 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. Sincere , a 6 rian J. I rasse, CEHT Director of Public Health cc: Hayes Engineering, Inc., 603 Salem Street, Wakefield MA 01880 File Page 2 of 2 North Andover Health Department 120 Main Street North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 f ti 4 North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 62 Farnum Street MAP: 107.A LOT: 0086 INSTALLER: James Kellett DESIGNER: Gordon Hayes PLAN DATE: 10/10/2017 BOH APPROVAL DATE ON PLAN: 11/20/2017 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11/22/17 DATE OF FINAL GRADE INSPECTION:11/27/2017 SITE CONDITIONS N/A Contractor reports any changes to design plan N/A Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Existing septic tank/pump chamber and pump being reused. DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution N/A Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: i 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: FINAL GRADE ® Loamed ® Seeded ® Cover per plan Comments: DOCUMENTS NEEDED ® Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer ® As-Built Plan -- r `v BM = 203.85 HR = 2.49 HI = 206.34 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Distribution Box IN 5.00 200.99 200.90 Distribution Box OUT 5.15 200.84 200.73 Lateral 1 TOP 5.37 / 5.48 Lateral 1 INVERT 200.62 / 200.51 200.62 / 200.50 Lateral 2 TOP 5.37 / 5.48 Lateral 2 INVERT 200.62 / 200.51 200.62 / 200.50 Lateral 3 TOP 5.37 / 5.48 Lateral 3 INVERT 200.62 / 200.51 200.62 / 200.50 Lateral 4 TOP 5.37 / 5.48 Lateral 4 INVERT 200.62 /200.51 200.62 / 200.50 Lateral 5 TOP Lateral 5 INVERT Lateral 6 TOP Lateral 6 INVERT Bottom of Bed 6.34 200.00 200.00 v 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 1.0 101 ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib.to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other)Foundation 10(5) 20(10) ® Drywells 20 25 ' Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3), also by NA wetland bylaws i E 21 a� p // Lo l 3 ' sw °' Commonwealth of Massachusetts Map-Block-Lot ----------------------- ' BOARD OF HEALTH � Permit No North Andover BHP-2017-1101 ----------------------- p,l, t,-. FEE F.I. $350.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted James Kellett to(Construct)an Individual Sewage Disposal System. at No 62 FARNUM STREET as shown on the application for Disposal Works Construction Permit No. BHP-2017-1 'ated ve er 017 ------------ — ' ------------------------- --------------------------------------- Issued -Issued On:Nov-16-2017 BOARD OF HEALTH I i i i { rrrr to 4r Application for Septic Disposal System 16/ 2-41 -7 Construction Permit - TOWN OF TODAY'S DATE NORTH ANDOVER, MA 01845 $ 75.00-Full Repair $175.00-Component Important: Application is hereby made for a permit to: When filling out ❑Construct a new on-site sewage disposal system* forms on the computer,use epair or replace an existing on-site sewage disposal system* only the tab key to move your X ❑ Repair or replace an existing system component—What? cursor-do not use the return A. Facility Information p� key. 62— Address Address or Lot# tab Alt,orL A ti 4ye-L— City/Town 1' 2.-*TXP'5 OF SEPTIC SYSTEM*: WNCFNOEPp?ME1 ➢ Pump ❑Gravity(choose one) ***If p mp system, attach copy of electrical permit to application*** ❑Conventional System (pipe and stone system) ➢ ❑ Infiltrator or Biodiffuser(Gravel-Less) (Attach a copy of your certification to install this type of system.) ➢ ❑ Pressure Distribution S.A.S.(No D-Box) ➢ ❑ Pressure Dosed(D-Box Present)S.A.S. ➢ ❑ 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 / Name' 6 Address(if different from above) Al. MA ei's-y� City/Town State Zip Code Email address Telephone Number 3. Installer Information Name Name of Company Address .s/—ie 10� /M/ City/TState Zip Code Telephone Number(Cell Phone#if possible please) 4. Designer Information r Nine40' T 0�{ Name of ompany f� t9 Address !mac,/ 1*2 o ids City/Town State Zip Code 7 d"/_ 'j .3 -- & Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 C co '' /`��,� om J � t ; ,... w Application for Septic Disposal System ic, ZO(1 Construction Permit - TOWN OF TODAY'S DATE NORTH ANDOVER $1 MA 01845 50.00-Full Repair $175.00-Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Building: Residential Dwelling or❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover. 1 urilderstaVid th,,anntil a final Certificate of Compliance has been issued by is oard of Heal , t led stem is not approved. 7 Name r' Date Applic I Ap By: (Board of Health Representative) Name Date App(cation Disapproved for the following reasons: For Office Use Only: L Fee Attached? Yes No 2. Project Manager Obligation Form Attached. Yes No 3. Pump System? Ifso,Attach copy of Electrical Permit Yes No)( Applicant received copy of "Electrical Inspection Notes for Septic Systems" Yes NoX Handout? 4. Reviewed approval letter, all paperwork received. Yes No MlsSing: 5. Foundation As-Built?(new construction only): Yes No (Same scale as approved plan) 6. 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: (Address of septic system) For plans by fi! '1eS (Engineer) Relative to the application of 'J .1w{1 Ke, 0 0 (Installer's name) And dated CJ 8 2—o 1 17 ngina ate) Dated j-y ...�t w 19 zX i !.� C' [ dbe" /d (I o ay s to With revisions dated /7 (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 plansrD for 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(ls� 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.com) from the engineer must be submitted to the Board of Health,after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system,all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade—Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than 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 approved plans. No instructions by the homeowner,general contractor, or any other persons shall absolve me of this obligation. Undersigned �Licensed Septic Installer: d.�/ �� ��f (Today's ate) e..�,.,t- 2., IL-" ll-,-" (Name—Print) e—Signe r f R MORT1 8099 OE .•w,.1b0 Town of North Andover HEALTH DEPARTMENT CHUSE� CHECK#: 3 /q DATE: //.,/6 -,20/7 LOCATION: C.Z.. / /_/)0M d� H/O NAME: /i G C CONTRACTOR NAME: /7 e., A,�� !n7 Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $_ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: � I� ❑ Septic-Soil Testing f� $ �l) ❑ Septic-Design Approval $ xSeptic Disposal Works Construction(DWC) s,3-50- 1:3 .50❑ Septic Disposal Works Installers(DWI) $ ` ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ He'if Agent Initials White-Applicant Yellow-Health Pink-Treasurer RECEIVED ' OCT I � 2017 Commonwealth of Massachusetts TOWN OF NORTH ANDOVER City/Town of Alcwmll Xvoo4 HEALTH DEPARTMENT Form 9A — Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be y� used, but the information must be substantially the same as that provided here. Before �D using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. � i i System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer,use Brian &Jessica Hickey only the tab key Name to move your cursor-do not 62 Farnum Street c use the return Street Address key. North Andover Ma 01845 Cfty/Town State Zip Code 2. Owner Name and Address (if different from above): -"�U—"— Name Street Address City/Town State Zip Code Telephone Number i 3. Type of Facility (check all that apply): Residential Institutional Commercial School 4. Describe Facility: Single family house 5. Type of Existing System: t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 1 of 5 i t Privy Cesspool(s) Conventional Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): Infiltrator chambers A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: 330 gpd Design flow of proposed upgraded 330 system gpd 330 Design flow of facility: gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): Voluntary Required by order, letter, etc. (attach copy) Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: New leach bed pipe in stone. 3. Local Upgrade Approval is requested for(check all that apply): Reduction in setback(s) — describe reductions: Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction Reduction in separation between the SAS and high groundwater: Separation reduction ft. ! t5form9a.doc•rev.7/06 Application for local Upgrade Approval' Page 2 of 5 i i A Percolation rate min./inch Depth to groundwater ft. B. Proposed Upgrade of System (continued) Relocation of water supply well (explain): Reduction of 12-inch separation between inlet and outlet tees and high groundwater Use of only one deep hole in proposed disposal area Use of a sieve analysis as a substitute for a perc test Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: i i If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Gordon Rogerson SE2074 Sept.26,2017 . Evaluator's Name(type or print) &9n ture Date of evaluation i C. Explanation i Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: t5form9a.doc-rev.7/06 Application for Local Upgrade Approval' Page 3 of 5 i I f ; I s ' 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: I C. planation (continued) 3. shared system is not feasible: 4. Connectio o a public sewer is not feasible: NIA 5. The Application for ocal Upgrade Approv must be accompanied by all of the following (check the appropriate boxes): Application for Dis,,vsal Syste Construction Permit Complete plans and s� ecifi ations Site evaluation forms X. A list of abutters affec d b reduced setbacks to private water supply wells or property lines. ovide p of that affected abutters have been notified pursuant to 310 CMR 15 05(2). Other (List): D. Certificatio/ce "I, the facility owunder penalty of law that this ocumentand all attachments, to the best of mye and belief, are true, accurate; nd complete. I am aware that there may bt consequences for submitting fa a information, including, but not limited toor fine and/or imprisonment for delerate violations." Facility Owner's Si nature Date \ Print Name Gordon R gerson Sept.28, 2017 Name of Pr parer Date Date 603 S lem Street Wakefield, Ma. 01880 Prepar is address City/Town i i5form9a.doc-rev.7/06 Application for Local Upgrade Approval* P\4f I i I 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: I C. Explanation (continued) 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible: nl/A 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): Application for Disposal System Construction Permit Complete plans and specifications Site evaluation forms A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). Other (List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that th re m y be significant consequences for submitting false information, including, but n mi d , penalties or fine and/or imprisonment for deliberate violations." raqWolvnerls Signature Date Print Name Gordon Rogerson Sept.28,2017 WOSa ar�r\ Date ` Date Street Wakefield, Ma.01880 Preparer's address City/Town t5form9a.doc•rev.7/06 Application for local Upgrade Approval• Page 4 of 5 II I, i' ;f State/ZIP Code Telephone I� I I i I I I I I i I I i t5form9a.doc•rev 7/06 Application for Local Upgrade Approval• Page 5 of 5 1 Y . YAR99 CMR RECENE® �i L0 W D TOWN OF NORTH ANDOVE ''`"` '' �• SEP T.2 2011 ♦ �... �-:. �,. Community&Economic Development IV TOW'S OF NORTH Atmovm HEALTH DEPARTMENT ,,..M&E WTMEK 120 Mainn Street NORTH ANDOVER,MASSACHUSETTS 01.845 978.688.9540—Phone 978.688.9542—FAX healthdept@northandoverma.gov www.northandoverma.gov APPLICATION FOR SOIL TESTS DATE: Sept. 11, 2017 MAP&PARCEL: 107A/86 LOCATION OF SOIL TESTS: 62 Farnum Street OWNER: Brian &Jessica Hickey Contact#: 617-418-0517 APPLICANT: Contact#: ADDRESS: 62 Farnum Street ENGINEER: Hayes Engineering, Inc. Contact#: 781-246-2800 CERTIFIED SOIL EVALUATOR: Gordon Rogerson SE2074 Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing:X Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) ➢ 8.5"x]]"Plot plait&Location of Testine(please indicate test nit sites on the plait) ➢ Fee of$585.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$440.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line 17 n N.A. Conservafiou Commissionproval Date: (��/ J YU Y — Signature of Conservation Age Vv Date back to Health Departnte :(s tnp in): �i14 0 0Y4 Y- r"0/ SYS - W1 is Che ) q ct • v LEGEND OF SYMBOLS&ABBREVIATIONS: pe Fm. .Nu DEw � reR NN] 1NERE ARE xD wETINIDs wTilaH too FEET a PRavosm wK ABS sTsrDl. —_ —Fes.Twmw o tvc THEME ME NO WATER suPPEr TR®IffMIES wrnm+zaD FEET —E.of--E.LtisH FIELD. ® TDxs ® BRyw TXFRE AAE NO w£1..L5 wTDRII 100 FEET OF P0.OIq^ED IEADH iIM. T THERE ME NO PUDl1L wATEii SUPPLIES wfIHM AW FEET OF PPOFOYV—11 FIflD. w�T T a 11T\1Y1 TIIEii IRE ND RESERVOIRS 1w111B1 MO FEfT Oi FPOPOSED EFICH FIE1D. e u .`�_^)$ ILO CHNIGES ARE 10 BE LIME M THE FIELD wI1110Ui ME APPHWN °O"T "�1°w a i11E NORM MODVEH RONm a MVLTM AND THE OESM.N FNGIHEEIL BENCHMARK REFERENCE DATUM:NAVD88 S THM PINI R OESKHED M CONfORMNILE YRM THE 310 CNFt 5:00[IIU S) Tp OF MON PpE F1FI..maV \ f E <S AND TILE NgTM MWVFA BOWD OF HFILTH SUPPLEAIEMN REGUU NS TO]IO CNR 15:00 TOP Di TAON IN SIREEf flEV.�10B.]3' At oyo� iDPOG2IPNIC fEAT1RE5 iRp1 ACNAL FIELD SURVEY Br INY6 ENCINEEfIMG,RIC i F m SEM MFA TO M STAKED/W—CD TO AV010 TRAFTIL MD STOCK%LMC OF INTERNE AW SIIdRD ilE AVODED AT ALL TW6 PMdi.WPoNG IND AVIEii LOIISiRUCipN a Sr51E'M 1 EOi ONES TM(pl iRON PIAN Br P rMONO L.PRESSEY IML.DATED AUC.11.1865 , d By: l0 .W F1lID bl ESSF%NOHIN REGISTRY Oi OE£OS AS PIAN f— ¢( 2 A n M: 9 cemP�Na.Fa.�e,a,l1 \ ❑ ❑baueC Fw Rerin ` ❑NwN Fw Bla LOCUS MAP ❑ Fw CPaM.— / \ /SLNE: t•_b0• ❑.1 Fw CeMNacRon ! II � i 8 I � I ]IGNORE e1 rwR�A sTMET i..µa'w �ihm 9 b Vb�gIA Il rFgF s E FNren ala o .^ .•//t._ I 1'. 1 29x81 ! � ati •,/��,(5.�y�iy 1 �'/�,�'_�/L77,+,,�E F 1971"-%,, ,1x, o�.InB nle: ��•'A•E BENCHMARK 4 / /1���•: �. 114haTa' :p, In 00 n V) _.;q• = N aPa� ax.� R - F —Z r G—C—G a n I LER RY NAT I AN LURR.017 O COI0D Br T E VALLA S OF E T ITtYFMN PRD EL KM d n L > U PUNSUAM i0 J10 CMR 15.01)TO CONDUCT SOLE EVNUNI(KIS AND TNT TIE MOVE NNLYSIS Cn E7 0 INS BEEN PERFORMED BY NE CONS151ENf wC THE REOtRRED TRNNINC,ExPER15E.AND EKPOOENCE ' BENCHMARK OESCRBED M 310 CMR 15.011.I FURTHER CERTFT'LINT THE RESULTS OF NY 50K EYNI C 11 p C // 6EV-100.J0 310 C."'m THE AITN 1-07.I EVAU]ATON FORMS.ARE ACCURATE MD IN—01—CWTM SIGNATURD GATE: o • o z Seal: D--,NP.: PL SHEET 1 OF 2 9/13/2017 IMG_0224.jpg ti N/F ' COLEMAN 0 452.60, ;1V V CA ulc ^ ^.� 4� •tom '�rP{ _ ' M m s z'av i ENSx. T Z3RIVE i._..,ti.,.,�,•,jJ.y,' 00 t 9-4��` -moi f 3: m a r https:Hmail.google.com/mail/u/0/#inbox/l5e76e1119522231?projector=l 1/1 9/26/2019 Town of North Andover Mail-62 Farnum St JORtVV OR Toni Wolfenden <twolfenden@northandoverma.gov> Massachu s 62 Farnum St 1 message Isaac Rowe<irowe@millriverconsulting.com> Tue, Sep 26, 2017 at 1:04 PM To: Brian Lagrasse<blagrasse@northandoverma.gov> Cc: Toni Wolfenden <twolfenden@northandoverma.gov>, Michele Grant<mgrant@northandoverma.gov>, Pam Lally <plally@millriverconsulting.com>, Isaac Rowe <irowe@millriverconsulting.com> Brian, Attached are the repair soil testing results for the above referenced property. Upon arriving to the site, Gordy from Hayes Engineering indicated that the owners wish to replace the existing failed infiltrator chamber system in kind with a stone and pipe leach field using the previous soil testing data. Since I was already out there, I recommended that we dug (2)test pits and conducted a perc test in an undisturbed location in order to give Hayes Eng. some options to explore with the owners for the design. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager Vie. ?43'' AN 'IIVZp$A-IY 1%9 MILL RIVER CONSULTING f vear� .StsPul9c�i�+f6r I-ltnd l'k-%'i2lipnew 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.millriverconsulting.com 62 Farnum St-Soil testing results 9-26-17.PDF 1026K https:Hmail.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=Ea IL6uzd19M.en.&view=pt&search=inbox&th=15ebf25b849fbcc3&siml=15ebf25b849fbcc3 1/1 .�; J„F i t • � � I � �� i�I, � _ � �. ... .,.+ I .... •G .r s' ��.� .� .�...' C - -G / � � ��1 1 I %�- `� . , , � � - �� . �� ��� � g x } �� �: - - ;, i, � f , II► i k � / � / 1 , ,� - i f.. � ' •, G • t � � � / -r ' � / � �� `� } (( / '.i i �'�r �f � � � i � f• • ,. � } in ' Commonwealth of Massglchusetts. Environmentai Engine City/Town Form 11 - SoU Suitabfifty Assessment for On-Site Sewage Disposa0 Wakefield,MA 01E 7:V (761)246-2E F:(781)246-75 virvuw.hayeseng.com Mantucket.(508)228.79 A. Facility Information i lC.�.�/'.�I irk � �%"5 Sl G'�%� !�/e'�E"}�` Owner Name 17 %D '14' Street Address Map/Loth citYA-1-0 State Zip Code B. Site Information 1. (Check one) 7 New Construction 1;KPgrade ❑ Repair 2. Soil Survey Available? 2`Y;es Ej No If yes: � l C_ Source Soil Map Unit Soil Name Soil Limitations Geologic/Parent Material Landform 3. Surficial Geological Report Available? E] Yes 0 No If yes: Year Published/Source Publication Scale Map Unit 4. Flood Rate Insurance Map Above the 500-year flood boundary? [�'es EJ No Within the 100-year flood boundary? 7 Yes F-1 No If Yes,continue to#5. 5. Within a velocity zone? ❑ Yes �qo 6; Within a Mapped Wetland Area? El Yes 9-lqo MassGIS Wetland Data Layer: Wetland Type 7. Current Water Resource Conditions (USGS):. Range: [] Above Normal E] Normal El Below Normal Month/Year 8. Other references reviewed: t5form11.doc-rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 1 of 8 Commonwealth of Massachusetts, City/Town of lVoI2 j/./ - iCJf�D Form 11 e Soil Suitability Assessment for ®n-Sate Sewage Dosposa0 F. Board of Health Witness _.ZS Simi Name of Board of Health Witness Board of Health G. Soil Evaluator Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. f Si tore of Soil Evaluator Date Gordon RogerR SE2074 Typed or Printed Name of Soil Evaluator/License# Expiration Date of License 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. t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 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 6 �� Date Time Weather 1. Location 6,5�bWx161& 9Z_ Ground Elevation at Surface of Hole: Latitude/Longitude: / feet r/ -, 2. Land Use / CU Cj Ve_L— (e.g4,woodland,agn ultural field,vacant lot,etc.) Surface Stones(eg.,cobbles,stones, boulders,etc.) Slope(%) Vegetation Landform Position on Landscape(SU, SH, BS, FS, 3. Distances from: Open Water Body Drainage Way Wetlands ? to 0 feet feet feet Property Line Drinking Water Well Py bLi e-- Other -� feet feet feet 4. Parent Material: 11&e:._ Unsuitable Materials Present: ❑ Yes If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ©Ko If yes: /Ve)/uo- . 4/0°"J'J;r Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t5form1l.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwea!tq of Massachusetts City/Town of lVoX711 Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal w.. C. On-Site Review (continued) Deep Observation Hole Number: Redoximorphic Features Coarse Fragmentso Soil Soil Horizon/Soil Matrix: Color- Soil Texture ��by Volume Depth(in.) Layer Moist(Munsell) (USDA) Cobbles Soil Structure Consistence Other Depth7 (Moist) Color Percent Gravel Stones 10- 169z Y-3— Additional Notes: t5form11.doc•rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of /(/®,e;W. - Form °I I Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: oe1 �" / lacz-1 od Date Time Weather 1. Location 6',s 2 e/ Ground Elevation at Surface of Hole: Latitude/Longitude: / feet 2. Land Use �/Cf� �G1y1 (e.g,woodland,agri ultural field,vacant lot,etc.) Surface Sto es(e.g., cobbles,stones, boulders,etc.) Slope(%) Vegetation Landform Position on Landscape(SU,SH, BS, FS, 3. Distances from: Open Water Body -7 100 Drainage Way Wetlands ;;'/06 feet feet feet Property Line Drinking Water Well - t2&1 9- Other feet feet feet 4. Parent Material: Unsuitable Materials Present: ❑ Yes P-150- If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes [K]�o If yes: IUC)A-JC 1740 J Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: inches elevation t5forml 1.doc•rev.8/15 Form 11—Soil Suitability Assessment for on-Site Sewage Disposal •Page 4 of 8 Commonwealth ®f Massachusetts City/Town of Form I I o SoN Suitability Assessment for ®n-Sate SevIvage Dasposa� Co On-Site Review (continued) Deep Observation Hole Number: 00 62edoximorphic Features Coarse FragmentsSoil o Soil Horizon/Soil Matrix: Color- Soil Texture �o by Volume Depth(in.) Layer Moist Munsell (USDA) Soil Structure Consistence Other Y (Munsell) ) Cobbles (Moist) Depth Color Percent Gravel &Stones a r Additional Notes: t5form1l.doc•rev.8115 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of 1VO I'i/-F WN'V641�57/r— Form 11 - Soil Suitability Assessment for ®n-Site Sewage Disposal 'w D. Determination of High Groundwater Elevation 1. Method Used: Obs. Hole# Obs. Hole# ❑ Depth observed standing water in observation hole inches inches ❑ Depth weeping from side of observation hole r inches / ® inches J� F-1Depthto soil redoximorphic features (mottles) Y-� j inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) (USGS methodology) inches inches Index Well(Number Reading Date Sh = Sc—[Sr x (OWc—OWmaxyowr] Obs. Hole# So Sr OWc OWmax OWr Sh Obs. Hole# Sc Sr OWc OWmax OWr Sh 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? I�orYes ❑ No b. If yes, at what depth was it observed? Upper boundary: Lower boundary: inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of /5&,/ CJi� / Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: I S Trk_1Cj_ 0111 CAN- ar t5form11.doc•rev.8/15 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 �f � Y Commonwealth of Massachusetts City/Town of IV6,e7w Aino V" 'c u Percolation fest Form 12 Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important:When A. Site Information filling out forms on the computer, %�tis , % � `/ use only the tab `✓ j C��X key to move your Owner Name cursor-do not 6-0- A/J/?k/w�,U 2:>7-, use the return Street Address or Lot# key. 1ey City/Town State Zip Code Contact Person(if different from Owner) Telephone Number Bo Test Results —=>�-"� Date Time Date Time Observation Hole# 121— /7 Depth of Perc Start Pre-Soak End Pre-Soak Time at 12" Time at 9" 1/: 0 Time at 6" l / Time(9°_6„) Rate(Min./Inch) Test Passed: ❑� Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Gordon Rogerson SE2074 Test Performed By: /' Board of Health Witness Comments: t5form12.doc•08/15 Perc Test^Page 1 of 1 ,tate/zip'. Telephone i !I t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 5 of 5 .r 4MOFTM Y U U 8 Ot 1N • Town of North Andover HEALTH DEPARTMENT ,sswCM15Et CHECK DATE: - ,Z o?0/7 LOCATION: 62. /'ar l carr) J T H/O NAME: X/ 2 CONTRACTOR NAME: Cfn Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: /� x Septic-Soil Testing $Wy❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ altAgent Initials White-Applicant Yellow-Health Pink-Treasurer • ."VTIE)f�c . i I i North Andover Health Department Community and Economic Development Division October 4, 2017 COQ Peter Ogren, P.E. Hayes Engineering, Inc. 603 Salem Street Wakefield, MA 01880 Re: 62 Farnum Street (Map 107.A, Lot 86) Dear Mr. Ogren: .a The proposed v. water system design pl in for the above site dated September 28, 2017 and received on Se ber 28, 2017 has been eviewed. Unfortunately, the plan cannot be approved until the follc items are corrected. ie specific section in Title 5: 310 CMR 15.000, or North Ando gulation that is not oy this design follows each item where applicable. 1. Fon A, Local Upgrade A- ;val must be completed to indicate the request, signed and date )y the owner or the o' er's representative. 2. Lot rea is missing from tl iesign plan (NA 3.2). 3. The watershed note for Lai Cochichewick is missing from the design plan (NA 3.2). 4. There is a typo on sheet 2 of 2, the ESHWT depth for DOH2-17 is depicted as 40" instead of 70". 5. Wetland Line will need to be reconfirmed with Conservation Department Page 1 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 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. Since , Z ian J. L Grasse, CEHT Director of Public Health cc: Brian and Jessica Hickey File Page 2 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 i I • q,fi LED" 'TOWN OF NORTH ANDOVER Community & Economic Development LILA HEALTH DEPARTMENT 120 Main Street NORTH ANDOVER, MASSACHUSETTS 01845 978.W.9540- 11hoti: 979.698,0542 FAX E-NIA(L:hraltl�dcpt'ii nc�tllt;lritl(':cx'fq . 'n, WEBSITE:h4t9)a.,�wc:+.ncrtlt�ri�l.;w i rtr a.z�+ SEPTIC PLAN SUBMITTAL FORM cmVED Date of Submission:Sept. 29, 2017 �� �� 2017 Site Location:62 Farnum Street TO aLTN DEPARTMEW Engineer:Hayes Engineering, Inc. New Plans? Yes x $275/Plan Check# (includes 1St submission and one re- review only) Revised Plans?Yes $125/Plan Check# Site Evaluation Forms Included? Yes x No Local Upgrade Form Included? Yes x No Telephone#:781-246-2800 Fax #:781-246-7596 E-mail:grogerson@hayeseng.com Homeowner Name: Brian &Jessica Hickey 62 Farnum Street OFFICE USE ONLY fi When the submission is complete (including check): zq_ O / );> �/ Date stamp plans and letter ` / ➢ V Complete and attach Receipt ➢ V Copy ,File• Forward to Consultant ➢ __Enter on Log Sheet and Database OR 8U �9 MTi�1 • Town of North Andover HEALTH DEPARTMENT CHU`>ES CHECK#: 200 DATE: LOCATION: H/O NAME: 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 Systems: ❑ Septic-Soil Testing $ xSeptic-Design Approval $ J= ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other:(Indicate) $ He Agent Initials White-Applicant Yellow-Health Pink-Treasurer 11/9/2, 17 Town of North Andover Mail-62 Farnum St t NOR OVER Massachutts Toni Wolfenden <twolfenden@northandoverma.gov> Y.. 62 Farnum St 10 messages W. Gordon Rogerson <GRogerson @hayeseng.com> Fri, Sep 29, 2017 at 10:17 AM To: "TWOLFENDEN@NORTHANDOVERMA.GOV" <TWOLFENDEN@northandoverma.gov> Toni, Here is a PDF of the septic design for review. Thanks, Gordie 2 attachments In scan00236.pdf 674K Mn scan00235.pdf 470K Toni Wolfenden <twolfenden@northandoverma.gov> Fri, Sep 29, 2017 at 10:35 AM To: "W. Gordon Rogerson" <GRogerson@hayeseng.com> Thanks Gordie, I will email it over right away. Have a nice weekend. Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 a,>r,, [Quoted text hidden] Toni Wolfenden <twolfenden@northandoverma.gov> Fri, Sep 29, 2017 at 10:39 AM To: Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant<mgrant@northandoverma.gov>, Dan Ottenheimer <dano@millriverconsulting.com>, Isaac Rowe <irowe@millriverconsulting.com>, Pamela Lally <plally@millriverconsulting.com> Please find attached a copy of the PDF septic design plan for 62 Farnum Street. If there is anything we can do to speed this along, it would be truly appreciated. The homeowner is selling house the close date is coming up, they are a bit stressed. https://mail.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver-M-xhRW nOlpO.en.&view=pt&search=all&th=15f3O4l 974fb97df&siml=15ecdff76l c8Oa28&... 1/6 11/9/2017 Town of North Andover Mail-62 Farnum St i 4 Thanks and have a good weekend. Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 d NOW [Quoted text hidden] i 2 attachments i scan00236.pdf 674K scan00235.pdf 470K dano@millriverconsulting.com <dano@millriverconsulting.com> Fri, Sep 29, 2017 at 10:40 AM To: twolfenden@northandoverma.gov I will be out of the office and returning on Monday October 2, 2017. 1 will have intermittent access to checking email however if this email is of an urgent nature please call the office at 978-282-0014 and someone can assist you. Otherwise I look forward to addressing your message upon my return. Thank you, Dan Ottenheimer Toni Wolfenden <twolfenden@northandoverma.gov> Fri, Sep 29, 2017 at 11:01 AM To: "W. Gordon Rogerson" <GRogerson@hayeseng.com>, Jennifer Hughes <jhug hes@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov> Just a reminder, please follow up with Conservation about the wetland line for 62 Farnum Street. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 https://mail.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOlpO.en.&view=pt&search=all&th=l 5f3041974fb97df&siml=15ecdff761 c80a28&... 2/6 11/9/2017 Town of North Andover Mail-62 Famum St On Fri, Sep 29, 2017 at 10:17 AM,W. Gordon Rogerson <GRogerson@hayeseng.com>wrote: [Quoted text hidden] Toni Wolfenden <twolfenden@northandoverma.gov> Wed, Oct 4, 2017 at 12:11 PM To: Isaac Rowe <irowe@millriverconsulting.com>, Pamela Lally<plally@millriverconsulting.com>, Dan Ottenheimer <dano@millriverconsulting.com>, Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov> Hi Everyone, Just confirming that this was received. It is the pdf for 62 Farnum Street. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 ----------Forwarded message---------- From:W.Gordon Rogerson <GRogerson@hayeseng.com> Date: Fri, Sep 29, 2017 at 10:17 AM Subject: 62 Famum St To: "TWOLFENDEN@NORTHANDOVERMA.GOV"<TWOLFENDEN@northandoverma.gov> [Quoted text hidden] 2 attachments in scan00236.pdf 674K scan00235.pdf 470K Isaac Rowe<irowe@millriverconsulting.com> Wed, Oct 4, 2017 at 1:59 PM To: Toni Wolfenden <twolfenden@northandoverma.gov>, Pamela Lally<plally@millriverconsulting.com>, Dan Ottenheimer <dano@millriverconsulting.com>, Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov> Cc: Isaac Rowe <irowe@millriverconsulting.com> https://mail.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOlpO.en.&view=pt&search=all&th=15f3O4l 974fb97df&siml=15ecdff76l c8Oa28&... 3/6 11/9/2017 Town of North Andover Mail-62 Farnum St c Yes received and should be finalizing the review letter today. Thanks, Isaac Rowe Project Manager D AN `A VRNA=1't Cita lke 54e11113een."L for t.:uul]k��al�t]e3ne-iec 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.miliriverconsulting.com From: Toni Wolfenden [mailto:twolfenden@northandoverma.gov] Sent: Wednesday, October 04, 2017 12:11 PM To: Isaac Rowe; Pamela Lally; Dan Ottenheimer• Brian LaGrasse; Michele Grant , Subject: Fwd: 62 Farnum St [Quoted text hidden] All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. Visit us online at www.northandoverma.gov. Toni Wolfenden <twolfenden@northandoverma.gov> Wed, Oct 4, 2017 at 2:02 PM To: Isaac Rowe <irowe@millriverconsulting.com> thank you so much Toni K. Wolfenden Health Department Assistant 978-688-9540 https://mail.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOIpO.en.&view=pt&search=all&th=15f3041974fb97df&siml=15ecdff761 c80a28&... 4/6 11/9/2017 Town of North Andover Mail-62 Farnum St [Quoted text hidden] Isaac Rowe <irowe@millriverconsulting.com> Wed, Oct 4, 2017 at 2:41 PM To:Toni Wolfenden <twolfenden@northandoverma.gov>, Pamela Lally<plally@millriverconsulting.com>, Brian LaGrasse <blag rasse@northandoverma.gov>, Michele Grant<mgrant@northandoverma.gov> Cc: Isaac Rowe <irowe@millriverconsulting.com> Brian, Attached is the disapproval letter for the initial plan review for the above referenced property. Only minor edits needed.These could even be made on the design plan by the designer if he provides his initials and date. It appeared on the PDF that the LUA was incomplete but if your copy is complete and the request for 1 test hole is indicated then you can disregard item#1. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager V.- Z�L RIVE,R ONSI'L` INN €,gx.rti�r.4{atua'scan.*fiat tsuxl 1k 4110 iau°raf 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.millriverconsulting.com https://mail.google.com/mail/u/0/?ui=2&ik=a0c6f4e4cf&jsver-M-xhRWn01p0.en.&view=pt&search=all&th=15f3041974fb97df&sim1=15ecdff761 c80a28&... 5/6 11/9/2017 Town of North Andover Mail-62 Farnum St From: Toni Wolfenden [mai Ito:twolfenden@northandoverma.gov] Sent: Wednesday, October 04, 2017 12:11 PM To: Isaac Rowe; Pamela Lally; Dan Ottenheimer; Brian LaGrasse; Michele Grant Subject: Fwd: 62 Farnum St Hi Everyone, [Quoted text hidden] All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. Visit us online at www.northandoverma.gov. 62 Farnum St-disapproval letter 10-4-17.doc 396K Toni Wolfenden <twolfenden@northandoverma.gov> Wed, Oct 18, 2017 at 12:12 PM To: Jennifer Hughes <jhughes@northandoverma.gov> see the pdf for 62 Farnum Street Toni K. Wolfenden Health Department Assistant 978-688-9540 ----------Forwarded message---------- From:W.Gordon Rogerson <GRogerson@hayeseng.com> Date: Fri, Sep 29, 2017 at 10:17 AM Subject: 62 Farnum St To: "TWOLFEN DEN @NORTHANDOVERMA.GOV" <TWOLFENDEN@northandoverma.gov> [Quoted text hidden] 2 attachments In scan00236.pdf 674K in scan00235.pdf 470K hftps:/Imail.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOlpO.en.&view=pt&search=all&th=l 5f3041974fb97df&siml=l 5ecdff761 c80a28&... 6/6 11/9/2017 Town of North Andowr Mail-Fwd:Farnum St NORV 4 1AN :OVER Massachusrgs Jennifer Hughes<jhughes@northandoverma.gov> Fwd: Farnum St 1 message Toni Wolfenden <twolfenden@northandoverma.gov> Mon, Oct 16, 2017 at 9:02 AM To: Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov>, Jennifer Hughes <jhughes@northandoverma.gov> Good Morning, This was received this morning. Please let me know how to handle. Thanks so much, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 ------ Forwarded message ------- From: W. Gordon Rogerson <GRogerson@hayeseng.com> Date: Mon, Oct 16, 2017 at 6:53 AM Subject: Farnum St To: "TWOLFENDE N@NORTHANDOVERMA.GOV" <TWOLFENDEN@northandoverma.gov> Toni. I am requesting that the wetland line be reviewed at 62 Farnum St as per the review comments. Thanks, Gordie Hayes Engineering, Inc. hftps:Hniai l.g oog l e.com/mai I/u/0/?ui=2&i k-d96a89fc6c&j swr=M-)diRWnOl p0.en.&u eve pt&q=62°/`20farnum&q s=true&search=q uery&th=l5f25482cal cfee4&s i ml... 1/1 i 11/9/2017 Town of North Andover Mail-Fwd:62 Farnum Street NoRTM ,OVER Toni Wolfenden <twolfenden@northandoverma. ov> Massachusetts 9 Fwd: 62 Farnum Street 2 messages Jennifer Hughes <jhughes@northandoverma.gov> Tue, Oct 31, 2017 at 3:25 PM To: Toni Wolfenden <twolfenden@northandoverma.gov> Sorry, forgot to copy you on the email below. Jennifer A. Hughes Conservation Administrator Town of North Andover 120 Main Street North Andover, MA 01845 Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web www.northandoverma.gov ---------- Forwarded message ---------- From: Jennifer Hughes <jhughes@northandoverma.gov> Date: Tue, Oct 31, 2017 at 3:24 PM Subject: 62 Farnum Street To: GRogerson@hayeseng.com Gordie, I received the email below from the Health Dept(see highlighted text). As of today, no RDA has been submitted. Do you intend to file by Friday(deadline 12 p.m.)? No work in the buffer zone should commence until permits are issued. Let me know if you have any questions. Jennifer A. Hughes Conservation Administrator Town of North Andover 120 Main Street North Andover, MA 01845 https://mai l.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xh RW nOlpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 1/3 i 11/9/2017 Town of North Andover Mail-Fwd:62 Farnum Street Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web www.northandoverma.gov too ---------- Forwarded message---------- From:W. Gordon Rogerson <GRogerson @hayeseng.com> Date: Tue, Oct 31, 2017 at 2:18 PM Subject: RE: 62 Farnum St To: Toni Wolfenden <twolfenden@northandoverma.gov> Yes,We have filed with the ConCom with a RDA From:Toni Wolfenden [mailto:twolfenden@northandoverma.gov] Sent:Tuesday, October 31, 2017 1:10 PM To:W. Gordon Rogerson <GRogerson @hayeseng.com>; Brian LaGrasse<blagrasse@northandoverma.gov>; Michele Grant<mgrant@northandoverma.gov> Subject: Re:62 Farnum St Gordie, Remember you must be approved by Com Con. Please contact Jen Hughes. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 hftps://mai I.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOIpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 2/3 11/9/2017 Town of North Andover Mail-Fwd:62 Farnum Street • Toni Wolfenden <twolfenden@northandoverma.gov> Tue, Oct 31, 2017 at 3:56 PM To: Brian LaGrasse <blagrasse@northandoverma.gov> Please see email from Jen. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 ----------Forwarded message---------- From: Jennifer Hughes <jhughes@northandoverma.gov> [Quoted text hidden] hftps:Hmai l.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOlpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 3/3 11/9/2017 Town of North Andover Mail-62 Farnum NO RTH AN y OVER Massachus tls Jennifer Hughes<jhughes@northandoverma.gov> 62 Farnum 1 message Jennifer Hughes<jhughes@northandoverma.gov> Mon, Oct 16, 2017 at 9:10 AM To: GRogerson@hayeseng.com Cc: Toni Wolfenden <twolfenden@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov>, Kale Kalloch-Getman <kkgetman@northandoverma.gov> Gordie, The health department forwarded me an email requesting a review of the wetland line at 62 Farnum. It appears you will need to file with the Conservation Commission as work on the property is within the 100' Buffer Zone to wetland resource areas. As the majority of the work is outside the buffer zone, I think a Request for Determination of Applicability would be appropriate. If you need assistance with this filing, please let me know. Jennifer A. Hughes Conservation Administrator Town of North Andover 120 Main Street North Andover,MA 01845 Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web www.northandoverma.gov 0 https://mail.google.con/nail/u/0/?ui=2&ik=d96a89fc6c&jsver=M-)bRWnO]po.en.&\iew pt&q=62%20farnum&gs=true&search=query&th=15f254ef510759e4&siml... 1/1 11/9/2017 Town of North Andover Mail-62 Farnum St NOR -IAN OVER onoenen woenen northandoverma. Massachus�s Ti Wolfenden <tlfdov>� @ 9 62 Farnum St 10 messages W. Gordon Rogerson <GRogerson@hayeseng.com> Fri, Sep 29, 2017 at 10:17 AM To: "TWOLFENDEN @NORTHANDOVERMA.GOV" <TWOLFENDEN@northandoverma.gov> Toni, Here is a PDF of the septic design for review. Thanks, Gordie 2 attachments In scan00236.pdf 674K on scan00235.pdf 470K Toni Wolfenden <twolfenden@northandoverma.gov> Fri, Sep 29, 2017 at 10:35 AM To: "W. Gordon Rogerson" <GRogerson @hayeseng.com> Thanks Gordie, I will email it over right away. Have a nice weekend. Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 [Quoted text hidden] Toni Wolfenden <twolfenden@northandoverma.gov> Fri, Sep 29, 2017 at 10:39 AM To: Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant<mgrant@northandoverma.gov>, Dan Ottenheimer <dano@millriverconsulting.com>, Isaac Rowe<irowe@miIIrive rconsulting.com>, Pamela Lally <plally@millriverconsulting.com> Please find attached a copy of the PDF septic design plan for 62 Farnum Street. If there is anything we can do to speed this along, it would be truly appreciated. The homeowner is selling house the close date is coming up, they are a bit stressed. - https://mail.google.com/mail/u/O/?ui=2&ik=aOc6f4e4cf&jsverM-xhRWnOl O.en.&view= t&q=9ro erson%40ha esen9•com& s=true&search= ue ry&th... 1/6 i 11/9/2017 Town of North Andover Mail-62 Farnum St Thanks and have a good weekend. Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 [Quoted text hidden] 2 attachments scan00236.pdf 674K scan00235.pdf 470K dano@millriverconsulting.com <dano@millriverconsulting.com> Fri, Sep 29, 2017 at 10:40 AM To: twolfenden@northandoverma.gov I will be out of the office and returning on Monday October 2, 2017. 1 will have intermittent access to checking email however if this email is of an urgent nature please call the office at 978-282-0014 and someone can assist you. Otherwise I look forward to addressing your message upon my return. Thank you, Dan Ottenheimer Toni Wolfenden <twolfenden@northandoverma.gov> Fri, Sep 29, 2017 at 11:01 AM To: "W. Gordon Rogerson" <GRogerson@hayeseng.com>, Jennifer Hughes <jhughes@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov> Just a reminder, please follow up with Conservation about the wetland line for 62 Farnum Street. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 https://mai l.goog le.com/m a i I/u/0/?u i=2&i k=aOc6f4e4cf&jsver=M-xh RW nOl pO.en.&view=pt&q=g rogerson%40 hayeseng.co m&qs=true&search=query&th... 2/6 11/9%2017 Town of North Andover Mail-62 Farnum St On Fri, Sep 29, 2017 at 10:17 AM,W. Gordon Rogerson <GRogerson @hayeseng.com>wrote: [Quoted text hidden] Toni Wolfenden <twolfend en @north andoverma.gov> Wed, Oct 4, 2017 at 12:11 PM To: Isaac Rowe <irowe@millriverconsulting.com>, Pamela Lally<plally@millriverconsulting.com>, Dan Ottenheimer <dano@millriverconsulting.com>, Brian LaGrasse <blag rasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov> Hi Everyone, Just confirming that this was received. It is the pdf for 62 Farnum Street. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 ----------Forwarded message---------- From:W.Gordon Rogerson <G Rogerson @hayeseng.com> Date: Fri, Sep 29, 2017 at 10:17 AM Subject: 62 Farnum St To: "TWOLFENDEN @NORTHANDOVERMA.GOV"<TWOLFENDEN@northandoverma.gov> [Quoted text hidden] 2 attachments .n scan00236.pdf 674K in scan00235.pdf 470K Isaac Rowe <irowe@millriverconsulting.com> Wed, Oct 4, 2017 at 1:59 PM To: Toni Wolfenden <twolfenden@northandoverma.gov>, Pamela Lally<plally@millriverconsulting.com>, Dan Ottenheimer <dano@millriverconsulting.com>, Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov> Cc: Isaac Rowe<irowe@miliriverconsulting.com> https://mai l.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOlpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 3/6 11/9%2017 Town of North Andover Mail-62 Farnum St Yes received and should be finalizing the review letter today. Thanks, Isaac Rowe Project Manager r Y" .'0' AN 'i v:RSA Z (.9t[ittc-Srshraiim fi.er U1ntl W%cJrllmi't1! 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.miliriverconsulting.com From: Toni Wolfenden [ma i Ito:twolfenden@northandoverma.gov] Sent: Wednesday, October 04, 2017 12:11 PM To: Isaac Rowe; Pamela Lally; Dan Ottenheimer; Brian LaGrasse; Michele Grant Subject: Fwd: 62 Farnum St [Quoted text hidden] All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. Visit us online at www.northandoverma.gov. Toni Wolfenden <twolfenden@northandoverma.gov> Wed, Oct 4, 2017 at 2:02 PM To: Isaac Rowe <irowe@millriverconsulting.com> thank you so much Toni K. Wolfenden Health Department Assistant 978-688-9540 https://mai I.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xhRWnOIpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 4/6 11/9/2017 Town of North Andover Mail-62 Farnum St [Quoted text hidden] Isaac Rowe <irowe@millriverconsulting.com> Wed, Oct 4, 2017 at 2:41 PM To: Toni Wolfenden <twolfenden@northandoverma.gov>, Pamela Lally<plally@millriverconsulting.com>, Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant<mgrant@northandoverma.gov> Cc: Isaac Rowe <irowe@millriverconsulting.com> Brian, Attached is the disapproval letter for the initial plan review for the above referenced property. Only minor edits needed.These could even be made on the design plan by the designer if he provides his initials and date. It appeared on the PDF that the LUA was incomplete but if your copy is complete and the request for 1 test hole is indicated then you can disregard item#1. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager 110' aha }+ 'Vcp ;n.:Y < MI;LLL RIVER CONSULTING 6 Sargent Street Gloucester, MA 01930-2719 Phone:978-282-0014 ext.804 www.millriverconsulting.com https:Hma i l.goog le.com/ma i I/u/O/?u i=2&i k=aOc6f4e4cf&jsver=M-xh RW n OlpO.en.&view=pt&q=g rog erson°/o40hayese ng.com&qs=true&search=query&th... 5/6 11/9/1017 Town of North Andover Mail-62 Farnum St F From: Toni Wolfenden [mailto:twolfenden@northandoverma.gov] Sent: Wednesday, October 04, 2017 12:11 PM To: Isaac Rowe; Pamela Lally; Dan Ottenheimer; Brian LaGrasse; Michele Grant Subject: Fwd: 62 Farnum St Hi Everyone, [Quoted text hidden] All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. Visit us online at www.northandoverma.gov. 62 Farnum St-disapproval letter 104-17.doc 396K Toni Wolfenden <twolfenden@northandoverma.gov> Wed, Oct 18, 2017 at 12:12 PM To: Jennifer Hughes <jhughes@northandoverma.gov> see the pdf for 62 Farnum Street Toni K. Wolfenden Health Department Assistant 978-688-9540 U- ----------Forwarded message---------- From:W.Gordon Rogerson <G Rogerson @hayeseng.com> Date: Fri, Sep 29, 2017 at 10:17 AM Subject: 62 Farnum St To: "TWOLFENDEN @NORTHANDOVE RMA.GOV" <TWOLFENDEN@northandoverma.gov> [Quoted text hidden] 2 attachments Mn scan00236.pdf 674K in scan00235.pdf 470K https://mai I.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xh RWn0IpO.en.&view=pt&q=grogerson°/a40hayeseng.com&qs=true&search=query&th... 6/6 11/9/t17 Town of North Andover Mail-Fwd:62 Farnum Street + NOT AN DOVER Massachu"bks Toni Wolfenden <twolfenden@northandoverma.gov> Fwd: 62 Farnum Street 2 messages Jennifer Hughes <jhughes@northandoverma.gov> Tue, Oct 31, 2017 at 3:25 PM To: Toni Wolfenden <twolfenden@northandoverma.gov> Sorry, forgot to copy you on the email below. Jennifer A. Hughes Conservation Administrator Town of North Andover 120 Main Street North Andover, MA 01845 Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web www.northandoverma.gov i ----------Forwarded message ---------- From: Jennifer Hughes <j hug hes@northandoverma.gov> Date: Tue, Oct 31, 2017 at 3:24 PM Subject: 62 Farnum Street To: GRogerson@hayeseng.com Gordie, I received the email below from the Health Dept(see highlighted text). As of today, no RDA has been submitted. Do you intend to file by Friday(deadline 12 p.m.)? No work in the buffer zone should commence until permits are issued. Let me know if you have any questions. Jennifer A. Hughes Conservation Administrator i Town of North Andover 120 Main Street North Andover, MA 01845 https://mail.goog le.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver=M-xh RWnOIpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 1/3 11/9/2017 Town of North Andover Mail-Fwd:62 Farnum Street Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web www.northandoverma.gov ---------- Forwarded message---------- From: W. Gordon Rogerson <GRogerson@hayeseng.com> Date: Tue, Oct 31, 2017 at 2:18 PM Subject: RE: 62 Farnum St To: Toni Wolfenden <twolfenden@northandoverma.gov> Yes,We have filed with the ConCom with a RDA From:Toni Wolfenden [mailto:twolfenden@northandoverma.gov] Sent:Tuesday, October 31, 2017 1:10 PM To:W. Gordon Rogerson <GRogerson@hayeseng.com>; Brian l_aGrasse<blagrasse@northandoverma.gov>; Michele Grant<mgrant@northandoverma.gov> Subject: Re:62 Farnum St Gordie, Remember you must be approved by Com Con. Please contact Jen Hughes. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 https://mail.google.com/mai I/u/0/?ui=2&ik=aOc6f4e4cf&jsver-M-xh RWnOlpO.en.&view=pt&q=grogerson%40hayeseng.com&qs=true&search=query&th... 2/3 11/9/2017 Town of North Andover Mail-Fwd:62 Farnum Street Toni Wolfenden <twolfenden@northandoverma.gov> Tue, Oct 31, 2017 at 3:56 PM To: Brian LaGrasse <blagrasse@northandoverma.gov> Please see email from Jen. Thanks, Toni Toni K. Wolfenden Health Department Assistant 978-688-9540 ----------Forwarded message---------- From:Jennifer Hughes <jhughes@northandoverma.gov> [Quoted text hidden] _ _ - - htts://mail. oo le.com _ _ a p g g /mail/u/0/.w 2&ik a0c6f4e4cf&jsver-M xhRWn01p0.en.&view-pt&q-grogerson/o40hayeseng.com&qs=true&search=query&th... 3/3 10/31/20174 Town of North Andover Mail-62 Farnum Street-Form 9A app for local Upgrade Approval No ANOVER Massachus Toni Wolfenden <twolfenden@northandoverma.gov> sett 62 Farnum Street - Form 9A app for local Upgrade Approval 2 messages Toni Wolfenden <twolfenden@northandoverma.gov> Tue, Oct 31, 2017 at 1:07 PM To: Isaac Rowe <irowe@millriverconsulting.com>, Pamela Lally<plally@millriverconsulting.com>, Dan Ottenheimer <dano@millriverconsulting.com>, Brian LaGrasse<blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov>, Jennifer Hughes <jhug hes@northandoverma.gov> Please find attached a copy of the signed Form 9 A Application for Local Upgrade Approval for 62 Farnum Street. Thank you, Toni 20171031131327057.pdf i Toni K. Wolfenden Health Department Assistant 978-688-9540 u� I Isaac Rowe <irowe@millriverconsulting.com> Tue, Oct 31, 2017 at 3:44 PM To:Toni Wolfenden <twolfenden@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov> Cc: Isaac Rowe <irowe@miliriverconsulting.com> Brian, The only outstanding matter that remains is the ESHWT typo on sheet 2 for DOH2-17. It should be noted as 40" instead of 70". If this has been changed then I would recommend approval of the plan. Thanks, Isaac Rowe Project Manager https://mai l.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver-ARz2Td5dGjw.en.&view=pt&search=inbox&th=15f73f7l 2e3b829f&siml=15f7366c91 dd4af... 1/3 10/31/2017 Town of North Andover Mail-62 Farnum Street-Form 9A app for local Upgrade Approval i'N a4 ' ANNYFR6w-'ti '%,�k MILL RIVER CONSULTING t`re+rig<;soliiwit+r4�fhr Tsni�l 134nalu�lnle'Y1G 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.miliriverconsulting.com From: Toni Wolfenden [maiIto:twolfenden@northandoverma.gov] Sent: Tuesday, October 31, 2017 1:07 PM To: Isaac Rowe; Pamela Lally; Dan Ottenheimer; Brian LaGrasse; Michele Grant; Jennifer Hughes Subject: 62 Farnum Street - Form 9A app for local Upgrade Approval Please find attached a copy of the signed Form 9 A Application for Local Upgrade Approval for 62 Farnum Street. Thank you, Toni Toni K. Wolfenden Health DepartfAL lW1k 4P9tahbdf 978-688-9540 All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. https://mail.google.com/mail/u/0/?ui=2&ik=a0c6f4e4cf&jsver=ARz2Td5dGjw.en.&view=pt&search=inbox&th=15f73f712e3b829f&siml=15f7366c91 dd4af... 2/3 10/31/2017 it Town of North Andover Mail-62 Farnum Street-Form 9A app for local Upgrade Approval r Visit us online at www.northandoverma.gov. hftps:HmaiI.google.com/mail/u/0/?ui=2&ik=aOc6f4e4cf&jsver-ARz2Td5dGjw.en.&view=pt&search=inbox&th=15f73f712e3b829f&siml=15f7366c91 dd4af... 3/3 Town of North Andover — Septic System - AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected and noted on the as-built plan 2) V As-built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans) 3) Street Address,Assessor's Map and Lot Number 4) /Lot Lines and Location of Dwellings served by the system 5) __41cations,Elevations and Dimensions of As-built system components,including reserve (if applicable) 6) y Ties to all tank openings,d-box,and leach area from dwelling or Permanent Structure Setback distances are shown on the as-built plan from system components to: 11-14 K Subsurface,interceptor&foundation drains (v/}_Catch basins ✓ Property lines Dwellings or other structures NA X Private water supply or irrigation wells 4ocations Watercourses or wetlands 8) of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) "/Location of water,gas,electric lines,cable,control panel (if applicable) 10) �/ Location of Structures within 6 Inches of Finished Grade 11) Original Stamp &Signature 12) AA Location and holder of any easements which could impact the system 13) 7Impervious Areas;Driveways,etc 7 14) North Arrow 15) /Location&Elevation of Benchmark used 16) ZLSTATEMENT ON PLAN (NA 5.3) Ia. "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 break out elevations,if applicable,have been met." Signature of Designer Date "If a STUCTURAL WALL IS PRESENT W 4.9)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:Tuesday,March 17,2015 I s�cT` �6 •, RECEIVED NOV 2 7 2017 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT PUBLIC HEALTH DEPARTMENT (ommunity&Economic Development TOWN OF NORTH ANDOVER SCO SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System{ )constructed;{ }repaired; By: / (Print Name) Located at:62 Farnum Street (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated September 9R, 9017 and last revised on October 10, 2017 ,with a design flow of 330 gallons per day. The materials used were in conformance with those specified on the approved plan;the system was installed in accordance with the provisions of 310.CMR 15.000,Title 5 and local regulations,and the final grading agrees substantially with the approved plan.All work is accurately represented on the As-built which has been submitted to the Board of Health. Bottom of Bed Inspection Date:Nov. 17, 2017 1 Engineer Represen a(Signature) Gordon Rogerson And—Print Name Final Construction Inspection Date:Nov. 27, 2017 1 Engineer Representativ gnature) Gordon Rogerson And—Print Name Installer: A (Signature) Date:No u• 1-1, 2 o 1 l rA Me) �o And—Print Name PETER (Signature) Date: Nov. 27, 2017 No.77145 - - Peter J. Ogren P.E. And—Print Name 120 Main Street, North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov � TI"ED 7�6 ♦ � Q MEE D OT( PUBLIC HEALTH DEPARTMENT Town of North Andover Community and Economic Development Division CERTIFICATE OF COMPLIANCE As of: November 27, 2017 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Full Repair of On-Site Sewage Disposal System By: James R. Kellett At: 62 Farnum Street Map 107.A Lot 86 N rth Andover, MA 01845 The Is ce of this c i cat shall no e construed as a guarantee that the system will function satisfactorily. Br i J. La rasse, HT Di ector of Public Health 120 Main St.,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web www.northandoverma.gov Commonwealth of Massachusetts City/Town of North Andover RECEIVED Certificate of Compliance Nov 2 i 2017 Form 3 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. This is to Certify that the following work on an On-Site Sewage Disposal System Important:When filling out forms ❑ Construction of a new system on the computer, ® Repair or replacement of an existing system use only the tab ❑ Repair or replacement of an existing system component key to move your cursor-do not use the return Has been done in accordance with Title 5 and the Disposal System Construction Permit(DSCP): key. rQ DSCP Number DSCP Date Brian &Jessica Kickey Facility Owner 62 Farnum Street Street address or Lot# North Andover Ma. 01845 City/Town State Zip Code 'a� , resigner Information: /j PETER J. \ \ }Jo NLS �Pdter J. Ogren P.E. Hayes Engineering, Inc NO.27145 N ime, Name of Company Nov. 27, 2017 �� .. '., kbignature Date Installer Information: J A►K CS �- �e��e ������ �xe�fia L. G N Name o Com any (/ x-1 /7 ture Date se of this system is conditioned on compliance with the provisions set forth below: This Certificate relates only to the construction of the septic system components as shown on the As-built plan for#62 Farnum Street. North Andover, Ma. 01845 The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Appr, Authority 2 -7- Signa re Date t5form3.doc•06/03 Certificate of Compliance-Page 1 of 1 by 6us, Y�� 62 Farnum Street April 8, 2006— system Fail per Title 5 Inspection Form — Inspector Kimball July 17, 2006— permit pulled for Septic Disposal System — Installer J.W. Watson August 16, 2006— Deed bk 10344 pg 195: Good sold to Gattis August 17, 2006— Bed Bottom DWC— System Construction Approved — Susan Sawyer October 6, 2006— Certificate of Compliance — Full System Repair— Michele Grant October 8, 2008.—Title S Inspection Form Pass — Inspector Benjamin C. Osgood .November 28, 2008,— Deed bk 11388 pg 339: Gattis sold to Hickey January 10, 2011— Witness system Fail see paperwork April 13, 2014— System Pumping Record — Good, system operating properly— Pumper Jason Elliott April 6, 2016— System Pumping Record — Good, system operating properly— Pumper Jason Elliott April 16, 2017— System Pumping Record —Good, system operating properly— Pumper Jason Elliott t , Commonwealth`{ issachusetts Title 5 Gaicial Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form GSM Inspection results must be submitted on this form or on the official Title 5 Inspection Form dated 611512000. Inspection forms may not be altered in any way. A. Certification Important: When filling out 1. Property Information: forms on the computer,use 62 Farnum St. only the tab key Property Address to move your John Good cursor-do not use the return Owners Name key. 62 Farnum Owner's Address N. Andover ma 01845 City/Town State Zip Code Date of Inspection: 4-8-06 Date Date 2. Inspector: Robert Kimball Name of Inspector R. Kimball Excavation LLC 21 Clifton Ave Company Address Salem NH 03079 City/Town State Zip Code 978-375-1011 Telephone Number Certification Statement: I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes Conditionally Passes ® Fails ❑ ed urthe. flu 1 bft&e o pproving Authority ('L b InspLvcffs Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Forms John Good.doc•1112004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 1 of 16 • Commonwealth of Massachusetts y Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form M A. Certification (cont.) 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) 62 Famum st. Property Address N.Andover MA 01845 Cityrrown State Zip Code John Good 4-8-06 Owner's Name Date of Inspection B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 3 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) 62 Famum St PropertyAddress N.Andover MA 01845 cityrrown State Zip Code John Good 4-8-06 Owner's Name Date of Inspection I C) Further Evaluation is Required by the Board of Health(cont.): 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia ni(Cogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other. Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form r •, A. Certification (cont.) 62 Famum St Property Address N.Andover MA 01845 Cityfrown State ZipCode John Good 4-8-06 Owner's Name Date of Inspection D)System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet ❑ ® from a private water supply well with no acceptable water quality analysis. [This system passes N the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] Yes No ® ❑ The system fails.l have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. Title 5 Inspection Fomes John Good.doc.11!2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 16 Commonwealth of Massachusetts . Title 5 Official Inspection Form ° Not for Voluntary Assessments '�Ar bye Subsurface Sewage Disposal System Form A. Certification (cont.) 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owners Name Date of Inspection E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either" es" or"no"to each of the following, in addition to the questions in Section D. YES NO ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6of16 c Commonwealth of Massachusetts _ Title 5 Official Inspection Form Not for Voluntary Assessments �tM SV By`v Subsurface Sewage Disposal System Form B. Checklist 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code JohnGood 4-8-06 Owners Name Date of Inspection Check if the following have been done. You must indicate"yes"or"no"as to each of the following: YES NO ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of 16 Commonwealth of Massachusetts _ Title 5 Official Inspection Form } Not for Voluntary Assessments Subsurface Sewage Disposal System Form GSM y`'V C. System Information 62 Farnum St. Property Address N. Andover MA 01845 Cityrrown State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): See Sump pump? ❑ Yes ® No Last date of occupancy: ocupied Date Commercial/Industrial Flow Conditions: Type of Establishment: 0IN Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): i Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 8 of 16 Rpr 1,9 06 02: 55p p, 1 Summary Record Card generated on 4/19/2006 2:07:03 PM by Lisa Warren Page 1 Town of North Andover Tax Map # 210-107.A-0086-0000.0 62 FARNUM STREET GOOD, JOHN J. 62 FARNUM STREET N. ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1.12 Acres FY 2006 UB Mailing Index Name/Address Type Loan Number Activelinact. From Until GOOD, JOHN J. Payor 62 FARNUM STREET N. ANDOVER, MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 14287.0- 62 FARNUM STREET Last Billing Date 3/7/2006 2100282 02 Cycle 02 Active UB Services Maint. Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 64.41 /1 UB Meter Maintenance Serial No Status Location Brand Type Size YTD Cons 16335864 a Active ERT METE METE w Water 0.63 0.63 O Date Reading Code Consumption Posted Date Variance 2/8/2006 369 a Actual 19 3/13/2006 -3% 11/4/2005 350 a Actual 18 12/14/2005 -20% 8/8/2005 332 a Actual 23 9/12/2005 55% 5/10/2005 309 a Actual 14 6/8/2005 -17% 2/14/2005 295 a Actual 18 3/15/2005 5% 11/15/2004 277 a Actual 18 12/17/2004 1% 8/11/2004 259 a Actual 16 9/20/2004 20% 5/17/2004 243 a Actual 14 6/14/2004 -12% 2/17/2004 229 a Actual 18 4/16/2004 0% 11/7/2003 211 n New Meter 0 11/7/2003 0% Commonwealth of Massachusetts Title 5 Official Inspection Form a Not for Voluntary Assessments Subsurface Sewage Disposal System Form SIM SV By`W C. System Information (cont.) 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owner's Name Date of Inspection General Information Pumping Records: Source of information: owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 40+/- Were sewage odors detected when arriving at the site? ❑ Yes ® No Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 9 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments ;M Subsurface Sewage Disposal System Form C. System Information (cont.) 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: city feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2'feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of ❑ Yes ❑ No certificate) Dimensions: 1500 gal-round Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 48" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 1" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? field observation Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 10 of 16 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 62 Famum St Property Address Andover MA 01846 Cityrrown State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: 00 Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 11 of 16 Commonwealth of Massachusetts w Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M C. System Information (cont.) 62 Farnum St. Property Address N. Andover MA 01845 Cityrrown State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 5" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution Box was flooded Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form } Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: 2-30' ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Dug hole next to trench and determined hydraulic failure Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) 62 Farnum Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer 00 Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): 00 Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form ° Not for Voluntary Assessments Subsurface Sewage Disposal System Form M C. System Information (cont.) 62 Farnum St. Property Address N. Andover MA 01845 City/Town State Zip Code John Good 4-8-06 Owners Name Date of Inspection Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. G ACT va' 6 c = as' A o= i c? g Title 5 Inspection Forms John Good.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 16 Commonwealth of Massachusetts a Title 5 Official Inspection Form ° Not for Voluntary Assessments Subsurface Sewage Disposal System Form Gl SBBy`Bv C. System Information (cont.) 62 Farnum St. Property Address N. Andover MA 01845 Cityrrown State Zip Code John Good 4-8-06 Owner's Name Date of Inspection Site Exam: Slope Surface water norne, Check cellar Or '- Shallow wells none- Estimated one- Estimated depth to ground water: Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design pians on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: USDA Northern Essex soil maps You must describe how you established the high ground water elevation: Title 5 Inspection Forms John Good.doc•11!2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 16 of 16 Application for Septic Disposal System s�!;r,'.`•,• o =Construction Permit - TOWN OF TODAY'S DATE {`'�• -�--• 'NORTH•ANDOVER MA 01845 $250.00—Full Repair $125.00-Component s�crru�� Important: Application is hereby made for a permit to: When filling out ❑Construct a new on-site sewage disposal system* forms on the computer,use ❑Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑Repair or replace an existing system component cursor-do not use the return key. A. Facility Information _ I Address or Lot# AX-) ,z�n D-ey� Cityrrown 2.-*,TYPE OF SEPTIC SYSTEM''`: Pump ❑Gravity(choose one) ***If pump system,attach copy of electrical permit to application*** ❑Conventional System(pipe and stone system) Wrifiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S.(No D-Box)(Attach Draft Maintenance Agreement) ❑ Pressure Dosed(D-Box Present)S.A.S. 2. Owner Information, Name Address(if different from above) City/Town State Zip Code Telephone Number 3. Installer Information J. 41. 1JA75 Alz .�_ Gl/. L\/'t, Name Name of Company y 3 Z,r!w J" Address C' frown State Zip Code Telephone Number(Cell Phone#if possible please) a. Designer Information Name D Name of Company Address 4a4,.elll� State Zip Code 17y7s"- 3s rs- Telephone Number(Best#to Reach) Application for Disposal System Construction Permit-Page 1 of 2 leg' Application for Septic Disposal System • Of r 4 :s�4f _• O 3 � � =Construction Permit - TOWN OF TODAY'S DATE " •- ^;; 'NORTH ANDOVER, MA 01845 250.00-Full Repair cNwt ' $125.00-Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Buildinsa: DKesidential Dwelling or❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code,as well as the Local Subsurface Disposal Regulations for the Town of North Andover,and not to place the system in operation until a Certiticate of Compliance has been issued by this Board of Health. Namp Date Appli ion Approve y: (Board of Health Representative) Naim Date A'plication Disapproved for the following reasons: For Office Use Only: L Fee Attached. Yes No 2. Project Manager Obligation Form Attached? Yes-1.=__ No A Pump S sy tem? Ifso,Attach copy ofElectrrcal Permit Yes --- No 4. Foundation As-Built?(new construction ronly). /.Yes_ No (Same scale as approved plan) S. Floor Plans?(hew construction only): Yes Application for Disposal System Construction Permit-Page 2 of 2 1011912005 14:53 9786888476 HEALTH PAGE 02102 INSTALLER PROJECT 1VJ A NAGENNNT OBLIGATIONS As the North Andover licensed,installer for the construction of the septic system for the property at relative to the application of dated 4/ h6 for plans by-{�'���C.' «�_and dated with revisions dated I understand the following obligations for management of this project: I. As the installer I am obligated to obtain all permits and Board of Hcalth 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 T must call for any and all inspections. If homeowner, contractor, project manger,or any other person not associated with.my company schedules an inspection and the system is not ready thea item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in,accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally fust inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final. inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after, which installer calls for inspection, time. Tnstaller must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer i understand that only I may perform the work (other than simple excavation) required to complete the instatlation of the system identifiedin the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or, revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that T 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, A-box, pipes, stone, vent, pump chamber,.retaining wall and other components, 6. As the installer I understand that i am solely responsible for the installation of the system.as per the approved plans. No instructions by the homeowner, general contractor, or any other perso s shall absolve me of this obligation. Under ed Licensed Sep 'c Installer ` �� Date: MERRIMACK ENGINEERING SERVICES, INC. 66 PARK STREET ANDOVER, MA 01810 (978)475-3555 FAX (978)475-1448 AUG 0 1 2006 FACSIMILE COVER PAGE TOWN Lr t\vnTH ANDOVER HEALTH DEPARTMENT DATE: NUMBER OF PAGES: 0? (INCLUDING COVER SHEET) TO: �5 U FROM.: COMMENTS: SENDING TO FAX NUMBER: _ q�g� 12 CONFIRMING TELEPHONE NUMBER: FOR PROBLEMS,PLEASE CALL OPERATOR: (978)475-3555 TRANSMISSION: CONFIRM NO CONFIRlMATION NEEDED MERRIMACK ENGINEERING SERVICES,INC, 66 PARK STREET • ANDOVER,MASSACHUSETTS 018iD t10RTy 61 LAK Arlo O CCKN Cw,wKw 1' ��SSAC HUSE��� PUBLIC HEALTH DEPARTMENT Community Development Division August 4, 2006 Mr. John Good 62 Farnum Street North Andover, MA 01845 RE: Septic System Desitin, 62 Farnum Street,North Andover, Map 107A,Lot 86 Dear Mr. Good, At a regularly scheduled meeting, on August 3, 2006,the North Andover Board of Health approved local upgrade approvals and variances for the above-mentioned property. With the items listed below, three (3) bedroom, nine (9)room maximum design has been approved for use in the construction an onsite subsurface disposal system. The design was submitted on your behalf by Merrimack Engineering Services, dated June 8, 2006, with a revision dated July 28, 2006, and received by this office at 3:55 p.m. on July 31, 2006. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. During this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid. 1. Allow the use of a sieve analysis in lieu of field percolation tests 2. Allow the setback from wetlands from 100 feet to 82 feet from the soil absorption system (SAS). This approval is subject� t to the following conditions: 1. The attached DEP Form 9b must be submitted by the homeowner to the appropriate Regional Office of the Department of Environmental Protection; Bureau of Resource Protection, Mass DEP NERO, 205B Lowell Street, Wilmington, MA 01887 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.townofnorthandover.com system installer or other representative to ensure that all other state and municipal " rbquirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe or imply compliance with any of the aforementioned requirement Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you may have. Sincerely, Michele E. Grant Public Health Inspector Encl: list of licensed septic system installers Cc: Merrimack Engineering Services 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com K 10344 PG 195 QUU.CLAUX DEED Ln .Folli:J.Good and Carol Good,husband and wide,bath •r CO 4-)o of North Andover Essex County,Massachusetts $ in consideration of S47 a500.00 > grant to Christopher G. Gattis and Ann W. Gattis, husband and wife r.,U as Tenants by the Entirety w0:4of with.gttitclaim covenants C,j The land in&'bid North Andover with the buildings thereon situate on the Northerly side of Farnttm Street,bounded and described as follows: Q) SOUTHWESTERLY: by Farnum Street on two courses, 157 feet,more or less.; a NORTHWESTERLY: by lot 10 as shown on plan hereafter referred to,452.60 >1 feet: a sa v a NORTHEASTERLY: by lot 22 on said plan,63.32 feet; C a SOUTI EAS77iRLY: by lot 17 on said plan,433.461'ea Conitatining 40,000 square feet,more or less. Being shown as lot 16 on a plan entitled"Plan of Lots 14 to 22 Colonial Acres,Norfl, Andover,Mass.,Cmmer—George 1I.Farr,Scale: 1" 40',August 1 L 1465,Raymond C', a Pressey,Inc.,Registered land surveyors.Lynn"and recorded with Essex North Uistrct: Registry of needs as Plan#5318. n For our title,see deet:recorded with said Registry at 1look 1057,rage 83. r)m .r 7- - EXECUTED as a sealed instrument this clay of July,2006. o OIIN J.GOOD CAROL GOOD The Commonwealth of MassachuscU.q Essex, ss. July 3l ,2006 Then personally appeared the above named Jahn J.Good and Carol Good,to me 43 . personally known,and acknowledged the foregoing instrument to be their free act and I deed,before me o t a as VMDW COMWO ... AYVIlEAC 9H OF. Notary Public s Vi COWAMW c l3CTt?BEfi Q4,20M ks My commission expires: %C— 2 UiLDI [-i;ES. d t it' TMS Pi,.,..� � Gc+r�fl t►cam-rfor.l i S �oT ; f ET-4 ' �Df1J• `� ?�-C7 .Ce�1� Q q �,I���tr.�.ITY 0�'f►�E i-+g'eiUatw_9 54FOt'L� Id oIN SYe,rZH , 57 IS A rz�toca OF T'49 t tb�1 d NO E LE V�vf10J OF Trl E �► `n N� �iYS?t?t-� Id, S ...Z GaHPONa,�th. �r O -Fp E r G}� l-1 ,� 0 ( T7:7 7 F01r. ) r't i v I� ►,. c" t ��, ..�-r�t >r: ' F �a3't" ,� 17 A. d r PGc- E�t6>7" D1,}GLL y ��Z��N L'f�2�A('fs12 GI��M�� 1T,M.T» Imp jz I I Cmin Pio, 'Tx p Le' I I Ut G o./I rA L4�,j AS oml t vI LT PLAN OF SUBSURFACE DISPOSAL SYSTEMA RZ-C'E1V D LOCATEDIN F- Q Q U i-I Gam �P_\�OF MAS`S,pc SEP 2 9 2006 AS PREPARED FOR o VLADIMIRL. tiG CHENO TOWN OF NORTH ANDOVER o M1J/ m HEALTH DEPARTMENT ,,.1V 4 0 a2 r2 col) DATE: 61-0-0(o GIs �� .o�o� FO/s �w SCALE: It ® ` TL SCo F`SS/ONAL C o�p RRIMACK ENGINEERING SERVICES,, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 O TEL (617) 475-3555, 3MS721 -r 62 FARNUM STREET JS-2007-000004 PYoiect Detail Repot Printed On:Tue May 21,2013 Project Name: GIS#: 7394 Project No: JS-2007-000004 Owner of Record GOOD,JOHN J&CAROL GOOD s�K= °'err Map: 107.A Date Submitted: Jul-17-2006 62 FARNUM STREET Block: 0086 Status: Open NORTH ANDOVER,MA 01845 Lot: Work Category: Work Location: 62 FARNUM STREET Zoning: Proposed Use: District: land Use: 101 Proposed Use Detail Subdivision Description Septic System Comments: of Work: Department Status GeoTMS Module: Status File No. Comments: LCDate: Board of Health GREEN FLAG BHJ-2006-000048 Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: DWC-System Constructio BHP-2006-0220 SIGNED OFF e JS-2007-000004 Inspection History Inspection Type: Permit Type: Permit No: Insp Date: Status: Inspector: Project No: Comment: Final Inspection DWC-System Construction BHP-2006-0220 Dec-03-2010 New Susan Sawyer JS-2007-000004 failure 4 years old,gave owner number for infiltrator Kyle 866.511.6068.No action after 1/10/11,observation of system,see letter,case closed 5/21/13. Bed bottom DWC-System Construction BHP-2006-0220 Aug-17-2006 APPROVED Susan Sawyer JS-2007-000004 GeoTMS®2013 Des Lauriers Municipal Solutions,Inc. Page 1 of 1 tAORTj" q O ttLEO , 6'6 O O Ot4�«`y1 ORATED PPa '(5 'AC US PUBLIC HEALTH DEPARTMENT (ommunity Development Division ff.-,R IE'IC2E O E 'j- J-1 As of: October 2, 2006 ,This is to cert that the individuaCsu6surface dzsposafsystem received a: FudSeptic System Repair by Joseph �Buddy) Watson At: 62 Earnum Street jrlrorthAndover, 94,4 01845 The Issuance of this certiftate shaft not 6e construed as a guarantee that the system wiff function satisfactoriCy. 9dicheCe E. Grant Pu6Cic.ICeaCth Inspector 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com ` Commonwealth offMassachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. '^� Important: A. General Information t� When filling out forms on the computer,use 1. Inspector: P. only the tab key to move your Benjamin C. Osgood, Jr. cursor-do not Name of Inspector use the return key. New England Engineering Services, Inc. Company Name 1600 Osgood Street Suite 2-64 Company Address No. Andover MA 01845 City/Town State Zip Code 978-686-1768 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: asses ❑ Conditionally Passes Cl Fails ❑ Needs Further Evaluation by the Local Approving Authority /o/g/o S Inspector' ignature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 t Commonwealth of-Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owners Name required for is No Andover required for MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 15 ' Commonwealth of Massachusetts u . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM <'� 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water. supply well. TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ❑/ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ge Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ �/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ [�re Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow ❑ Q/ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ []� Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ [ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ 0,' Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 12 Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,. provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ [�K The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ 0/ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ 2 the system is within 400 feet of a surface drinking water supply ❑ [a' the system is within 200 feet of a tributary to a surface drinking water supply ❑ 13/ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. TITLE 5 FORM MASTER.DOC•08/06 'rifle 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 15 ' Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes" or"no"as to each of the following: Yes No No G2 ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 2 Were any of the system components pumped out in the previous two weeks? L�' ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) Ld ❑ Was the facility or dwelling inspected for signs of sewage back up? L/ ❑ Was the site inspected for signs of break out? ESI ❑ Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Lq' ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•P g p yste age 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w "r 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: 3 Number of bedrooms (design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 3 Number of current residents: 3 Does residence have a garbage grinder? Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes No Laundry system inspected? ❑ Yes ] No Seasonal use? ❑ Yes © No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ® Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments j 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: NDS P�►+'�PFS s[�L� tiZw Was system pumped as part of the inspection? ❑ Yes [K No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: Q Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank.Attach a copy of the DEP approval. Other(describe): l'"M C 1:44nn R C2 Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes No TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: Z feet Material of construction: ❑ cast iron 40 PVC ❑ other(explain): l Distance from private water supply well or suction line: feet Comments (on condition of joints, venting,,evidence of leakage, etc.): Septic Tank(locate on site plan): z , Depth below grade: feet Material of construction: concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: Sludge depth: L Distance from top of sludge to bottom of outlet tee or baffle 33 Scum thickness �- 2 Distance from top of scum to top of outlet tee or baffle •, 0 Distance from bottom of scum to bottom of outlet tee or baffle N How were dimensions determined? AAG4AL,i s06k TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 7�}�vaC A,J G-OaD GanOn se ie 4-0 Pic T2s t ti _U�c�D GO�J.fl'7c�N, Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of lastum in • P P g• Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): i TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): vi x / 1/4L L-1D64C0 v: JDLtOs e-,¢( (t�eOLiC.r OOL L4—a-AK 14GC /.v cay,'7 ac 17—( Y24 jF4.3 Pump Chamber(locate on site plan): Pumps in working order: Yes ❑ No Alarms in working order: Yes ❑ No TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 'r 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: 14 leaching fields number, dimensions: 28 1tiFl(- t 2P_ C 1�i4�►B�lu ❑ overflow cesspool number: ❑ innovative/alternative system .Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Y�'Yl t"A MEE LIF"i9tk �i�6-P A)0Z.,40C .t/o A_✓I O tie C e- r-W AA P :kyIC_ O/Z VAjo-s✓ge— C4 e721167P11 TITLE 5 FORM MASTER.DOC•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts SEUBM Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer. Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): TITLE 5 FORM MASTER.DOC•08/06 'rifle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 • Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town State Zip Code Date of Inspection j i D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. D�S��4Nte5 tl�- D Ar 2„ EAcH �tE�� ISS �Aua�� S00 &Jk art ' W AA00 -t-*,UIL vi too' A4 TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 15 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 62 Farnum Street Property Address Chris Gattis Owner Owner's Name information is required for No Andover MA 01845 10/8/08 every page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Site Exam: a Check Slope [Surface water ►1�yi� [-Check cellar Shallow wells N,o&J" Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: s?8 iv► G o✓+r'2 JG j ED y ' A-S a,)J- HI 6,H G 230 Q w�"2 EZ.E✓q-�7o M TITLE 5 FORM MASTER.DOC•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 t10RTi'► q O tt�eo 06� �rO 6 O 10- A► O COCMKM/wKw 1' 'A 1j PUBLIC HEALTH DEPARTMENT Community Development Division C1T RTjFIC3T1F O F CO9VI<1'LI. OXff As of: Octo Ger 2, 2006 This is to cert that the ind viduaCsu6surface disposaCsystem received a: FuffSeptic System Repair 6y Yoseph .(Ouddy) Watson 62 Farnum Street North Andover, qw q 01845 The Issuance of this certificate shaCC not 6e construed as a guarantee that the system wiCC function satzsfactoriCy. 4nT;Sar, RE9TSIW S' Pu6Cic YleaCth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com J s, -. POR7H a �A•1t0•P��tS �SSACHUSFS PUBLIC HEALTH DEPARTMENT Community Development Division TOWN OF NORTH ANDOVER - RC; IVED SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( )constructed;( )repaired; SEP 2 9 2006 By: I'7LI bl7l e; JJA Tr�;,oM TOWN OF NORTH ANDOVER (Print Name) HEALTH DEPARTMENT Located at: t'OZ F-,A tZN ti i.,I (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated and last revised on 7 -3't--W& ,with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan;the system was installed in accordance with the provisions of 310.CMR 15.000,Title 5 and local regulations,and the final grading agrees substantially with the approved plan.All work is accurately represented on the As-built which has been submitted to the Board of Health. Bottom of Bed Inspection Date: 01. Engineer Representative(Signature) �?l LL --7 And-Print Name Final Construction Inspection Date: --7-0& �f. [��,�/�v�. Engineer Representative(Signature) 12� And-Print Name Installer• nature) Date: CIO And-Print Name Enginer: 404014(4 'VFWg4, Ve- (Signature) Date: 9--29-06 V(A©r4&1 And-Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com 6k 11388 P's 339 �3Oi434 11--28-2048 a 11 = 12a MASSACWSETTS STATE EXCISE TAX Essex Horth Resistrs Date: 11-28-2008 0 11:12as Ctl`.: 38 DocO: 30430 Fee: OPM5.72 Cans: $424r350.00 QUITCLAIM DEED We, Christopher G. Gattis and Ann W. Gattis, of North Andover, Massachusetts, For consideration paid of Four Hundred Twenty-Four Thousand Three Hundred Fifty and 00/100 ($424,350.00) Dollars V. Grant to BrianiNickey, Individually 14 Of 62 Farnurn Street, North Andover, Massachusetts d Wkh QUIrCLAIM COVENAWS o The land in said North Andover with the buildings thereon situate on the Northerly side of Farnum Street, bounded and described as follows: w 0 SOUTHWESTERLY by Farnum Street on two courses, 157 feet, more or less; .1 NORTHWESTERLY by lot 15 as shown on plan hereafter referred to, 452.60 feet; G7 PW NORTHEASTERLY by lot 22 on said plan, 63.32 feet; N SOUTHEASTERLY by lot 17 on said plan, 433.46 feet. Containing 40,000 square feet, more or less. d a Being shown as lot 16 on a plan entitled "Plan of Lots 14 to 22 Colonial Acres, North Andover, Mass., Owner—George H. Farr, Scale: 1"—40', August 11, 1965, Raymond C. Pressey, Inc., Registered land surveyors, Lynn" and recorded with Essex North District Registry of Deeds as Pian#5318. r " Bk 11388 Pg340 #30430 For title we deed of John J.Good and Carol Good dated July 31, 2006 and recorded with the Essex North Registry of Deeds at Book 10344, Page 195. Witness our hand(s)and seals this 21 day of November, 2008. Christopher G. Gattis STATE OF ALABAMA On this day of November,2008, before me,the undersigned notary public, personally appeared Christopher G. Gattis, proved to me through satisfactory evidence of identification, which was a Driver's license,to be the person whose name is signed on the preceding or attached docxun6K and acknowledged to me that he signed it voluntarily for Its stated purpose. A % Notary Public: My Commission expires: oar a%i Z640 Bk 11388 Pg341 #30430 Witness our hand(s)and seals this day of November, 2008. fitness Ann W. Gattis COMMONWEALTH OF MASSACHUSETTS Essex, ss. ,.� On this_aday of November, 2008, before me, the undersigned notary public, personally appeared Ann W. Gattis, proved to me through satisfactory evidence of identification, which was a Drivers License, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that she signed It voluntarily for its stated purpose. �igtary Public: hf- R zltt' My Commission expires �` GITA B. BRAZEUS Notary Public commonweakh of maswamseas My Corrani Wn Up s.:jia-o4 6,2012 ' i 4 a NORTy r� O�10"o 161 6 q�O o � 'sem � 0�4 ��sSgcKuy���� PUBLIC HEALTH DEPARTMENT Community Development Division January 10,2011 Brian Hickey 62 Farnum Street North Andover,MA.01845 Dear Mr.Hickey, This document provides observations noted by the following people.Please note that these are merely observations January 6,2011 -Thursday Witnessing the opening of a failed system Present: Dennis Hallahan,PE Technical Manager,Infiltrator Systems Inc. Blake Johnston,Northeast Regional Manager,Infiltrator Systems Inca Bill Dufresne,Project Manager,Merrimack Engineering Services Joseph(Buddy)Watson,Ryan Watson,Septic Installer AB Septic Pumping Service Brian Hickey—Home Owner Michele Grant—Health Inspector—Town of North Andover Observations: I. Ryan Watson opens a hole at the opposite end of the distribution box 2. Dennis Hallahan digs down and pulls off the end chamber,effluent rushes out. 3. A clear visual of the layers are given. 4. The Infiltrators are pushed down into the Title V sand,4 or 5 inches 5. From the top of the inside of the Chamber,there is a. Approximately.5 inches of scum b. Four to Five inches of black bio-mat C. At the bottom of the bio-mat,there is a very defined line of Title V sand to the bio-mat d. No graying under the bio-mat e. Good Title V sand f. Possible 6"between scum and top of chamber(air Space) Sincerely, W wm� Wichefe a;.Grant Tu6fic9fealthABent WortfiAndover9fearth(Department NorthAudover,M 01845 979-688-9540 (Fax—978-688-8476 Cc:Susan Sawyer Enc:Letter to resident,ie:garbage grinder,also,Septic System fact sheet 1600 Osgood Street,(forth Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web wwwjowoofnorthandover.com Mass DEP ::MA DEP Resource Protection- Septic SystemsfFitle 5:information for horn... Page 1 of 1 d How Do I as a System Owner Properly Care for my Septic System? J _ Conventional on-site septic systems can function very well with minimal care.In fact,most septic tanks will only require an inspection and pumping out by a professional every three to five years if they are used properly.This does not pertain to VA sy-sstems,which need more frequent oversight. DO... FDo haTthesystem inspected and pumped every 3 to 5 Fpwoducts, rtoilet or sink as a trash can by dumpingrs. ank fills up with an excess of solids,the ables(cigarette butts,diapers,feminine wastewater will not have enough time to settle in the or grease down your sink or toilet.Non- tank.These excess solids will then pass on to the leach can clog the pipes,while grease can field,where they will clog the drain lines and soil. thcenang the pipes.Store cooking oils,fats,and grease in a can for disposal in the garbage. MOCe irifopnatioal pnn dull!pitis Frepairs, know the location of the septic system and drain o not put paint thinner,polyurethane,anti-freeze, d,and keep a record of all inspections,pumpings, pesticides,some dyes,disinfectants,water softeners,and contract or engineering work for future other strong chemicals into the system.These can cause rences.Keep a sketch of it handy for service visits. major upsets in the septic tank by killing the biological part of your septic system and polluting the groundwater. Small amounts of standard household cleaners,drain cleansers,detergents,etc.will be diluted in the tank and should cause no damage to the s stem. o grow grass or small plants(not trees or shrubs)above Do not use a garbage grinder or disposal,which feeds the septic system to hold the drain field in place.Water into the septic tank.If you do have one in the house, conservation through creative landscaping is a great way severely limit its use.Adding food wastes or other solids to control excess runoff uces your system's capacity and increases the need to pump the on-site tank.If you use a grinder,the system must be umped more often. Do install water-conserving devices in faucets, rdrainfield not p:tocotlapse. es within 30 feet of your system or showerheads and toilets to reduce the volume of water k/driany part of the system.Tree roots will running into the on-site system.Repair dripping faucets g youand heavy vehicles may cause your and leaking toilets,run washing machines and dishwashers onlywhen fu41,and avoid ton showers. Do divert roof drains and surface water from driveways Do not allow anyone to repair or pump your system and hillsides away from the septic system.Keep sump without first checking that they are licensed_system pumps and house footing drains away from the system as professionals. well. Do take leftover hazardous chemicals to your approved Do not perform excessive laundry loads with your hazardous waste collection center for disposal.Use washing machine.Doing load after load does not allow bleach,disinfectants,and drain and toilet bowl cleaners your septic tank time to adequately treat wastes and sparingly and in accordance with product labels. overwhelms the entire system with excess wastewater. You could therefore be flooding your drain field without allowing sufficient recovery time.You should consult your task professional to determine the gallon capacity and number of loads per day that can safely go into the system. o use only septic system additives that have been o not use chemical solvents to clean the plumbing or allowed for usage in Massachusetts by DEP.Additives septic system."Miracle"chemicals will kill that are 9-119—NA-d.for use in Massachusetts have been microorganisms that consume harmful wastes.These determined not to produce a harmful effect to the products can also cause groundwater contamination. individual system or its components or to the environment at large. http://209.85.165.104/search?q=cache:OSxSWhzZovAJ:www.mass.gov/dep/water/wastew... 1/22/2007 p Kt�ao �y'�ti ��SSACHUS S, PUBLIC HEALTH DEPARTMENT Community Development Division J To: All North Andover Residents with Septic Systems and Garbage Grinders Please note that due to recent reviews of Title 5 Reports, your property has been identified as maintaining a working garbage grinder that is being used in conjunction with a septic system. The Health Department is concerned for the longevity of your septic system. ., Garbage grinders are never recommended where septic systems are used,but if they are installed, the system must be specifically designed to handle the waste from them;your system can not handle the waste as designed. Please note that continued use of this grinder could quickly cause a pre-mature failure of your septic system,resulting in a large expenditure to replace it. The North Andover Health Department recommends that you remove it from your home as soon as possible. Some information regarding regular maintenance of your septic system is attached. Please call the Health Department-at 978.688.9540 if you have any questions,or e-mail your questions to: healthdept@towno horthandovencom. Thank you for taking the time to consider the impact that your current setup has on your septic system and`the environment. Sincerely, /Susan Y. Sawyer, REHS Public Health Director /pfd Enc: Septic System Information:http://www.mass.gov/dey/water/wastewater/dodont htm 1600 Osgood Street, North Andover,!Massachusetts 01845 Phone 978.688.9540 Fax 978.688,8476 Web http://www.townofnorthandover.com t - AV „� s • Jo Aid Jc , W. ” ., •.-'. i1 ♦ ,_e- �it tY4 't. r, Y art - a: r i4 _ r "6 x w ,r a t. '3t r �k i may ¢{ ! ^ala' r` jR", y w ^ y df a"t ep , ski q' a -� - a. � .. " • - .� „ c 4- It 'tae, +s .. 9�"�_,. .. ..t jo y i e� M w e yam," 3 f r t l F= fa r i TO P J11 4 l - jr � lxf . k ti No v vz � l c w r- "fit, > xa as oloe 40, Alvo r rtlt „ 5 Grant, Michele To: Sawyer, Susan . Subject: 62 Farnum street 62 Farnum Street North Andover MA. System Failure of the above SAS installed in 2006 2006 July 17th Title V fails-Owner is John Good 2008 Oct 8th New Title V Passes New Title V states that there is a Garbage Grinder Nov. 27,2008 New Owner—Brian Hickey Brian Hickey states there is no garbage disposal present January 6, 2011-Thursday Witnessing the opening of a failed system Present: Dennis Hallahan, PE Technical Manager, Infiltrator Systems Inc. Blake Johnston, Northeast Regional Manager, Infiltrator Systems Inc. Bill Dufresne, Project Manager, Merrimack Engineering Services Joseph (Buddy)Watson, Ryan Watson,Septic Installer AB Septic Pumping Service Brian Hickey—Home Owner Michele Grant—Health Inspector—Town of North Andover Observations: 1. Ryan Watson opens a hole at the opposite end of the distribution box 2. Dennis Hallahan digs down and pulls off the end infiltrator, effluent rushes out. 3. A clear visual of the layers are given. 4. The Infiltrators are pushed down into the Title V sand,4 or 5 inches 5. From the top of the inside of the Chamber,there is a. Approximately .5 inches of scum b. 4 to 5 inches of black bio-mat c. At the bottom of the bio-mat,there is a very defined line of Title V sand to the bio-mat d. No graying under the bio-mat e. Good Title V sand f. Possible 6" between scum and top of chamber(air Space) Infiltrator System has donated new Infiltrator chambers to the homeowner Bill Dufresne and Joseph (Buddy)Watson will work with the homeowner Bill Dufresne has requested that the Health Department enter the home to investigate whether or not there is a garbage disposal. 91lichele E. Grant Pu6Czc MeafthAgent .NorthAndovergfeafth(Department .North Andover, WA. 01845 978-688-9540 978-688-8476-Ear, 1 DelleChiaie, Pamela From: Sawyer, Susan Sent: Friday, April 08, 20112:59 PM To: DelleChiaie, Pamela; 'brdufresne@comcast.net' Subject: RE: 62 Farnum Street-Septic File Information -Atach 2 Hi Bill,The homeowner has not contacted Buddy again yet, so he has not agreed on his part yet.The owner just thought we were farther ahead. He also said the field hasn't been breaking out that much as they try to regulate the water usage. One thing about the plan. I have a question. Will you be wanting to go down to the parent soil; removing all the sand? If not, I can tell you that the board did approve one on Winter street that was similar. There were a couple of requests, but see below B. 2. Basically, we just required that the engineer and health approve the level the sand looks good. (A. 1. Don't need) I already waived the fees myself. I can't remember, but if there were any other LUA's on the plan, just include them with the submittal,when you get to it. I am sure your phone is ringing a lot now that the snow is melting. What do you think? If you put in a request, I can put it on the April meeting and just have Mr. Hickey show up, rather than have to pay you to represent. Susan Motion Mr.McCarthy made a motion to approve the updated plan as noted.The motion was seconded by Ms.Brennan and approved by a unanimous vote of the board. In summary the motion approved the following: A. Septic-545 Winter Street—Local Health Bylaw Variance Request 1. Allow the use of deep observation test pits which are older than two years. 2. Allow the waiver of fees for approval of design. B. Septic—545 Winter Street—Local Upgrade Approvals Required 1. Allow the placement of a subsurface sewage disposal system in an area with only one deep observation test pit in lieu of two as required by Title S Section 15.102(2) 2. Allow the use of existing septic sand in lieu of removing all material down to the receiving layer as required in Title 5 Section 15.255. From: DelleChiaie, Pamela Sent: Friday, April 08, 201110:52 AM To: 'brdufresne@comcast.net' Cc: Sawyer, Susan Subject: RE: 62 Farnum Street- Septic File Information -Atach 2 Ok,thanks Bill. We were wondering because the homeowner told Susan he was under the impression that you had already submitted a plan,and was wondering about the status. Thank you. I will let Susan know. Sint Ref m4, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, April 08, 2011 10:52 AM To: 'brdufresne@comcast.net' Cc: Sawyer, Susan Subject: RE: 62 Farnum Street-Septic File Information -Atach 2 Ok,thanks Bill. We were wondering because the homeowner told Susan he was under the impression that you had already submitted a plan,and was wondering about the status. Thank you. I will let Susan know. fiat Re f*14, Pamela DelleChiaie Departmental Assistant I Community Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover,MA o1845 i Office-978-688-9540 1 Fax-978-688-8476 Email-pdellechiaieotownofnorthandover.com Website bM://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet."--Anonymous From: brdufresneoacomcast.netmailto: r f j � du resneC&cemcast.net] Sent: Friday, April 08, 201110:42 AM To: DelleChiaie, Pamela Subject: Re: 62 Farnum Street- Septic File Information -Atach 2 Pam Based on my conversation with your Dept. and given the fact that I could re-use the soil testing data, I agreed to re-design the system for the home owner even though no negligience was recognized on the part of Merrimack Engineering. I told this to the owner, Brian Hickey, and he was going to talk to Buddie Watson to determine what part, if any, Watson would have in this matter and then get back to me. Until yesterday, I had not heard back from Brian Hickey. I am still willing to complete the plan, but it has gotten busy, I have many other commitments, so it will be a 2-3 weeks before the plan is done. ----- Original Message ----- From: "Pamela DelleChiaie" <PdellechCa)_townofnorthandover.com> To: "Bill Dufresne (b rd ufresne(&-com cast.net)" <brdufresneacomcast.net> Sent: Thursday, April 7, 2011 2:19:49 PM Subject: FW: 62 Farnum Street - Septic File Information -Atach 2 Hi Bill, Can you let me know about the septic plan submission status on this one? Thanks. Best Regards, Pamela DelleChiaie Departmental Assistant lCommunity Development Health Department Town of North Andover 1 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA 01845 N Office - 978-688-9540 9 Fax - 978-688-8476 9 Email - pdellechiaie(a)_townofnorthandover.com ; Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet."--Anonymous -----Original Message----- From: Bill Dufresne [mai Ito:brdufresne(aD-comcast.net, Sent: Tuesday, January 04, 20114:19 PM To: DelleChiaie, Pamela Subject: Re: 62 Farnum Street - Septic File Information - Atach 2 Thank you Pam Sent from my Bill's i phone On Jan 4, 2011, at 3:59 PM, "DelleChiaie, Pamela" <pdellech(a-townofnorthandover.com > wrote: > Information you requested on 62 Farnum Street -Atach 2 > Best Regards, > Pamela DelleChiaie > Departmental Assistant lCommunity Development Health Department > Town of North Andover > 1600 Osgood Street I Bldg 20 1 Suite 2-36 > North Andover, MA 01845 > N Office - 978-688-9540 > 9 Fax - 978-688-8476 > 9 Email - pdellechiaie(ccD_townofnorthandover.com > ; Website http://www.townofnorthandover.com/Pages/index > "We can never see the path of our life if we are too busy focusing > on the pebbles under our feet."--Anonymous > -----Original Message----- • From: noreply(a)-townofnorthand over.com > [ma iIto:noreplya-townofnorthandover.comj > Sent: Tuesday, January 04, 2011 3:51 PM > To: DelleChiaie, Pamela > Subject: 62 Farnum Street - Septic File Information -Atach 2 > This E-mail was sent from "RNPOA428C" (Aficio MP C5000). > Scan Date: 01.04.2011 15:50:58 (-0500) > Queries to: noreply(c-townofnorthandover.com 2 > > Please note the Massachusetts Secretary of State's office has > determined that most emails to and from municipal offices and > officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm > Please consider the environment before printing this email. > <20110104155058205.pdf> Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: hftp://www.sec.state.ma.us/pre/r)reidx.htm. Please consider the environment before printing this email. 3 1600 Osgood Street I Bldg 20 I Suite 2-36 North Andover,MA o1845 2 Office-978-688-9540 Fax-978-688-8476 (] Email-pdellechiaie(a)townofnorthandover.com Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet."--Anonymous From: brdufresne@comcast.net [mailto:brdufresne@comcast.net] Sent: Friday, April 08, 201110:42 AM To: DelleChiaie, Pamela Subject: Re: 62 Farnum Street- Septic File Information -Atach 2 Pam Based on my conversation with your Dept. and given the fact that I could re-use the soil testing data, I agreed to re-design the system for the home owner even though no negligience was recognized on the part of Merrimack Engineering. I told this to the owner, Brian Hickey, and he was going to talk to Buddie Watson to determine what part, if any, Watson would have in this matter and then get back to me. Until yesterday, I had not heard back from Brian Hickey. I am still willing to complete the plan, but it has gotten busy, I have many other commitments, so it will be a 2-3 weeks before the plan is done. ----- Original Message ----- From: "Pamela DelleChiaie" <pdellech@townofnorthandover.com> To: "Bill Dufresne (brdufresne@comcast.net)" <brdufresne@comcast.net> Sent: Thursday, April 7, 2011 2:19:49 PM Subject: FW: 62 Farnum Street - Septic File Information -Atach 2 Hi Bill, Can you let me know about the septic plan submission status on this one? Thanks. Best Regards, Pamela DelleChiaie Departmental Assistant lCommunity Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA 01845 N Office - 978-688-9540 9 Fax - 978-688-8476 9 Email - pdellechiaie@townofnorthandover.com ; Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet."--Anonymous -----Original Message----- From: Bill Dufresne [mailto:brdufresne@comcast.net] Sent: Tuesday, January 04, 20114:19 PM To: DelleChiaie, Pamela Subject: Re: 62 Farnum Street- Septic File Information - Atach 2 2 Thank you Pam Sent from my Bill's i phone On Jan 4, 2011, at 3:59 PM, "DelleChiaie, Pamela" <pdellech@townofnorthandover.com > wrote: > Information you requested on 62 Farnum Street- Atach 2 > Best Regards, > Pamela DelleChiaie > Departmental Assistant lCommunity Development Health Department > Town of North Andover > 1600 Osgood Street I Bldg 20 1 Suite 2-36 > North Andover, MA 01845 > N Office - 978-688-9540 > 9 Fax - 978-688-8476 > 9 Email - pdellechiaie@townofnorthandover.com > ; Website http://www.townofnorthandover.com/Pages/index > "We can never see the path of our life if we are too busy focusing > on the pebbles under our feet."--Anonymous > -----Original Message----- > From: noreply@townofnorthandover.com > [ma i Ito:no rep ly@townofno rthand over.com] > Sent: Tuesday, January 04, 2011 3:51 PM > To: DelleChiaie, Pamela > Subject: 62 Farnum Street - Septic File Information - Atach 2 > This E-mail was sent from "RNPOA428C" (Aficio MP C5000). > Scan Date: 01.04.2011 15:50:58 (-0500) > Queries to: noreply@townofnorthandover.com > Please note the Massachusetts Secretary of State's office has > determined that most emails to and from municipal offices and > officials are public records. For more information please refer to: hftp://www.sec.state.ma.us/pre/preidx.htm > Please consider the environment before printing this email. > <20110104155058205.pdf> Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: hftp://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 3 d PRINTED BY: Pamela DelleChiaie- PLEASE LEAVE IN PRINT-OUT TRAY.......THANK YOU. DelleChiaie, Pamela From: Grant, Michele l Sent: Monday, January 24, 2011 11:43 AM To: Sawyer, Susan Cc: DelleChiaie, Pamela Subject: FW: Hickey Residence, North Andover l Hi Sue, Met with Bill on Friday, last week, he was here on other business, however we discussed 62 Farnum Street. Had not been in touch with Brian Hickey as of Friday but would contact him to discuss the future of the septic system. Please see below. 9Kichefe E. Grant Tu6Gc 91eafth Agent NorthAndoverYfeafth Department North Andover,9KA. 01845 978-688-9540 978-688-8476-Tay, From: Brian Hickey Lmailto:bvhickey0)gmail.com1 Sent: Sunday, January 23, 20116:51 PM To: brdufresne@comcast.net Subject: Re: Hickey Residence, North Andover Bill, Hope this e-mail find you well. Thank You for the follow up e-mail. First off I truly appreciate you taking the time a few weeks ago to come out to my property and in good faith put together an updated plan for the new system. You and the town are more than welcome to inspect for an garbage disposal. With that being said I have to assume the next step on my part is to contact Buddy Watson. Please advise. On Fri, Jan 21, 2011 at 12:49 PM, <brdufresne2comcast.net>wrote: Brian, I met with the Town of North Andover yesterday relative to your situation. They will allow us to update the plan which has already been done for your property, revised date 7-28-06, and modify it to reflect today's regulation changes. I OF 4 DelleChiaie,Pamela PRINTED BY:Pamela DelleChiaie- PLEASE LEAVE IN PRINT-OUT TRAY.......THANK YOU. Although there were no design issues relating to your current failure, and in a good faith effort, I will be glad to update the plan at no expense to you. A condition of my commitment to do so, is that at the time of construction inspections and as-built. I am able to view the home to certify that no garbage disposal exists. With regard to construction, you should talk directly to Buddie Watson to determine what involvement he will have. As you know from the site meeting, Infiltrator is willing to donate the necessary chambers at no cost. Let me know if you want me to proceed. Bill Dufresne Merrimack Engineering ----- Original Message ----- From: "Brian Hickey" <bvhickey(aD-gmail.com> To: BRDufresnea-comcast.net Sent: Friday, January 7, 2011 9:36:11 AM Subject: Hickey Residence, North Andover Ladies and Gentleman, Good morning. Thank You very much for taking the time yesterday to come out to my house and inspect the system. I truly appreciate that everyone is working together to find a solution on this matter. Have a great weekend and look forward to working with you all. On Tue, Jan 4, 2011 at 3:17 PM, Hallahan, Dennis <DHALLAHANCa�infiltratorsystems.net> wrote: Hello all: I spoke to most of you today. We are set to meet everybody at the site at 10 am Thursday, Buddy will be there with Pumper and Excavator, Michelle will be there because Susan will be away. The goal is to excavate the end of the system,pump out the effluent, and have a look at the system to evaluate the chamber product to ensure that it is functioning properly. And after this is done then the biomat and other features of the system can be viewed as well. 2 2 OF 4 DelleChiaie,Pamela 1 i PRINTED BY:Pamela DelleChiaie-`PLEASE LEAVE IN PRINT-OUT TRAY.......THANK YOU. Bill Durfesene will also be able to attend and will email me a copy of the plan, and Susan was going to check her files for any info as well. If the home is on public water then it would be essential to have that information as well, as far back as possible. If you have any questions then please do not hesitate to ask, looking forward to meeting all of you. Thanks, Dennis Dennis F. Hallahan, P.E. Technical Director Infiltrator Systems Inc. (860) 577-7100 This message contains PRIVILEGED AND CONFIDENTIAL INFORMATION intended solely for the use of the addressee (s) named above. Any disclosure, distribution, copying or use of the information by others is strictly prohibited. If you have received this message in error, please advise the sender by immediate reply and delete the original message. Kind Regards, Brian Hickey Cell.781.354.1193 Kind Regards, Brian Hickey Cell.781.354.1193 3 3 OF 4 DelleChiaie,Pamela PRINTED BY:Pamela DelleChiaie- PLEASE LEAVE IN PRINT-OUT TRAY.......THANK YOU. Kind Regards, Brian Hickey Ce11.781.354.1193 Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 4 4 OF 4 DelleChiaie,Pamela Grant, Michele From: Brian Hickey[bvhickey@gmail.com] Sent: Friday, January 07, 2011 9:32 AM To: Hallahan, Dennis Cc: Buddy Watson (Wat475@verizon.net); Bill Durfesne(BRDurfesne@comcast.net); Grant, Michele; Sawyer, Susan; Johnston, Blake; Landis, Kyle Subject: Re: Hickey Residence, North Andover Ladies and Gentleman, Good morning. Thank You very much for taking the time yesterday to come out to my house and inspect the system. I truly appreciate that everyone is working together to find a solution on this matter. Have a great weekend and look forward to working with you all. On Tue, Jan 4, 2011 at 3:17 PM, Hallahan, Dennis <DHALLAHANninfiltratorsystems.net>wrote: Hello all: I spoke to most of you today. We are set to meet everybody at the site at 10 am Thursday, Buddy will be there with Pumper and Excavator, Michelle will be there because Susan will be away. The goal is to excavate the end of the system,pump out the effluent, and have a look at the system to evaluate the chamber product to ensure that it is functioning properly. And after this is done then the biomat and other features of the system can be viewed as well. Bill Durfesene will also be able to attend and will email me a copy of the plan, and Susan was going to check her files for any info as well. If the home is on public water then it would be essential to have that information as well, as far back as possible. If you have any questions then please do not hesitate to ask, looking forward to meeting all of you. Thanks, Dennis Dennis F. Hallahan, P.E. Technical Director Infiltrator Systems Inc. (860) 577-7100 This message contains PRIVILEGED AND CONFIDENTIAL INFORMATION intended solely for the use of the addressee (s) named above. Any disclosure, distribution, 1 copying or use of the information by others is strictly prohibited. If you have received this message in error, please advise the sender by immediate reply and delete the original message. Kind Regards, Brian Hickey Cell.781.354.1193 Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. 2 I Sawyer, Susan From: Grant, Michele Sent: Friday, January 07, 20113:03 PM To: Sawyer, Susan Subject: 62 Farnum street 62 Farnum Street North Andover MA. System Failure of the above SAS installed in 2006 2006 July 17th Title V fails-Owner is John Good 2008 Oct 8th New Title V Passes New Title V states that there is a Garbage Grinder Nov. 27, 2008 New Owner—Brian Hickey Brian Hickey states there is no Garbage Disposal present January 6,2011-Thursday Witnessing the opening of a failed system Present: Dennis Hallahan, PE Technical Manager, Infiltrator Systems Inc. Blake Johnston, Northeast Regional Manager, Infiltrator Systems Inc. Bill Dufresne, Project Manager, Merrimack Engineering Services Joseph (Buddy)Watson, Ryan Watson,Septic Installer AB Septic Pumping Service Brian Hickey—Home Owner Michele Grant—Health Inspector—Town of North Andover Observations: 1. Ryan Watson opens a hole at the opposite end of the distribution box 2. Dennis Hallahan digs down and pulls off the end infiltrator, effluent rushes out. 3. A clear visual of the layers are given. 4. The Infiltrators are pushed down into the Title V sand,4 or 5 inches 5. From the top of the inside of the Chamber,there is a. Approximately.5 inches of scum b. 4 to 5 inches of black bio-mat c. At the bottom of the bio-mat,there is a very defined line of Title V sand to the bio-mat d. No graying under the bio-mat e. Good Title V sand f. Possible 6" between scum and top of chamber(air Space) Infiltrator System has donated new Infiltrator chambers to the homeowner Bill Dufresne and Joseph (Buddy)Watson will work with the-homeowner Bill Dufresne has requested that the Health Department enter the home to investigate whether or not there is a garbage disposal. 9dichefe E. Grant Tu6Cac MealthAgent NorthAndoverMeafth Department .North Andover,MA. 01845 1 ! �1Dmu� � avi abuc� S �o� No eofOYs CIl1� �X- �iiJ ,�i� � SdurCP i5 s�t��� cgs(- puo 5' VLe5 uv� toowk, uAT000ll V Commonwealth of Massachusetts City/Town of North Andover w� System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, use only the tab 62 Farnum Street key to move your Address cursor-do not North Andover MA 01845 use the return City/Town State Zip Code key. 2. System Owner: Brian Hickey Name room Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping 4113/2014, 4/6/2016 2 Quantity Pumped: 1500 Date Gallons 3. Type of system: ❑ Cesspool(s) N Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? Yes ❑ No If yes, was it cleaned? Yes ❑ No 5. Condition of System: Good, system operating properly 6. System Pumped By: Jason Elliott S71437 Name Vehicle License Number Ivester and Elliott Services LLC-DBA Jason Elliott Pumping 7. Location where contents were disposed: GLSD........, 4113/2014, 4/6/2016 Si re of Hauler Date Signature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 55 ra� Commonwealth of Massachusetts RECEIVED City/Town of North Andover System Pumping Record JUN 'ro1( Form 4 TOWN OF NOR H ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351, A. Facility Information Important:When filling out forms 1. System Location: on the computer, use only the tab 62 Farnum Street key to move your Address cursor-do not North Andover MA 01845 _ use the return Cityfrown State Zip Code key. 2. System Owner: Brian Hickey Name reom ' i Address(if different from location) I City/Town State Zip Code Telephone Number I B. Pumping Record 1. Date of Pumping 6/16/2017 2. Quantity Pumped: 1500 Date Gallons 3. Type of system: ❑ Cesspool(s) ® Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? Yes ❑ No If yes,was it cleaned? Yes ❑ No 5. Condition of System: Good, system operating properly 6. System Pumped By: Jason Elliott S71437 Name Vehicle License Number Ivester and Elliott Services LLC-DBA Jason Elliott Pumping 7. Location where contents were disposed: GLSD 6/16/2017 r auler Date Signature of Receiving Facility Date t5form4.doc-03/06 System Pumping Record•Page 1 of 22 Commonwealth of Massachusetts City/Town of a Form 9A — Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 5.404(1), is not feasible. 310 CMR 15.403(4)requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information I mportant: When filling out 1. Facility Name and Address: forms on the computer,use only the tab key Name to move your lam, FLt,Yt- cursor-do not Street Address use the return 9 key. d o a U AO PfA' l EE C-- A City/Town Z_12. Owner Name and Address (if different from above): State Zip Code IWO ,r SFr Name Street Address City/Town /GS�tattee Zip Code lie elepho6 Number 5� 3. Type of Facility(check all that apply): [Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: rl �.t �6u!�6 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) Q�Conventional ❑ Other(describe below): t5form9a•rev. 5/02 Application for Local Upgrade Approval*pproval•Page 1 of 4 Commonwealth of Massachusetts City/Town of Form 9A — Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): 7. Design Flow per 310 CMR 15.203: Design flow of existing system: urjk;100L"jiKj gpd Design flow of proposed upgraded system 13a� gpd Design flow of facility: t? gpd B. Proposed Upgrade of System 1. Proposed upgrade is(check one): ❑ Voluntary ❑ Required by order, letter, etc. (attach copy) Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: l / tau a-t —2 r L-V 1 IF�t iaz W"a j Ir 3. Local Upgrade Approval is requested for(check all that apply): ❑ Reduction in setback(s)-describe reductions: ❑ Reduction in SAS area of up to 25%.- SAS size,sq.ft. %reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min.Cnch Depth to groundwater ft. t5form9a•rev. 5/02 Application for Local Upgrade Approval* Page 2 of 4 Commonwealth of Massachusetts City/Town of Form 9A - Application for Local Upgrade Approval G M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): [Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: i�n LIC/ �i E✓F . A&�A1.s' t5 OU LieU or r-1 �'�►�c�L�-r«�► 1 G��___--� �� -���� Eur �- ��wc If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(i)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Evaluators Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: p4,;'(L 4_ 412912 7n4 --4- 2. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: e'er I t. t5form9a•rev. 5/02 Application for Local Upgrade Approval, Page 3 of 4 a Commonwealth of Massachusetts City/Town of - Form 9A - Application for Local Upgrade Approval DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible:. 4. Connection to a public sewer is not feasible: by 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit �mplete plans and specifications Ite evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I,the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." I-�--cpC. tlity Owner's nature Date Print Name Name of Preparer Date (� �t� �i'(K EST city/Town Preparer's address LAA"- tate2lP C�ejjca r-170 Telephone t5form9a-rev. 5/02 Application for Local Upgrade Approval, Page 4 of 4 Geotechnical consultants, Inc. (508)229-0900 FAX: (508)229-2279 June 8, 2006 Mr. Bill Dufresne Merrimack Engineering Services Inc. 66 Park Street Andover, MA 01810 RE: Sieve Analysis 62 F arnum Street North Andover, Massachusetts GCI Project No. 2062578 Dear Mr. Dufresne: A representative soil sample was delivered to our laboratory for gradation analysis from 62 Farnum Street. Grain size distribution for the recovered sample was determined in accordance with ASTM D422. Based on the attached gradation curve, the samples were classified as Class 1 SAND in accordance with the USDA classification system. We trust the foregoing and attached are sufficient for your immediate needs. Should you have any questions, please do not hesitate to contact us. Sincerely, GEOTECHNICAL CONSULTANTS,INC. RECEIVED JUN 2 9 2006 Christopher Chlodv TOWN OF NORTH ANDOVER HEALTH DEPARTMENT cc/vas 201 Boston Post Road West • Marlborough, Massachusetts 01752 v 14.i. OFFNV .I .�.:, :,•`•'< '•'' � �� .,fir A���;• �1 ''pp�� � j' �,T 1)E-PA, -.-R. ,. 'TM- VNT ' IT . fiQ "V TEAT Robert E Kim. a-1.1 St. Has •satisfied;the De .quaiificati-wis. as required and: is hereby authorized 'to use the .title CE T PIED TITL S' SYSTEM IN PECTO�. as Px ov de ,Xn 3 .0 CMR 4 5::340 and Section .13 of Chapter 2 . A of,•the General Laws.. sued by '�'l e Dep�ar hent Of Enviironrtiental Protection. Junc 12, 1995 '` GtinR Director of the j�9 Of WateF P-6h- ion Contra TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845-2909 J. WILLIAM HMURCIAK, DIRECTOR, P.E. Eugene P. Willis RE f NORTH � Telephone (978) 685-0950 Director of Engineering ��e�`:"���''6"°0� Fax (978) 688-9573 July 28, 2006 �! '��Tfo• (g 9SSACHUS�t Sue Sawyer North Andover Health Dept. Osgood St. North Andover, MA. Re: SSDS 62 Farnum St. By Merrimack Engineering dated 6-04-06 Sue: It is my opinion that the existing drain that traverses the locus does not drain or intercept groundwater. It drains surface water runoff from across Farham St. to the BVW north of the house. I say this for two reasons first the pipe in question is solid and not perforated the way a drain line would be. Second is the invert out of the pipe is 4.4' above the ESHWT and the pipe slopes @ approx. 2%. The test pits indicate that the groundwater gradient is steeper and in the same direction as the pipe, therefore the drain should never be low enough to intercept groundwater. Sincerely, Eugene P. Willis, P.E. Director of Engineering Cc: File TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845-2909 J. WILLIAM HMURCIAK,DIRECTOR, P.E. Eugene P. Willis P.E E e►°eTp Telephone(978) 685-0950 Director of Engineering ar.!y+����`'•�°� Fax(978) 688-9573 F A July 28,2006 ,SSACNUS� Sue Sawyer RECEIVED North Andover Health Dept. Osgood St. AUG 0 1 2006 North Andover, MA. TOWN OF NORTH ANDOVER Re: SSDS 62 Farnum St. By Merrimack Engineering dated 6-04-06 HEALTH DEPARTMENT Sue: It is my opinion that the existing drain that traverses the locus does not drain or intercept groundwater. It drains surface water runoff from across Farham St. to the BVW north of the house. I say this for two reasons first the pipe in question is solid and not perforated the way a drain line would be. Second is the invert out of the pipe is 4.4' above the ESHWT and the pipe slopes @ approx. 2%. The test pits indicate that the groundwater gradient is steeper and in the same direction as the pipe, therefore the drain should never be low enough to intercept groundwater. Sin el 11 ene P. Willis, P.E. erector of Engineering Cc: File Residential Property Record Card#1 of 1 Parcel Year:2018 PARCEL ID: 210/107.A-0086-0000.0 MAP 107.A BLOCK 0086 LOT 0000.0 PARCELADDRESS: 62 FARNUM STREET as of:8/16/2017 PARCEL INFORMATION Use-Code: 101 Sale Price: 424350 Book: 11388 Tax Class: T Sale Date: 11/28/2008 Page: 339 Tot Fin Area: 2124 Sale Type: P Cert/Doc: Tot Land Area: 1.124 Sale Valid: Y Owner#1: HICKEY, BRIAN V. Grantor: GATTIS Owner#2: Address#1: 62 FARNUM STREET Inspect Da 5/1/2009 Road Type: T Exempt-B/L%: 0/0 Address#2: Meas Da 5/1/2009 Rd Condition: P Resid-B/L%: 100/100 NORTH ANDOVER MA 01845 Entran X Traffic: M Comm-B/L%: 0/0 CollectID: RB Water: Indust-B/L%: 0/0 Inspect eas: S Sewer: Open Sp-B/L%: 0/0 RESIDENCE#1 INFORMATION LAND INFORMATION Style: CL Tot Rooms: 8 Main Fn Area: 1212 Attic: NBHD CODE: 5 NBHD CLASS: 5 ZONE: R2 Seg Type Code Method Sq-Ft Acres Influ-1/2/3 Value Class Story Height: 2 Bedrooms: 3 Up Fn Area: 912 Bsmt Area: 912 Roof: G Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1 100/ 206910 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 5401 0.124 100/ 942 Masonry Trim: Ext Bath Fix: Tot Fin Area: 2124 Foundation: CN Bath Qual: T RCNLD: 236420 Kitch Qual: T Eff Yr Built: 1984 Mkt Adj: Heat Type: HW Ext Kitch: Year Built: 1966 Sound Value: Fuel Type: G Grade: AG Cost Bldg: 236400 Fireplace: 1 Bsmt Gar Cap: Condition: G Aft Str Val 1: DETACHED STRUCTURE INFORMATION Central AC: N Bsmt Gar SF: Pct Complete: Aft Str Val2: Str Unit Msr-1 Msr-2 E-YR-Blt Grade Cond %Good P/F/E/R Cost Class Aft Gar SF: 440 %Good P/F/E/R: /100/100/82 PV S 512 1988 A A /50//42 11900 Porch Type Porch Area Porch Grade Factor W 240 VALUATION INFORMATION SKETCH Current Total: 456200 Bldg: 248300 Land: 207900 MktLnd: 207900 Prior Tot: 456200 Bldg: 248300 Land: 207900 MktLnd: 207900 PHOTO - "-'---�—_--- 1— .. "_� ` 12 240 Sq.Ft. 12 �" ' 7 z " 15 38 20 -- ` p1 ; FU FM 912 Sq.Ft. 440 Sq.Ft. t= 20 300 Sq.Ft. 20 FM _ 24 912 Sq.Ft. -22 15 20 38 62 FARNUM STREET r TOWN OF NORTH ANDOVER t NORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES o HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 "►�, >'•' NORTH ANDOVER, MASSACHUSETTS 01845 C Susan Y. Sawyer,RENS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS:,�,? r �,w s MAP: /0-7./4- LOT: Y 6 INSTALLER: DESIGNER: PLAN DATE: ?1? . l o L BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTI N: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS �Exisfingseptic tank properly abandoned []internal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANKZ�j Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page 1 of 6 t TOWN OF NORTH ANDOVER °E NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES '' AL ? � ,a e ° HEALTH DEPARTMENT p 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 ^, . .r+� NORTH ANDOVER, MASSACHUSETTS 01845 'SS„CHU Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX Comments: PUMP CHAMBER ottom of tank hole has 6" stone base ❑ Weep hole plugged Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 r TOWN OF NORTH ANDOVER f�I0T Office of COMMUNITY DEVELOPMENT AND SERVICES ,r��``� � ° per HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 3"Ss„CH„St� Susan Y. Sawyer,RENS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to f,80il layer, as provided on plan ry Size of SAS excavated as per plan t— Title 5 sand installed, if specified on plan 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 r TOWN OF NORTH ANDOVER f NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES o: HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 `►", . NORTH ANDOVER, MASSACHUSETTS 01845 "SSCHU's Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OF NORTH ANDOVER F NORTH, Office of COMMUNITY DEVELOPMENT AND SERVICES 3? "'1'* HEALTH DEPARTMENT p 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 " NORTH ANDOVER, MASSACHUSETTS 01845 �'Ss�c►+ust� Susan Y. Sawyer, RENS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other)Foundation 10(5) 20(10) ❑ Drywells 20 25 1 Suction line 222(2) z 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 15.21 1Q),also by NA wetland bylaws Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER H°Rra Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 � �cHuS t Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6 1� 1 1� J /1-7 J � �J �1 �' v -744Y ttoRTy q O �tLec ti ,t c ,6, O t O O COCMKMiWKM 9 CH I s���y PUBLIC HEALTH DEPARTMENT Community Development Division July 28, 2006 _—-- — - ---- --- - - —- -— - - - Anthony Donato Merrimack Engineering Services 66 Park Street Andover, MA 01810 Re: Proposed On-Site Wastewater System Design for 62 Farnum Street, Map 107A, Lot 86 Dear Mr. Donato: The proposed on-site wastewater system design plan for the above site dated June 9, 2006 and received on June 22, 2006 has been reviewed. Unfortunately, the plans cannot be approved as submitted. The following items are in need of attention prior to approval, with the section of Title 5 (3 10 CMR 15.000) noted: 1. Please provide detailed information on the placement of tees and components within the primary (septic)tank: 3" air space above tee, 9" air space above flow line, tees extend 10"(min)below flow line, etc— 15.227 2. Please provide the inlet invert for the distribution box. 3. Please provide volume calculations for the dosing of the system which include flowback volume and head determination. 15.220(4)(r), 254(1), 231(6) 4. Please verify that the finished grade provides adequate cover over the distribution box. 5. Please specify the pump control panel that is to be used and the alarm location— 15.220(4)(r) 6. Please indicate that the excavation is to extend 6" into natural soil—NA 9.02 7. Please clarify the discrepancy between the site plan which indicates a 4' overdig is to be provided around the soil absorption system and Note#4 which indicates a 5' overdig is to be provided. If the design plan remains at a 4' overdig due to site constraints, a variance will need to be sought from the regulatory requirement. 8. Please provide a complete Application for Local Upgrade Approval, and also list all requested variances and Local Upgrade Approvals on the design plan. 9. Please indicate the date of resource area delineation shown on the design plan. 10. Please indicate on the design plan that a licensed plumber will be needed to adjust the plumbing inside the dwelling as shown on the design plan. 11. Please confirm that the building sewer can be adjusted as shown on the design plan without use of pump to provide the flow to the primary (septic) tank. If a pump is needed please provide specifications to assure compliance with regulation standards. 15.229 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com 12. Please specify methodology to be employed in area where water line and waste water line cross. 13. Please clarify if an effluent filter is or is not to be used as the manhole cover over the filter is needed to be specified to be brought to grade if one is present. Additionally, while not a reason for disapproval, you may wish to consider the following items in your design: The pump specified appears based on the pump curve provided to be larger than necessary to overcome the necessary head loss. You may be able to utilize a smaller horsepower pump for this task. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement on-site wastewater system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincere y, usan Sawyer. Public Health Director cc: Homeowner CD&S Dir. File 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Page 1 of 1 DelleChiaie, Pamela From: Kimberly Brown [kbrown@neengineeringinc.com] Sent: Wed 10/8/2008 1:08 AM To: DelleChiaie,Pamela Cc: Subject: As-Built Attachments: Hi Pam, Do you have an as-built for 62 Farnham St No Andover Kim Kimberly Brown Office Manager New England Engineering Services, Inc. 1600 Osgood Street Suite 2-64 North Andover, MA 01845 978-686-1768 www.neengineeringinc.com http://exchange2003.town.north-andover.ma.us/exchange/pdellechiaie/Inbox/As-Built.EM... 10/7/2008 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, September 26, 2006 12:03 PM To: Dufresne Bill (E-mail) Subject: 62 Farnum Street Importance: High Hi Bill, Buddy spoke with Susan today and requested a Final Grade Inspection. She is going to try and make it out there today. However, in anticipation of generating a COC, I need the certification form signed by you and Buddy. Can you get that to me? Thanks. Also, I faxed you the review letter re: 301 Summer Street. Please respond asap with your comments. You are all set on the agenda with that for Thursday with regard to the variance requests. Call if any questions. Thanks, P 8¢gf R¢guadg, AR40*004 D¢�l�¢G�lfiai¢ Health Department Assistant Town of North Andover 1600 Osgood Street Building 20, Suite 2-36 North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 1 Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Wednesday, September 13, 2006 6:30 PM To: Grant, Michele; Lisa Kozel LeVasseur; Marianne Peters; DelleChiaie, Pamela; Sawyer, Susan Subject: 62 Farnum Street I inspected 62 Farnum and will have the write up shortly for you but there are a few pressing items I need to call to your attention: The distribution box did not have 6" of crushed stone beneath to provide a stable base as required by Title 5. 1 have informed Buddy this will need to be done at this site. You'll need to check it or have us do it. I have asked him to place magnetic marking tape over the components and piping as required by Title 5. The drain line on the property which heads from the street towards the wetlands appears to be less than 10'from the edge of the SAS. It is tough to tell exactly because the pipe is not exposed anywhere except at the box vault near the street but I estimate it to be 9'. If you concur, this will require a Local Upgrade Approval to be issued by the Board or Health Department(not sure what the town's procedure is) prior to issuance of a C of C. I have asked Watson to keep the vault box and the corner of the SAS exposed in the event you want to visit and examine, or perhaps meet me out at the site. Dan ID Daniel Ottenheimer, President Mill River Consulting, Inc. On-Site Wastewater Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultingcom dano@-miLltriverconsultin2.com 9/14/2006 62 Farnum Street- Final Const. Inspection Request Page 1 of 1 DelleChiaie, Pamela From: Marianne Peters [mpeters@millriverconsulting.com] Sent: Tuesday, September 12, 2006 6:47 PM To: DelleChiaie, Pamela; 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; 'McBrearty Andrew (E-mail)' Subject: RE: 62 Farnum Street- Final Const. Inspection Request PAMELA, THIS IS SCHEDULED FOR SOME TIME TOMORROW AFTERNOON; I LEFT A DETAILED MESSAGE ON BUDDY'S CELLPHONE THIS EVENING; CAN'T PINPOINT THE EXACT TIME, BUT TOLD HIM WE'D CALL ABOUT AN HOUR OR SO BEFOREHAND SO THAT HE CAN GET TO THE SITE. MARIANNE From: DelleChiaie, Pamela [mai Ito:pdellechiaie@townofnorthandover.com] Sent: Monday, September 11, 2006 12:59 PM To: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail); Marianne Peters (E-mail); McBrearty Andrew (E-mail) Subject: 62 Farnum Street - Final Const. Inspection Request Hi Dan, Please schedule a Final Construction Inspection for above. All set per Buddy Watson and Bill Dufresne. Call Buddy at: 508.932.3204. Thank you. Nos/R¢gaads, Pa1*¢4410 D¢BG'¢G�liiai¢ Health Department Assistant Town of North Andover 1600 Osgood Street Building 20, Suite 2-36 North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax htt ;//www.townofnorthandover.com healthdept@townofnorthandover.com 9/13/2006 I DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Monday, September 11, 2006 12:59 PM To: 'Daniel Ottenheimer(E-mail)'; 'Lisa LeVasseur(E-mail)'; Marianne Peters (E-mail); 'McBrearty Andrew(E-mail)' Subject: 62 Farnum Street- Final Const. Inspection Request Hi Dan, Please schedule a Final Construction Inspection for above. All set per Buddy Watson and Bill Dufresne. Call Buddy at: 508.932.3204. Thank you. 8¢st Ropaads, Raiyaea A-0-004064W.0 Health Department Assistant Town of North Andover 1600 Osgood Street Building 20, Suite 2-36 North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com DelleChiaie, Pamela From: Sawyer, Susan Sent: Monday, September 11, 2006 8:27 AM To: DelleChiaie, Pamela Subject: septic Pam Buddy Watson called 22 Bannon needs BOB=I am going this AM 2 Famum -you should be hearing from Bill D this AM he did the as-built Friday Susan Sawyer, R.S. Public Health Director office 978 688-9540 fax 978 688-8476 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Thursday, July 20, 2006 2:15 PM To: Dufresne Bill (E-mail) Subject: 62 Farnum Street Importance: High Hi Bill, This plan is currently in for review. Please note that our next BOH meeting is on August 3rd. If there are any requests that you want to go before the BOH, please send your letter of request asking for the specific items that you want approved, such as the note we just happened to notice on the plan re: perc test and the variance request for distance to wetlands, and to be a 3 bedroom instead of a 4-bedroom, per N.Andover Reg. -- reference Section 9.01 #4- Local Variance Request. All requests need to be formally submitted on letterhead so that we are immediately aware of them, and be received 10 days before the meeting. Thanks. 810sf Ragwods, PuyyaBw Da010110 410 Health Department Assistant Town of North Andover 1600 Osgood Street Building 20, Suite 2-36 North Andover,MA 01845 978.688.9540-Phone 978.688.8476-Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com 1 62 Farnum Street Page 1 of 1 DelleChiaie, Pamela From: Marianne Peters [mpeters@millriverconsulting.com] Sent: Friday, July 07, 2006 10:47 AM To: DelleChiaie, Pamela Subject: RE: 62 Farnum Street YES,WE RECEIVE IT EARLIER THIS WEEK. From: DelleChiaie, Pamela [ma i Ito:pdel lech ia ie@townofnorthandover.com] Sent: Friday, July 07, 2006 10:31 AM To: Daniel Ottenheimer(E-mail); Lisa LeVasseur (E-mail); Marianne Peters (E-mail); McBrearty Andrew (E-mail) Subject: 62 Farnum Street Did you receive the plan for review on this one? It was mailed on 6/26/06. SOW R¢gwrd8, Health Department Assistant Town of North Andover 1600 Osgood Street Building 20, Suite 2-36 North Andover,MA o1845 978.688.9540-Phone 978.688.8476-Fax http:_//_www.townofnorthandover.com healthdept@townofnorthandover.com 7/20/2006 Grant, Michele From: Hallahan, Dennis [DHALLAHAN@infiltratorsystems.net] Sent: Tuesday, January 04, 2011 3:17 PM To: Buddy Watson (Wat475@verizon.net); BVH ickey@gmail.com; Bill Durfesne (BRDurfesne@comcast.net); Grant, Michele; Sawyer, Susan Cc: Johnston, Blake; Landis, Kyle Subject: Hickey Residence, North Andover Hello all: I spoke to most of you today.We are set to meet everybody at the site at 10 am Thursday, Buddy will be there with Pumper and Excavator, Michelle will be there because Susan will be away.The goal is to excavate the end of the system, pump out the effluent, and have a look at the system to evaluate the chamber product to ensure that it is functioning properly.And after this is done then the biomat and other features of the system can be viewed as well. Bill Durfesene will also be able to attend and will email me a copy of the plan, and Susan was going to check her files for any info as well. If the home is on public water then it would be essential to have that information as well, as far back as possible. If you have any questions then please do not hesitate to ask, looking forward to meeting all of you. Thanks, Dennis Dennis F. Hallahan, P.E. Technical Director Infiltrator Systems Inc. (860) 577-7100 This message contains PRIVILEGED AND CONFIDENTIAL INFORMATION intended solely for the use of the addressee (s) named above. Any disclosure, distribution, copying or use of the information by others is strictly prohibited. If you have received this message in error, please advise the sender by immediate reply and delete the original message. Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records.For more information please refer to:http://www.sec.state.ma.us/ore/preidx.htm. Please consider the environment before printing this email. 1 MERRIMACK ENGINEERING SERVICES, INC. ' PROFESSIONAL ENGINEERS LAND SURVEYORS PLANNERS 66 PARK STREET•ANDOVER,MA 01810•(978)475-3555,373-5721 •FAX(978)475-1448• E-MAIL info@merrimackengineering.com August 1, 2006 Ms. Susan Sawyer Public Health Director AUG 0 3 2006 1600 Osgood Street Building 20, Suite 3-64 TOWN OF Mi ,,-t-rr 4.. uv&p HEALTH North Andover, MA 01845 RE: 62 Farnum Street Dear Ms. Sawyer: We are in receipt of your review letter dated July 28, 2006 for the above referenced site. We have revised the plan in response to your letter. With regard to item 5 of your letter, 15.220 (4)(r) does not pertain to control panel or alarm location, however, the panel shall be one recommended by the manufacturer and the location of the alarm shall be per Title 5 and as stated on the plan see pump note#3. With regard to item#11 of your letter, I am not certain how we can confirm this issue, however, the home owner did consult with a plumber prior to our design and was assured that this plumbing change could be achieved. Lastly, with regard to item#8 of your letter, a local upgrade application has been submitted to your office and the appropriate local variance for setback to wetlands is noted on the plan. On behalf of our client, we respectfully request the design be approved as resubmitted. Very truly yours, MERRIMACK ENGINEERING SERVICES William Dufresne Project Manager cd MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS LAND SURVEYORS PLANNERS 66 PARK STREET•ANDOVER,MA 01810•(978)475-3555,373-5721 • FAX(978)475-1448 • E-MAIL info@merrimackengineering.com July 21, 2006 _ R2C �V' JUL 2 5 2006 Ms. Susan Sawyer, Director TOWN OF NORTH ANDOVER Department of Public Health HEALTH DEPART ,ENT Town of North Andover 1600 Osgood Street Building 20, Suite 3-64 North Andover, MA 01845 RE: 62 Farnum Street Dear Ms. Sawyer: We have prepared and submitted a replacement septic plan for the above referenced site to your department for review. As designed, the plan requires variances from the North Andover Regulations regarding setbacks from wetlands and for a three bedroom design. On behalf of our client, we respectfully request this matter be placed on your August 3, 2006 meeting agenda for consideration of these local variances. Very truly yours, MERRIMACK ENGINEERING SERVICES William Dufresne Project Manager cd cc: Mr. John Good 62 Farnum Street North Andover, MA 01845 Mf1RTN +"""•'•, 4 TOWN OF NORTH ANDOVER A � • PERMIT FOR WIRING r i r �'a��wvys4 'nais cxniti 7 L 7 that ........ ..../...'" has permitsion to perform .. . __� �r SS _ t wining in the building of. ....... at ..._..................... ,.F{!.(1 4M. ,North Andover,Mass. ��.r . Fac_. S. [.ic. No. y 7g ...._... � .1?L8C7�ICA,[_INetbc`tr�it ��� Check # 6783 JUL 11,2006 12:31 9786828563 Page 1 f w Commonwealth of Massachusetts Official Use Only y kJ - V - Department of Fire Services Permit No. Cp 7 [R - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev.9/051 leave blank APPLICATION l work to be pFORormed� PErRMIdance T TElectricale Massachusetts� O PERFORMELECTRICAL WORK (MEC),527 CMR 12.00 (PLEA SE PRINT IN INK OR TYPE ALL INFORM4 yyOpo Date: 7 -//'— 0 6 City or Town of: N, hfv� o u e.- To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1k it 1 Owner or Tenant ('��,y b Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Q1 Undgrd ❑ No. of Meters New Service Amps 1 Volts Overhead ❑ Undgrd ❑ No. of Meters t Number of Feeders and Ampacity Location and Nature of Proposed Elec ical Work: Completion o the olloivin table m be waived b the Ins Inspector o Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of ota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool A ove ❑ n- nn i,o.o mergency ig g rnd. rnd. y Batte Units No. of Receptacle Outlets , No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o. of Detection an initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Ue—at7u—mip7Number Jons MV No.of Self-Contamed Totals: I Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local[] Municipal Connection ❑ � No,of Dryers Heating Appliances , Security S stems:* No.of Devices or Equivalent i o.o Heaters I{W ter i o.o o.or— Data Wiring: Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors. Total HP a ecommunications irmg: No.of Devices or Equivalent OTHER: G,,) Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: �� (When required by municipal policy.) Work to Start: 7— /.�. --O_6_Inspections to be requested in accordance with I4tEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under theawns andpenalties o P P jper�ury, that the information on flus application is true and complete. FIRM NAME: A i"F j. r~ t~r:t T✓L c, LIC.NO.: 1 Lf Licensee: _ h J ,. P TZ, Signature �_ LIC.NO.: .3 �i'4-S`v C" (If a licabl t"in the license number line.) Q- -- 1 r Bus.Tel.No.: l 5 J * ecunty System Con ctor License required for this work; if applicable,enter the license number Tel. "> r_ Pp tuber here: OWNER'S INSURAN E WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally rc jt edJyNaJ0*my -ignature below,I hereby waive this requirement. I am the(check one)❑ owner ❑owner's agent. Owner/Agent Signatnrq , .U�y COVER Telephone No. PEJUHT FEE: $ ly F ,,...i H DEPAR'TIMEN TRANSMISSION VERIFICATION REPORT TIME 07/28/2006 16:16 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE,TIME 07/28 16:14 FAX N0./NAME 89784751448 DURATION 00:01:25 PAGE(S) 03 RESULT OK MODE STANDARD ECM f(ArMAndover Health Department adRrh 1 600 Osgood Street Building 20, Suite 2.36 Letter of Transmittal o , Noah Andover, MA 01845 * 3 978.688.9540 - Phone �A G� a«w�i�M� 978.688.8476— Fox Page—/_of - 7► Cat Uwc�$�+�°J cw thde t ownofno Andover am- E-mail www.to inofnortha,dover coMcoM-Website TO: WILLIAM(BILL)DUFRESNE,PROJECT MANAGER DATE: COMPANY: MERRIMACK ENGINEERING SERVICES FROM: Pamela DelleChiaie, Health Department Assistant Phone: 978.475.3555 Re! Fox: . 978.475.1448 We dre sending you; �eview Letter p AppRI VE1 APAPMOVED 47 system Constroction follow--Up pOther These are transmitted as checked below. 0 A Required ©As Requested []For your File REMAR 1, COPY T0: Homeowner Fox# Or Norifh Andover Health Department NORT11 q 1600 Osgood Street O st"' ti Letter of Transmittal 3? �``' . ` Building 20, Suite 2-36 y North Andover, MA 01845 eh � 978.688.9540 - Phone Page ofArEO ev OR 978.688.8476 — Fax �SSACHUS�t healthdept(CDtownofnorthandover.com- E-mail www.townofnorthandover.com-Website TO: WILLIAM(BILL) DUFRESNE, PROJECT MANAGER DATE: ///w r,/D COMPANY: MERRIMACK ENGINEERING SERVICES FROM: Pamela DelleChiaie, Health Department Assistant Phone: 978.475.3555 Re. Fax: 978.475.1448 We are sending you. L wa eeview Ietter OAPPROVED �OrAPPROVED O System Construction follow-11p O Other These are transmitted as checked below: 0A Required 0A Requested []For your File REMARKS: COPY TO: Homeowner Fax# Or Mailed COPY TO: Fax# Or Mailed COPY TO: Fax# Or Mailed LETTER OF TRANSMITTAL NORTH North Andover Health Department of .� 400 Osgood Street 32► e���� »s*e/OOL North Andover,MA 01845 to �. 978.688.9540 -Phone...MW..��.� _.._ 978.688.8476 - Fax ,•""4L 'A CwtwK�NwrKw,y7' healthdept(a7townofnorthandover.com - E-mail 0 rao www.townofnorthandover.com -Website Page Of--.5— TO: TO: DATE: Daniel Ottenheimer COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting RE: 0 Phone: 1.800.377.3044 or 978.282.0014 �� ✓` �l-2�'LGr�'y/ �� . Fax: 978.282.0012 We are sending you: 17Soil Test OPlans or Review OOther fill in below) These are transmitted as checked below: Of'or Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: on-Der's Name: Location: jq,�J i�, Map/Parcel: P, J Addmsc Installer. Tel Neer(sISVL---RepzIr jr Date: WeduthLx-,zone Ir L_�- SoIlSymba!Z' eK" �r Son(3 Dep Observation Hole Lags ElLwation Depth Son H6izou Sall Temre Sop tolor Sall mottling % Grxvel,Stove4 ew A 4f7 A z Parent Material 6, �Depth to 1I4mk.2_shWjn Wxwftft Rol -VeC&I fm ft Face wuwmcnwwcu� Date 'remintion Tests me- Observation Holes Depth of Pert: Start Prie-sad-L Time at n-f Time at 9" ---------- 006 Time at 6" Time(.g"- MENT -Unte bun& NDOVER Performed lar. g r Geotechnical consultants, Inc. (508)229-0900 FAX (508)229-2279 June 8, 2006 Mr. Bill Dufresne Merrimack Engineering Services Inc. 66 Park Street Andover, MA 01810 RE: Sieve Analysis 62 F arnum Street North Andover, Massachusetts GCI Project No. 2062578 Dear Mr. Dufresne: A representative soil sample was delivered to our laboratory for gradation analysis from 62 Farnum Street. Grain sire distribution for the recovered sample was determined in accordance with ASTM D422. Based on the attached gradation curve, the samples were classified as Class I SAND in accordance with the USDA classification system. We trust the foregoing and attached are sufficient for your immediate needs. Should you have any questions, please do not hesitate to contact us. Sincerely, GEOTECHNICAL CONSULTANTS, INC. 6 7 RECEIVED Christopher Chlodv JUN 2 9 zoos TOWN OF NORTH ANDOVER HEALTH DEPARTMENT cc/vas 201 Boston Post Road West • Marlborough, Massachusetts 01752 ti U.S.STANDARD SIEVE NUMBER 100 S. 4 3" 2" 11,2- 1" 3/i '/3" /a" 4 8 81012 18 20 30 40 50 70 100 200 270 D I - Project:62 Farnum St. 90 i - Project#:2062578 10 I Sample#: 2105 Source: Unknown aD Date Tested:6/6/06 20 Tested BY: CC/MM 70 ' 30 3 = 60 I I 40 3 i — z z 50 - _ 1 50 W Z U i 40 i I ----- 60 w i 30 70 '—...—� 20 80 10 I 90 1000 100 10 1 0.1 0.01 0.001 GRAIN SIZE IN MILLIMETERS UNIFIED COBBLES GRAVEL SAND —I COARSE FINE COARSE MEDIUM FINE SILT or CLAY 5 T tilz t_ Geotechnical Consultants, Inc. _-n z 201 Boston Post West Marlborough, MA 01752 oz (508) 229-0900 Fax (508) 229-2279D o fig;, n1 7D Geotechnical Consultants, Inc. 16� 1 201 Boston Post Road West Marlborough, MA 01752 Phone 508 229-0900 Fax 508 229-2279 Sample ID#: 2105 Project#: 2062578 Sample Source: Unknown Project Name: 62 Farnum St. Date Received: 30-May-06 Project Location: North Andover, MA Date Tested: 7-Jun-06 Project Manager: Tested By:I CC/MM Specification: Test Method D-422 Particle-Size Analysis of Soils Sieve Mesh# TSieve Opening (mm) % Retained % Passing Specification Range 3" 76.2 2" 50.8 1 1/2" 38.1 1" 25.4 0.0% 100.0% 3/4" 19.1 '/2" 12.7 3/8" 9.52 8.1% 91.9% #4 4.76 11.8% 88.2% #8 2.38 # 10 2.00 17.8% 82.2% # 16 1.19 # 30 0.59 #40 0.42 33.9% 66.1% # 50 0.297 40.3% 59.7% # 80 0.18 53.6% 46.4% # 100 0.149 59.2% 40.8% #200 0.074 82.5% 17.5% #270 0.053 92.3% 7.7% PAN 0.00 100.0% 0.0% REMARKS: l 6 �6 o ��� y �� Town of North Ando r Z Health Department Date: Location: (Indicate Address,if Residential,or Name of Business) Check#: /lle 5-0 Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ;L] Se�pticoil Testing $ esign Approval $ lede ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) Health Agent Initials 163-4 White-Applicant Yellow-Health Pink-Treasurer f d;9e Town of North Andover Health Department Date: Location: (Indicate Address,if Residential,or Name of Business) Check#: A`- d Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢,`-Recreational Camp $ i ➢ SEPTIC PERMITS: ❑ Septic-.Soil Testing $ �eptic Design Approval $ � ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool f $ ➢ Tobacco $ ➢ Trash/Solid Waste Hauler �1 $ ➢ Well Construction - $ ➢ OTHER:(Indicate) T Health Agent Initials 1634 White-Applicant Yellow-Health Pink-Treasurer L�� TOWN OF NORTH ANDOVER 14ORT14 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 ACH„ ` .978.685.9540 Phone Susan Y.Sawyer,REHS/RS 978.688.8476--FAX Public Health Director E-MAIL:healthdeptr)townofiiorthandover.com WEBSITE:hqp://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM RECEIVE[ Date of Submission: JUN 2 2 2006 Site Location: (aZ— ef 7 r TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Engineer: 1.•1 f 1G�t�Cc i clp New Plans? Yes `//$225/Plan Check# J(PSO (includes 1"submission and one re- review only) Revised Plans?Yes $75/Plan Check#/ Site Evaluation Forms Included? Yes r/ No Local Upgrade Form Included? Yes ,". No Telephone#: Q � —tel S�l� Fax#: (J?Tq7!S� E-mail: M CK-K e t,) Q L, Homeowner Name: .J o w 6l or-9 h OFFICE USE ONLY When the submis on is complete(including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File;Forward to Consultant ➢ All' Enter on Log Sheet and Database NORTH 3 4 (� Town of North Andover HEALTH DEPARTMENT �Ss�cHust4 CHECK#: � DATE: LOCATION: H/O NAME: r 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 Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic sposal Works Installers(DWI) $ tle 5•Inspector $ Title 5 Report $ �0 ❑ Other. (Indicate) $ Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer Town of North Andover Health Department .,e: � p� Location: 4, - (Indicate Addre s,if Residential,or Name of Business) Check#: Ole Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWQ$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashIsolid Waste Hauler $ ➢ Well Construction $ � ➢ OTHER:(Indicate) C Health Agent Initials Vhite-Applicant Yellow-Health Pink-Treasurer 2 Town pf Noah Andover /A0 Health DepartmentDate: � Location: 104 (Indicate Address, if Residential,or Name of Business) Check#: /,�9& Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: co eptic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) Health Agent Initials 1553 White-Applicant Yellow-Health Pink-Treasurer LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street �' e�; _ »• 'b �o North Andover,MA 01845 0 •w 70 978.688.9540 - Phone 978.688.8476 - Fax +` # healthdeAt(a townofnorthandover.com -E-mail �.y q''��raD ,•f'`�y.� www.townofnorthandover.com -Website Page o SS,�C14 TO: DATE: Daniel Ottenheimer 14ffllo�1� COMPANY: FROM:Pamela DelleChiaie, Health Dept. Assistant Mill River Consulting RE: n � � ' Phone: 1.800.377.3044 or 978.282.0014 pJ Fax: 978.282.0012 We are sending you: OSoil Test OPlans or Review /7 Other all in below) These are transmitted as checked below: OFor Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: ` " s « TOWN OF NORTH ANDOVER riflT�, Office of COMMUNITY DEVELOPMENT AND SERVICES-ab'.�o HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER.,MASSACHUSETTS 01845 wcNusf� *— _i 1►yam Susan Y.Sawyer,REHS,RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX healthdeat@,townofhorthando eLc-0A PR 2 8 2006 wwTNv.towaof.'northandover.co R TOWN OF NORTH;,,'':,OVER APPLICATION FOR SOIL TESTS HEALTH DEPP.k .,^; fir. DATE: Z7—C2 Co MAP&PARCEL: 107'k LOCATION OF SOIL TESTS: rA le-0 Ll i---1 -27 - OWNER: JOUK) 6-d2r-212 Contact#: (afA�2 6 APPLICANT: !/A l-i e Contact#: ADDRESS: C,oZ FA k,::Lj Lt H ENGINEER: t--I LW(n,�)JS Contact#:�e-�7�j'2j CERTIFIED SOIL EVALUATOR: t2u h�5 UL Intended Use of Land: Residential Subdivision ingle Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) ➢ 8.5"x 11"Plot plan&Location of Testing(please indicate test pit sites on the elan) ➢ 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: Signature of Conservation Agent: Date back to Health Department: (stamp in): 1 y 1 ACTIVITY REPORT TIME 04/28/2006 15:59 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 NO. DATE TIME FAX NO./NAME DURATION PAGE(S) RESULT COMMENT #465 04127 14:00 89786823637 01:58 05 OK TX ECM #466 04128 09:33 819786490981 01:00 03 OK TX ECM #467 04128 09:42 819787771025 30 03 OK TX ECM #468 04128 10:11 816035958753 01: 26 08 OK TX ECM #469 04128 12:47 89789468046 19 01 OK TX ECM #470 04128 12:49 89786889594 28 02 OK TX ECM 04128 13: 17 36 02 OK RX ECM #471 04128 15: 50 819782820012 03:18 06 OK TX ECM #472 04128 15:56 819783360449 01:01 04 OK TX ECM BUSY: BUSY/NO RESPONSE NG POOR LINE CONDITION 1 OUT OF MEMORY CV COVERPAGE POL POLLING RET RETRIEVAL PC PC-FAX Address G 'UM S-r Title of File Page of Date File Open: Date File closed: Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes: action Document/ document/ Num.— Action Department Board of Appeals — Board of Health — Planniing Board — Con servatiion Commission — Building Departmer t TRANSMISSION VERIFICATION REPORT TIME 08/08/2006 09:44 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE,TIME 08108 09:43 FAX NO./NAME 89784751448 DURATION 00:01:23 PAGE{S} 03 RESULT OK MODE STANDARD ECM North And-ver Health De artment "�p'b�ltiQ 1600 Osgood Street Letter of Transmittal Building 20, Suite 2.36 North Andover, MA 01845 978.688.9540 - Phone page of t 978.688.8476— Fax ��cNuS healthdept ar.townofnorthan -E-mail www.townofnarthandaver.com-Website To: WILLIAM(BILL)DUFRESNE, PROJECT MANAGER DATE: COMPANY: MERRIMACK ENGINEERING SERVICES FROM Pamela DelleChiaie,Health Department Assistant Re: Phone: 978.475.35S5 Fax: 978.475.1448 We are sending you: "loneview Letter 90PROVED I.7 N0,rAPPROVED D S�s�em COpstrutt'0n f0/%W 1P ©Other These are transmitted as checked belo�: 0 A Required ❑ARequested -05 your File REMARKS: COPY TO: Homeowner Fax Or .y North Andover Health Department NORThq 1600 Osgood Os g Street Letter of Transmittal Building 20, Suite 2-36 North Andover, MA 01845 y O 978.688.9540 - Phone 9A COC.11! lwKM`y _� 978.688.8476 — Fax Page of SSACHUSS healthdept(cD-townofnorthandover.com-E-mail www.townofnorthandover.com-Website TO: WILLIAM(BILL) DUFRESNE, PROJECT MANAGER DATE: COMPANY: MERRIMACK ENGINEERING SERVICES FROM: Pamela DelleChiaie, Health Department Assistant Phone: 978.475.3555 �J Fax: 978.475.1448 We are sending you: /an Review Letter P-ArpP'RovED ONOTAPPROW O System Construction Follow-Up O Other These are transmitted as checked below: 0 A Required 0 A RequestedoC -r your File REMARKS: COPY TO: Homeowner Fax# Or Mailed COPY TO: Fax# Or Mailed COPY TO: Fax# Or Mailed TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 CHOP, 1�11 Ell Susan Y.Sawyer,RENS,RSI R E C E 7V'�_ Public Health Director 978.688,8476—.FAX bealtlideptagownofborthando "-co PR 2 8 2006 w,ArNv.towtiof.'iiortliaiidoveT.COI n TMAIN OF APPLICATION FOR SOIL TESTS DATE: Z:7--e2 C, MAP&PARCEL: 107 A LOCATION OF SOIL TESTS: rA V-0 LJ H OWNER: .. 1410 Contact#: 1�-2 6_1 APPLICANT: _! A Contact#: ADDRESS: C,oZ 64 g::�hj u ENGINEER: LM)��)JS Contact#: CERTIFIED SOIL EVALUATOR: 1 Lt-- t2a Fa�5 UL Intended Use of Land: Residential Subdivision ingle Family Hom - Commercial Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM > Proof of land ownership(Tax bill,or letter from owner permitting test) > 8.5"x 11"Plot Plan&Location of Testing(please indicate test Pit 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 A r ate: I Signature of Conservation Agent..!!F Date back to Health Department: (stamp in): WzMa V0 —4uc, IWK, bf-FK6 _t�' 6(", 6t rA U.S.STANDARD SIEVE NUMBER 6" 4 3" 2" 1'/z^ 1" /4" /2" �/4" 4 6 8 1012 16 20 30 40 50 70 100 200 270 100 I 0 l Project:62 Farnum St. 90 _ Project#:2062578 10 j j I Sample#: 2105 j Source: Unknown eo I Date Tested . 6/6/06 Tested By: CC/MM zo 70 i — 30 I � 3 60 40 I � a z 50 50 v 1 w 40 60 Q. T--_--_ a I 30 70 ---- 20 ! --- ------ 80 10 90 1000 100 10 1 0.1 0.01 0.001 GRAIN SIZE IN MILLIMETERS GRAVEL SAND .0 UNIFIED COBBLES COARSE FINE COARSE MEDIUM FINE SILT or CLAY p T5 ffl D Z `— x Geotechnical Consultants, Inc. _-' z 201 Boston Post West Marlborough, MA 01752 00 b"D (508) 229-0900 Fax (508) 229-2279 v= 7 No va mG O CT)-i m �o I Geotechnical Consultants, Inc. OW 201 Boston Post Road West > =Q Marlborough, MA 01752 F a Phone 508 229-0900 Fax 508 229-2279 U z= Sample ID#: 2105 Project#: 2062578 LIJ Sample Source: Unknown Project Name: 62 Farnum St. Uj �= Date Received: 30-May-06 Project Location: North Andover, MA Date Tested: 7-Jun-06 Project Manager: Tested By: CC/MM Specification: Test Method D-422 Particle-Size Analysis of Soils Sieve Mesh# Sieve Opening (mm) % Retained % Passing T Specification Range 3" 76.2 2" 50.8 1 /2" 38.1 1" 25.4 0.0% 100.0% 3/4" 19.1 1/Z" 12.7 3/8" 9.52 8.1% 91.9% #4 4.76 11.8% 88.2% # 8 2.38 # 10 2.00 17.8% 82.2% # 16 1.19 # 30 0.59 #40 0.42 33.9% 66.1% # 50 0.297 40.3% 59.7% # 80 0.18 53.6% 46.4% # 100 0.149 59.2% 40.8% #200 0.074 82.5% 17.5% #270 0.053 92.3% 7.7% PAN 0.00 100.0% 0.0% REMARKS: It FINAL GRADE INSPECT ON Date: Address: Y/4 axOAMED? ey" SEEDED? ZCOVER PER PLAN? Other: SEP-14-2006 11:02 PEABODY SUPPLY 976 685 7397 P.01 <-, inator Serie', IAN Pvm'ps ittle Gl ' f'. P'nnap Company h CIS SERIES Features li °a,c�airy. 'I1 ■ Handles liquids and sated'wfe'finaterials up to ;� , . 2" meter. diff,.;;1:,,; •..,r ,`I ;1 ''t % ■ Cast iron pump housin$- te with protective epoxy coating for corT�oiii� iiist resistance o, ■ Oil-fi lled motor hou,ingtl5>�'IJimc lubrication ahc� ^' rapid heat dissipation `+ a Stainless steel fasteners „' 1 Mechanical seals (stain spring, nitrile ' carbon and ceramic carbo ramicfac.e9 r ■ overload prote0 .r. -fhennal overl Manua and 1 Automatic m ■ Auto nr' ;;�- ` :� '_���'�I ■ uratic operation haaa�i'.;�,0 8 'Un level and A to, • 12 level range ^ i yback mechanical "()ff' ngc {, gg Iloatswitch '•,.e>.rt�.a°7, , �:� n ,,'•� .y.,;,,;'c,;.� +;✓ Jr,, ■ All models are UL/CSA' is� V h "tai%v Cast Iron Housing and Volute iii^�I�r,�'Iq���„u}�Power Card ;7r� w/Protective Epoxy Coaling ,,,� Rosi Al+ to 51 COfrg8len Upper Ball Soaring Oil-F S t^i r' ,;r,. .I Illed r. 'ie. To ate Hoel Dissipate i LL:r a i•'i: �' ',.1'! For EYIehdmd Life Lower Oa)I L" 't f.••fir'. �+ .,e'. 4 gleerin9 :,�`;�..rtiig't;' 1 r Motor Designed o -,•,+,.�. Mn'xlmum Porlortnanco Carbon 6• Coramic Face Sou)' %'• tas&•Fillcd Nylon ,:r• •' " `�;" VorteJcimpeller i ,o pereased pumping demands,the Model l OS Series Wastewater and Sew " ;�I' astew Ejector - i6 t,thc 9S Series. Pumps teat dischur age Pi?i? t cr greater capaciti( urt n Z" c with h a lift of 20'. r , -'l' b Cast iron ' ink andp=i protective epoxy !•4 • � it",,.X.a r. I.. SEP-14-2006 11:03 PEABODY SUPPLY 01: •- y i ^��•' 978 685 7397 P.02 �d '94',N�M1W�,7A';v•�YrIM '„y>'q.1`1'tan6Nlr4rr 'r ,r,••irtuP' rv , �' p' y •,,„ ,�'.M1 r M1p�, 1 •�,ht•'^ I.�M1� Iry �'r,_ ,..rM''r1rt�,vrRir.^w,+Gn'p11'H .;+� La r.�:71�1,.�, :,':r: 'err •'.,'•, �. n?` '] R SEWAGE j ECT 'n l� '�i': �� ,�' 10.30' :'��•,', � ,Lri"".`,i �'., ;, :1„1,x..': r.',,t,�r'• ''7Gr�r�: 12.702' WIT DISCHARGE v 2.00* DIA INTAXE t;;. � I�5.50'. •.�:ii�irl ;�.;r,.1';• :is�! �':•,�',. ' ITEM SOLIDS SIZE RUNNING PERFORMANCE(GPM HEAD) SHUTOFF ^"r r,• „(, NOL LISTING .HP VO4T$ I MT DIMENSIONS (Div In.) AMPS/WATTS 5' 1d 15 (F1.1 P•S,I. „ IN c L r W 11r.) 511400 UUCSA 1/2 115 7, 12/1000 8. 45 20 ^^ 110 5 8.7 15 A 12.70x10.3x8.25 %'c ;• I,41014 511501 UUCSA 1/2 1271211000 44 12.70 x 10 3x 8.3 r"" 40 �h(1• 511450 UUCSA 1/2 115 2 150 100 54 20 e.7 2 12/1000 49 12.70 x 10,3x'8,25 511475 JL/CSA 1/2 206/230 2 110 d5 45 20 8.7 i1b'?, '.; 6.6/ttDO 20 8.7 110 A5 45 �Y,S:-..:"."'47 t2J0x1D.3x8.25 'r I•fl qi.tr�:r_, d,;r',�.,:, : • how- L ,�e adw Cons� t�uCtson T5 p , � Motor Housin Ep4r3';� 1J ron I �z•::;:,,'�<;: ' ;; ;l;: to Impeller Material _Fr4� J • e •Impeller Typic ', • 4. , 1� -..1 j.. E;..r,l Volu L� i j. .. ... W%y; 8 ,GRSt 1 n :..; .nr. '" i> ,'. ' :76 Powcr CoriT.1 al Shaft ' Mechanic aft Seal A;' ••dr`'�'�: Nlt>ra1 'Tl�txf►;':C'�T�UQ 1111( '%;• 'a' •'? lb' 1t:` 2.6 C atiteners Stap > �i 1.26 Shall,..: -- SleC�'..'.a.''1'+f' Bearings U ,. p, ball }. �. 40 e0 eo ron ,20 bcan„ vucr Little Q. PO Box 12010 1' >c;405.947.2511 Okla.City,OK 73157 ` z:405.951.5674 Jf�liif. ISO 9001 CERTIFIED) www.�.it>�leG 'i'� mp.�®m .No,99434a TOTAL P.02~ Alm* Alvn6ver 12.6. 4. )Zh X14m St QT'S SEPTIC TANK SERVICE A 47 RAILROAD STREET BRADFORD, MA 01835 978-372-7471 MON'T'H OF c )k,L rMONML Y REP W FOR 7M OF DATE ADMU SS f o 7 0 GALLONS MI5 163 UJ l �R& c93 4�re5l—. 1 ?yc� it/i h�-r 5t We) Lo 4�3 Fd 7� s IWO&r 7 'eLl f MOO -Fr)CO ; ;� U.S.STANDARD SIEVE NUMBER 100 6" 4 3" 2" 1'/z" 1" ) ^ '/z" /a' 4 6 8 1012 16 20 30 40 50 70 100 200 270 I I I I II Project 62 Farnum St. so -- Project#: 2062578 10 Sample#: 2105 — Source: Unknown 80 -_ ! �I Date Tested : 6/6/06 20 Tested By: CC/MM 70- � . t7 i 60403 50 i I � l f- O W w 40 i ! I O a I ! I f' T----- 60 W I I a -.._._. I ! I 8 20 0-� = ----- --- 10 — so 1000 100 10 1 0.1 0.01 0.001 GRAIN SIZE IN MILLIMETERS UNIFIED COBBLES GRAVEL SAND SILT or CLAY COARSE FINE COARSE MEDIUM FINE Geotechnical Consultants, In . 201 Boston Post West Marlborough, MA 01752 (508) 229-0900 Fax (508) 229-2279 _a. Geotechnical Consultants, Inc. 201 Boston Post Road West Marlborough, MA 01752 Phone 508 229-0900 Fax 508 229-2279 Sample ID#: 2105 Project#: 2062578 Sample Source: Unknown Project Name: 62 Farnum St. Date Received: 30-May-06 Project Location: North Andover, MA Date Tested: 7-Jun-06 Project Manager: Tested By: CC/MM Specification: Test Method D-422 Particle-Size Analysis of Soils Sieve Mesh# Sieve Opening (mm) T % Retained % Passing Specification Range 3" 76.2 2" 50. 1 �/2" 38.1 ill 25.4 0.0% 100.0% 3/4" 19.1 1/2" 12.7 3/8" 9.52 8.1% 91.9% #4 4.76 11.8% 88.2% #8 2.38 # 10 2.00 17.8% 82.2% # 16 1.19 # 30 0.59 #40 0.42 33.9% 66.1% # 50 0.297 40.3% 59.7% #80 0.18 53.6% 46.4% # 100 0.149 59.2% 40.8% #200 0.074 82.5% 17.5% #270 0.053 92.3% 7.7% PAN 0.00 100.0% 0.0% REMARKS. Location, jtqI?,T Mapiparcei: Address: Telm Nen'muL__Repilr Date:_ -OC, Wetlands>(f;KZoue1k -- SoftSymbol CfL 11&M c3us Deep Observation Hole IAgs Elea-Rdon Depth son HO ft* n Soil Texture Soil tolor Soil moul; 9. % Gravel,Stones,ete V_V_i"Ake e7 Y5/t I 'CIO 9ye"cqV10,4. J Parent Kfateria _DqA toRdmk.Z— Uu&g WatcrIft the Rain Ch�! % e1q, 1 5 y 5jq" -6 7- Date Percolation Tests Observadou Holed 4 Depth of Peer Start Pre-salk Time at na Time at 9" 006 Time at 6" Time(V_vj_ Tn\A/N OF NOF�TH NDOVER HEALTH.DEAR -MENT__ Rate burfin ch Performed R 2- Witnessed Br. ----------- ©0 1'orth Andover Health Department Date: 7,17,1,71X946 Location• L0 a f e) /� ✓./ . (Indicate Address, if Residential,or Name of Business) Check#: yXaf Type of Permit or License:(Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service-Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal(Septic)Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ eptic Disposal Works Construction(DWC)$ �. ❑ Septic Disposal Works Installers(DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER:(Indicate) Health Agent Initials 1675 White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Massachusetts Map-Block-Lot 107.A-0086- p Board of Health PennitNo 20 • * North Andover ______BHP-2006-02-_______ --____ '4e:�;.. ` P.I. FEE SSACIHWS� F.I. $250.00 ------- Disposal Works Construction Permit Permission is hereby granted JOSEPH R. WATSON - ----------------- --- ------------1 -- ------------------------------- _ ------------------ to(Repair)an Individual Sewage Disposal System. at No 62 FARNUM STREET -------------------- as shown on the application for Disposal Works Construction Permit No. BHP-2006-022 Dated - ---------- ------ ---------------- ------------ i Printed On: Board of Health f µORTM Map-Block-Lot Commonwealth of Massachusetts 1o7.A-0086- o Health ----- ----------------- North Andover Js���ust to of ComplianceOin THIS IS TO CERTIFYThat the Individual Sewage Disposal System (Repaiby ___JOSEPH R. WATSON-------------- Installerat No 6-- FARNUM STREET has been installed in accordance with the provisions of TITLE 5 of the State Environmental Cod application for Disposal Works Construction Permit No. BHP-2006-022-- -- Dated --------------- ---- ------ --- -------- - --------------- -------- Printed On:Jul-2---- --- Board of Health