HomeMy WebLinkAboutMiscellaneous - 67 SUNSET ROCK ROAD 4/30/2018 (2) _ 67 SUNSET ROCK ROAD ad _;
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PARCEL
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CONS_T_RUCTI.ON APPROVGI,
HAS PLAN REVIEW FEE BEEN PAID? _ YES NU
q LkjtA__)
PLAN APPROVAL: DATE J APP. BY
DESIGNER: PLAN DATE. v
i4t��
CONDITIONS
WATER SUPPLY: WELL
WELL PERMIT DRILLER
WELL TESTS: CHEMICAL DA I E ni-FPRUVED_-.--.___.__..__._.___.
B 'TERIA 1 Ufa I E (IPPIRUVEU
BACTER II DATE
COMMENTS:
FORM U APPROVAL: '�/J¢/ 97 APPROVAL 1'0 ISSUE YES NO
DATE ISSUED BY -
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID YES NO
WELL CONSTRUCTION APPROVAL YES NU
SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO
OTHER YES NU
ANY VARIANCE NEEDED YES NO
FINAL BOARD OF HEALTH APPROVAL: DATE:.
,,�.: .i. ... :d`,}:. . .... . .� 'A�_��f�='...:t-i.ef1: .}"';.:t'•.. rte• .Z- -
IS THE INSTALLER LICENSED <t_
NO
?
RUCT
.TYPE OF CONSTION:
_ NEW REPAIR'
NEW CONSTRUCTION: ,., CERTIFIED PLOT. PLAN REVIEW NO
;:. CONDITIONS OF..APPROVAL .. YES NO
(FROM FORM U) r
°.,ISSUANCE OF DWC PERMIT NO
DWC PERMIT N0. !� INSTALLER:
BEGININSPECTIONYES NO:
:EXCAVATION . INSPECTION: : NEEDED:
wt
PASSED BY
CONSTRUCTION INSPECTION: NEEDED:�
-,
AS BUILT PLAN SATISFACTORY: YES:
APPROVAL TO BACKFILL: DATE:Ll
BY��
�l :FINAL . GRADING APPROVAL: DATE 1'7':F BY
Y>�
+�
DATE: Y
FINAL CONSTRUCTION APPROVAL:
Commonwealth Of Massachusetts RECEIVED
City/Town of N® Andover
System Pumping Record
{v 2014
Form 4 TOWN OF rdvr<TH 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 you
local Board of Health to determine the form they use. The System Pumping Record must be submitted ti:
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
ocation:on the computer, /� r�
use only the tab (D ( e/ o c (�
key to move your Address
emsor-do not No Andover
use the return Ma
key. City/Town State
.. Zip Code
2. System Owner:
6��ss l
Name
renin
Address(if different from location)
City/Town State
_ Zip Code
/ I elephone Number
B. Pumping Record
1. Date of Pumping ���)JoLJ 2. Quantity Pumped: 15M
Date p 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:
r
6. System Pumped By:
Name Vehicle License Number
Stewart's Septic Service
Company
7. Location wher contents were disposed:
Stewart's e-treatment Plant, 20 So. Mill Bradford, Ma 01835
Signature_o Havter Date
Signature of Receiving Facility Date
jjorm4dorc�- 3/06
System Pumping Record-Page 1 of 1
L
North Andover, Mass.
S h o w i n g
"A
As-Built Sari t ary Disposal System "
Lot 1 Lot 15 - Sunset Rock Road
50.p0' Prep are d For
(Open Space) Lot 16 Frank Rossi
Scale: 1" = 40' Date: April 30, 1998
50y Schedule of In vents Schedule Of Tie Distances
C Invert ® Foundation = 151.7' AD 36. 1' AG = 49.8' Al = 96.7'
Lot 15' 4 4 0 Septic Tank /n 151.07' BD = 50.8' BG = 70. 1' Cl = 96. 1'
,� cL Septic Tank Septic Tank Out 150.93'
,� �j• (1500 Gallon) wrn D—Box In = 150.69'
35,046 S.F.. g �h B AE = 47. 1' AH = 98.5' AJ = 96.9'
ti w D—Box Out = 150.52' BE = 55.8' CH = 85.7' C✓ = 107.8'
0.80 Acres �' 0 /� Water rn Trench 1 /n = 150.28', End = 150.04'
Up/and = 35,046 S.F. er"�°e Tre:7ch 2 /n 150.32', End = 150.07' AF = 50.5'
26, Trench 3 /n = 150.28", Out = 150.07' BF = 42.6'
�p F Trench > i '
Dff
w
603 � A ?s`,�, 0 E _ Trench 2
/ hereby certify that / have inspected the construction of this disposal
D-Box
►7 Trench 3 system and that the construction and final grading has been in cccordanc
G - __y ✓ with the designer's intent and that the materials used conform to the
L=c,� plan specifications and 310 CMR 15.0
179.76 utilities C,4,-V, R = 6Q per, L=2.00
R=30.00 This plan has been prepared for the purpose of showing the "As—Built"
conditions of the sanitary disposal system instal/ed on the premises.
Leach Trench System: All work was done in substantia/ conformance with the design plans as
3�Trenches: 50' Long, prepared. Al/ work was done within the construction limitations expected
4 Wide, 24 Deep for a job of this type.
Sun se11?00km ��
- 4/3oi 98
Lot 14Road Design Engineer P.E. Date:
Private — 50' Wide �vt of r
♦� JOHN M. ter.
MORIN �.
CIVIL
No.39836
Thomas E. Neve Associates, Inc.
E AL Ems+ Engineers — Surveyors — Land Use Planners
447 Old Boston Road — U.S. Route 1
Topsfield, Massachusetts 01983 887-8586
164 7—SSDAsEl t
Commonwealth of Massachusetts RECEIVED
v City/Town of No. Andover
System Pumping Record MAY 'IQ CUll
Form 4 TOWN
OF NORTH
ER
HEALTH DEPARTMENT
GSM
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 1. System Location:
forms on the
computer, use 67 Sunset Rock Rd
only the tab key Address
to move your No. Andover Ma 01845
cursor-do not City/Town State Zip Code
use the return
key. 2 System Owner:
Rossi
Name
Address(if different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping 44// o
2911 2. Quantity Pumped: 15l100ns
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 Condition
6. System Pumped By:
+--�-c L n 0 r' c I Cr
Name Vehicle License Number
Stewart's Septic Service
Company
7. Location where contents were disposed:
Stewart's Pre-treatment Plant 20 So. WJ.Bratfford Ma 01835
Signature of Hauler Date"
Signature of Receiv' g acility Date
t5form4.doc•03/06 System Pumping Record•Page 1 of 1
SEPTIC PLAN SUBMITTALS
LOCATION: Lor'-A'
NEW PLANS: YES $60.00/Plan
REVISED PLANS: YES l//," $25.00/Plan
DATE: ZZ
DESIGN ENGINEER.--
When
NGINEER:When the submission is all in place, route to the Health Secretary
Town of North Andover, Massachusetts Form No. 1
oRrM BOARD OF HEALTH
19 i
APPLICATION FOR SITE TESTING/INSPECTION
Q�AATEO PPP`.��J
9SSACHUSE�
i
Applicant
NAME . ADDRESS TELEPHONE
Site Location
Engineer
NAME ADDRESS TELEPHONE
I Test/I nspection Date and Time �' �J �� �U` `�L '
l
`= CHAIRMAN,BOARD OF HEALTH
Fee 7 Test No. 1'
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
FORM 11 - SOIL EVALUATOR FORM
Page 1 of 3
No. Date: 5/19/97
Commonwealth of Massachusetts
North Andover, Massachusetts
Soil Suitability Assessment for On-site Sewage Disposal
Performed By: Steven D'Urso Date: May 1, 1997
Witnessed By: Sandra Starr
File #1647
Location Address or Sunset Rock Road Owner's Name Frank Rossi
Lot# 15 Address and PO Box 3178,Andover,MA 01810
Telephone# (508)683-6277
New Construction . XD Repair
Office Review
Published Soil Survey Available: No F7 Yes —1
Year Published 1981 Publication Scale 1:15840 Soil Map Unit Charlton Holles Complex
Drainage Class Mod.Well-drained Soil Limitations very stoney,steep
Surficial Geologic Report Available: No = Yes
Year Published Publication Scale
Geologic Material(Map Unit)
Landform Esker
Flood Insurance Rate Map:
Above 500 year flood boundary No X Yes
Within 500 year flood boundary No X Yes
Within 100 year flood boundary No X Yes Wetlands near Ipswich River
Wetland Area:
National Wetland Inventory Map(map unit)
Wetlands Conservancy Program Map(map unit)
Current Water Resource Conditions(USGS): Month
Range: Above Normal Normal Below Normal
Other References Reviewed:
DEP APPROVED FORM-12/07/95 soileval.sam
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. Lot#15 Sunset Rock Road,North Andover-Frank Rossi
File# 1647
On - Site Review
Deep Hole Number OP#97-1 Date May 1, 1997 Time Weather
Location(identify on site plan)
Land Use Slope(%) Surface Stones
Vegetation
Landform
Position on landscape(sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG*
OP #97-1
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
Consistency,%
Gravel)
011-511 A FSL 10yr 3/2
5"-3611 BW Stoney SL l0yr 5/8
36"-120" C Stoney SL 5y 4/4
96t1 Observed Ground Water
Could not get in Hole for
REDOX
*MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic) None Depth to Bedrock: None
Depth to Groundwater: Standing Water in the Hole: 96" Weeping from Pit Face:
Estimated Seasonal High Ground Water: None
DEP APPROVED FORM-17/07/95 soileval.sam
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. Lot#15 Sunset Rock Road,North Andover- Frank Rossi
File #1647
On-Site Review
Deep Hole Number OP#97-2 Date May 1, 1997 Time Weather
Location(identify on site plan)
Land Use Slope(%) Surface Stones
Vegetation
Landform
Position on landscape(sketch on the back)
Distances from:
Open Water Body Feet Drainage Way Feet
Possible Wet Area Feet Property Line Feet
Drinking Water Well Feet Other
DEEP OBSERVATION HOLE LOG*
OP#97-2
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency,
%Gravel)
0"-5" A FSL 10y 3/2
5"-34" Bw Stoney SL 7.5yr 4/4
34"-50" Cl Stoney SL, Bldy 2.5y 5/4 Var.
50"-76" C2 BLY SL 5y 4/4
76" CR-
Must Redig
*MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic) Depth to Bedrock: None
Depth to Groundwater: Standing Water in the Hole: None Weeping from Pit Face: None
Estimated Seasonal High Ground Water: None
DEP APPROVED FORM-12/07/95
SOn.EVISAM
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. Lot#15 Sunset Rock Rd.,No.Andover-Frank Rossi
File# 1647
On - Site Review
Deep Hole Number OP#97-2 Date 6/16/97 Time Weather
Location(identify on site plan)
Land Use Woods Slope% Surface Stones
Vegetation Woods
Landform Esker
Position on landscape(sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG*
Redug OP #97-2
Depth from Soil Horizon Soil Texture Soil Color Soil Mottling Other
Surface(Inches) (USDA) (Munsel) (Structure,Stones,Boulders„
Consistency,%
Gravel)
To 117" : The same
Extend C2 to 117"
BLDRY SL
89" REDOX
*MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic): Depth to Bedrock: none
Depth to Groundwater: Standing Water in the Hole: none Weeping from Pit Face:
Estimated Seasonal High Ground Water: 89"
DEP APPROVED FORM-12/07/95 soilevlsam
i .
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. Lot#15 Sunset Rock Rd.,No. Andover-Rossi
Determination for Seasonal High Water Table
Method Used:
X� Depth.observed standing in observation hole See soil l
ogs inches
T1Depth weeping from side of observation hole inches
Xa Depth to soil mottles inches
Ground water adjustment feet
Index Well Number Reading Date Index well level
Adjustment factor Adjusted ground water level
Depth of Naturally Occurring_Pervious Material Too Wet to conduct Soil Profile Analysis.
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system?
If not, what is the depth of naturally occuring pervious material?
Certification
I certify that on 11/94 (date) I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me
consistent with the required training, expertise and experience described in 310 CMR
15.017.
V
Signature'iii -jj�Date June 24, 1997
DEP APPROVED FORM-12/07/95 soileval.sam
MORTfy
ToNvn of __ _ 4Andover
No.
* Z - LAKE- 19 e
dower, Mass.
9 CO CHICHEW ICK i.�.�Y /
S A.rED v
BOARD OF HEALTH.
Food/KitchenIT T �j
PERM DSep c Syste D L l i
p BUILDING INSPECTOR
THIS CERTIFIES THAT............................. ..........!1... ...
Foundation
has permission to erect....................s . buildings on ....
t0 b8 Occupied as.......................................... ..........���7• ., ....... ............................................ Chimney
,provided that the person accepting this permit shall in every respect conform to the term; �of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. �P.? 1"4AA
ri
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION ST T ELECTRIC SPEC R
ough
6 G�............................... .... ..... . ...........................
... . Se
UAL G INSPECTOR
Occupancy Permit Required to Occupy Building
GAS INSPECTOR
p" 41
T ``
Display in a Conspicuous Place on the Premises — Do Not Remove Roughp"
,FrqA
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FRE DEPARTMENT
Burner
Street No.
SmokeDet.
M
i
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
This is to certify that
r.
the individual subsurface disposal system
constructed (x) or repaired ( )
b North y ort Andover Licensed Installer
Robert Slombo
at
Lot#15 Sunset Rock Road, North Andover, MA 01845
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations as described in the Design
Approval Site System Permit# 958 dated July 14, 1997.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
Board of Health Inspector
Zo'd LLZ9 1289 80S 6V:9Z 8662—Zo--inf
TOW` OF NORTH ANDOVER
SEWAGE DUSPO,SAL SYSTEM
INSTALLATION CERTIFICATION ;
The undersigned hereby certify that the Sewage Disposal Svstein'�<)constructed; ( j rcpaircd:
by r\c c r ��sv►,.�i 2� _
located at
was installed in conformance with the North Andover Board of Health approved plats. System
Design Permit " is �dated '7111-1 7 , with an approved design flow of SS 0
gallons per day. The materials used werr,in conformance with those specified on the approved
plan; the system was installed in accordance with the provisions of 310 CMR 15,060 Title 5 and
local regulations.and the final grading agrees substantially with the approved pian. All work is
accurately represented on the As-built which has been submitted to the Board of I iealth.
Acd inspection dste: tJove.l.,,b`< 19167
- lnspecw C•�`f .
Final inspection date: Nov m t5,5 1 £ 4/Z8 9g
lRspector . _... 4 ee,
Installer: T y( r
Trate..
Design Engineer: _ T Date: -7/G/ 9
LO'd LLZ9 E99 SOS UA d9Z =EO 86-ZO- LSC
IVVV GJ iJ.il 1"'''J.7 1(1V11R.7 C. fC,iC R.7.7V1.• ( .V1
From: John Morin Thomas E. Neve Associates, Inc.
Questions? Call 508-887-8586 447 Old Boston Road
Fax 508-887-3480 Topsfield, MA 01983
To: Sandy Starr
Company: NABOH ,
Address:
Date: November 25, 1997
Time: 2:30 PM Pages: 1 (including this one)
Re: Lot 15-Sunset Rock Road
Dear Sandy:
I am writing to inform you that we have performed an as-built of the sanitary disposal
system at the above referenced property and everything is fine. Once the pipe is
installed at the foundation we will finish the as-built plan.
If you have any questions please do not hesitate to call.
Sincerely,
TOTAL P.01
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: , ,% 7 CURRENT INSTALLER'S LICENSE#
LOCATION: 16'r //-1,- 3 -v�S7Ifr, 1/ �R
LICENSED INSTALLER: %� a 13/7/47— 9 6•, '�,
SIGNATURE: *44Za— TELEPHONE# b ° 20-6 >}� G J6
CHECK ONE:
REPAIR: NEW CONSTRUCTION: K
IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
$75.00 Fee Attached? Yes L--� No
Foundation As-built? Yes No
Floor plans on file? Yes `^ No
Approval Date: /
Town of North Andover, Massachusetts F°'"' No.a
BOARD OF HEALTH
%ORTN
Z.e
DISPOSAL WORKS CONSTRUCTION PERMIT
• SSACHUS
-
Applicant0�
NAME ADDRESS TELEPHONE
Lar /� vv,e-r,r-
- - Site Location 5 _
4 _
- Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. q
�
CHAIRMAN,BOARD OF HEALTFF
Fee
$75 D.W.C. No.
7/
a; -
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
• SU�IISET �OC� �j�`• � .'7
APPLICANT: ���� 0�5 T,e Phone
LOCATION: Assessor's Map Number Parcel
Subdivision 1d�5'1qn -PL/4Ce� -��- Lot(s)
Street vC��V<SC--T�C �� St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
Q�-� Date Approved
Septic Inspector-Health Date Rejected
A
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
THO NEVE
ASSGIATE , INC.
June 24, 1997 j
Ms. Sandy Starr
Board of Health
.+.a.ww•c+sJ4
30 School Street
North Andover, MA 01845
Re: Lot 15 Sunset Rock Road
Dear Sandy:
Please find enclosed 3 prints of the revised sanitary disposal system design for the above-
referenced lot.
On Monday, June 23, 1997 I had discussed with you the possibility of redesigning the system for
a design flow of 440 gallons/day. You informed me that•if that were the case the design would
be treated as a redesign and would have to go through the review process. However, you did
indicate that if the existing design was revised according to the new test pits performed (ie: any
elevation changes required) and the soil evaluation forms were submitted then you could
approve the original design. Our client has waited several months to reach this point and further
has instructed us to proceed in the most expeditious way.
Please find attached revised plans which show the following-
-I' System design flow remains at 660 gallons/day.
2. Design system on new Title V loading rates therefore reducing system size from 1224 s.f.
to 1200 s.f.
3. Reduce fill requirement from 10' to 5'.
44. Add gas deflector to septic tank detail.
—5--'' Add note regarding lines from d=box.
6. Add note that excavation of topsoil and subsoil to extend at least 6" into natural pervious
material.
�7! Assessors map and parcel.
8� Revise note 14 to include wetlands.
9!� Add soil logs 97-1 and 97-2.
10. Revise all inverts and system components 0.1' according to results of test pit 97-2.
11. Add spot grades at foundation and septic tank.
12! Add elevation of perc tests
• ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS •
447 Old Boston Road U.S. Route #1 Topsfield, MA 01983
ku''J) ..v: FAX (505) 8887-3480
THO , NEVE
ASSOCIATE , INS.
April 3, 1997 � ���
air66 �-P07LTA /
Aft ` 8 IM7
Ms. Sandy Starr
Board of Health
146 Main Street
North Andover, MA 01845
Re: Lot 15 Sunset Rock Road
Dear Sandy:
It is our understanding that on Thursday, March 27, 1997 our client, Frank Rossi,
submitted to your office the fee for soil testing to be conducted at the above-referenced
lot.
Find attached a copy of the septic design of which the tests have expired and new deep
hole observation test pits will be required. It is our intention conduct new deep hole tests
and then redesign the system under the new 1995 Title V.
Please contact us at your earliest convenience to schedule this testing.
Very truly yours,
THOMAS E. NEVE ASSOCIATES, INC.
Kathy Molina
Personal Assistant
Enclosure
cc: Frank Rossi
ROSSIMPS
• ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS •
447 Old Boston Road U.S. Route #1 Topsfield, MA 01983
(508) 887-8586 FAX (508) 887-3480
=yTown of North Andover MassachusettsV
Form No.2
BOARD OF HEALTH
DESIGN APPROVAL FOR
CH
SOIL SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
' Applicant_�J,� Test No.
Site.Location- A'
Reference Plans and Specs. - 4 517
ENGINEER —DESIGN 6ATE
Permission is granted for an individual soil absorption sewage disposal system to be installed ;. ._
in accordance with regulations of Board of Health.
CHAIRMAN,BOARD OF HEALTH
Fee Site System Permit No. s�
y
' ]:.... ,n;,.:'�,y" --�r :s. rC. ^�- •t '� �,xc.^rc � . ;t€,. y e .�'.n� l�J.:.f] "i��.. h-:4_a+s x;�(1'�f.3s.t!
j,
•r {, Uzi S '
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- -��-- -gyp `�- ---- -- ---- -- - v- � -- � -
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...'�'�wiTlLv �..� '�'+.•_..'.".,.s..aenhal�—_.�.�."`� - .a `. ..,�.f+[ir..- . '--"r--: — s ._.,-._.�
I
16
TOWN OF NORTH ANDOVER --------
SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System constructed; ( )repaired;
by
located at a �fS ��AnSe4
was installed in conformance with thee North Andover Board of Health approved plan, System
Design Permit# dated �l!`�l 9 7 , with an approved design flow of ,rs L)
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.
Bed inspection date:
_InspEcter
Final inspection date:
Jspector
f
Installer: Lic. #: Date:
Design Engineer: Date:
PLAN REVIEW CHECKLIST
ADDRESS ENGINEER ��V6�
GENERAL � ZZaCU�
3 COPIES STAMP �� LOCUS t� NORTH ARROW �� SCALE `--�
.�tj A
CONTOURS PROFILE,-,--- SECTION BENCH MARK0'Ot',j IL &
PERC INFO ELEVATIONS WETS. DISCLAIMER WELLS &
WETLANDS I/ WATERSHED?410 DRIVEWAY --- (Elev) WATER LINE
FDN DRAIN L,,-- SCH40 C,--' TESTS CURRENT?
SEPTIC TANK
MIN 1500G L-- � . 17 INVERT DROP !/ GARB. GRINDER(+200% EDF)
25 ' TO CELLAR L" MANHOLE TO GRADE / ELEV GW
D-BOX
SIZE # LINES 3 FIRST 2 ' LEVEL STATEMENT
INLET ,���.�� - OUTLET /LD • = ry (2" OR . 17 FT) TEE REQ'D? /U6
, A6
LEACHING
MIN 660 GPD? -�,/ RESERVE AREA L-- 4 ' FROM PRIMARY? i-�2% SLOPE
`�-
100 ' TO WETLANDS �/� 100 ' TO WELLS k--'- 4 ' TO ,S.H.GW
35 ' TO FND & INTRCPTR DRAINS 325 ' TO SURFACE H2O SUPP
4 ' PERM. SOIL BELOW FACILITY bl�— MIN 12" COVER '--�FILL? (25 '
if above natural elev; 101if below) BREAKOUT MET?
6 ° /—e.
TRENCHES
MIN 660 gpd f,� SLOPE (min . 005 or 6"/1001 ) >31COVER?-VENT
SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) �� IS RESERVE BETWEEN
TRENCHES? IN -FILL? ✓MUST BE 10MIN. C----- 4" PEA STONE?
BOT_ X LDNGI-2 + SIDE 61� X LDNG 45.121TOT ,
(L x W x #) (G/ft2) (DxLx2x#) (G/ft2)
60
Copyright @1993 by S.L.Starr �0 6
i
I
T H
0 NEVE
AS "CIATE INC.
7 + ' , OVER/24, 1997 � i'
Ms. Sandy Starr JUN 26199
Board of Health
30 School Street
North Andover MA 01845
Re: Lot 15 Sunset Rock Road
Dear Sandy:
Please find enclosed 3 prints of the revised sanitary disposal system design for the above-
referenced lot.
On Monday, June 23, 1997 I had discussed with you the possibility of redesigning the system for
a design flow of 440 gallons/day. You informed me that if that were the case the design would
be treated as a redesign and would have to go through the review process. However, you did
indicate that if the existing design was revised according to the new test pits performed (ie: any
elevation changes required) and the soil evaluation forms were submitted then you could
approve the original design. Our client has waited several months to reach this point and further
has instructed us to proceed in the most expeditious way.
Please find attached revised plans which show the following:
1. System design flow remains at 660 gallons/day.
2. Design system on new Title V loading rates therefore reducing system size from 1224 s:f.
to 1200 s.f.
3. Reduce fill requirement from 10' to 5'.
4. Add gas deflector to septic tank detail.
5. Add note regarding lines from d-box.
6. Add note that excavation of topsoil and subsoil to extend at least 6" into natural pervious
material.
7. Assessors map and parcel.
8. Revise note 14 to include wetlands.
9. Add soil logs 97-1 and 97-2.
10. Revise all inverts and system components 0.1' according to results of test pit 97-2.
11. Add spot grades at foundation and septic tank.
12. Add elevation of perc tests
• ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS •
447 Old Boston Road U.S. Route #1 Topsfield, MA 01983
(508) 887-8586 FAX (508) 887-3480
..J Y
Ms. Sandy Starr Page 2
June 24, 1997
I hope you agree that these revisions do not require a full review and that you can issue the
approval of this design as soon as reasonably possible -as our client would like to start
construction immediately.
If you have any questions or concerns please do not hesitate to call.
Thank you for your time and effort in resolving this matter.
Very truly yours,
THOMAS E. NEVE ASSOCIATES, INC.
of-
John M. Morin, P.E.
Civil Engineer
JMWkmm
Enclosures
M. Frank Rossi
#1647 ROSSI.V TS
FORM U - IAT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: '�-='�- Phone
LOCATION: Assessor's
Mar Number Parcel
Subdivision ���Xl&. r 'A'I-e Lot(s)
Street �/J �P` ,C,L i/10/ St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Conservation Administrator Date ApprovedDate Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Food Inspector-Health Date Approved
Date Rejected
' o
Date Approved 7 aO A�
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
Town of North Andover, Massachusetts Form No.2
of N0*T#f BOARD OF HEALTH
o � r3qq
19—
DESIGN APPROVAL FOR
Ss""USE< SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant Test No.
Site Location t�i)—F 1,5 ( r 1'r ire(
Reference Plans and Specs. I 0�-� Y\J—A�
ENG®rHealth.
DESIGN
DATE
Permission is granted for an indiabsorption sewage disposal system to be installed
in accordance with regulations of
--\\ --CHATRMAN,BOARD OF HEALTH
Fee r Site System Permit No. /U Z `
:_r `
HORTIy
0 BOARD OF HEALTH
A
120 MAIN STREET TEL. 682-6483
�.ISACHUSNORTH ANDOVER, MASS. 01845 Ext23
January 27, 1995
Mr. Thomas Neve
447 Old Boston Road
Topsfield, MA 01983
Re: Lot 15 Sunset Rock Road
Dear Tom:
This is to inform you that the proposed plans for site
referenced above have been disapproved for the following reasons:
1) CB not 50 feet from leaching area. What is CB
elevation?
If you have any questions, please do not hesitate to
call the Board of Health Office at the number above.
Sincerely,
Sandra Starr, R.S.
Health Administrator
SS/cjp
DATE �� �� 9� Sheet of
BOARD OF HEALTH
TOWN OF NORTH ANDOVER
SUBSURFACE DISPOSAL DESIGN REVIEW
FEE 6o PERMIT = � DATE RECEIVED
APPLICANT j{)AJ05 Z ASSESSOR' S MAP
ADDRESS PARCEL
LOT /'1-17
STREET
ENGINEER
ADDRESS 407 OLD--86o
PI T DATE /Z / ep /?5L REVISION DATE
COivDT'TONS OF APPROVAL:
APPROVED
DISAPPROVED X
P
a JUL 919P
e
THO NEVE ---�
ASS CIATES, INC.
July 8, 1997
Ms. Sandy Starr
Board of Health
30 School Street
North Andover, MA 01845
Re: Lot 15 Sunset Rock Road
Dear Sandy:
In accordance with 310 CMR 15.018 - Function of Soil Evaluators, find enclosed copies
of the certification forms for the soil testing which was conducted at the above-
referenced property on May 1, 1997.
If you should have any questions regarding any of this information please do not hesitate
to contact our office.
Very truly yours,
THOMAS E. NEVE ASSOCIATES, INC.
Thomas E. Neve, PE, PLS
President, CEO
TEN/km
Enclosures
#1647 NASOILEV.WPS
• ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS •
447 Old Boston Road U.S. Route #1 Topsfield, MA 01983
(508) 887-8586 FAX (508) 887-3480
FORM 11 - SOIL EVALUATOR FORM
Page 1 of 3
No. Date: 5/19/97
Commonwealth of Massachusetts
North Andover, Massachusetts
Soil Suitabilitv Assessment for On-site Sewage Disposal
Performed By: Steven D'Urso,RS Date: May 1, 1997
Witnessed By: Sandra Starr
File #1647
Location Address or Sunset Rock Road Owner's Name Frank Rossi
Lot# 15 Address and PO Box 3178,Andover,MA 01810
Telephone# (508)683-6277
New Construction Repair ❑
Office Review
Published Soil Survey Available: No F-1 Yes
Year Published 1981 Publication Scale 1:15840 Soil Map Unit Charlton Holles Complex
Drainage Class Mod.Well-drained Soil Limitations very stoney,steep
Surficial Geologic Report Available: No = Yes
Year Published Publication Scale
Geologic Material(Map Unit)
Landform
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes X
Within 500 year flood boundary No X Yes
Within 100 year flood boundary No X Yes
Wetland Area:
National Wetland Inventory Map(map unit)
Wetlands Conservancy Program Map(map unit)
Current Water Resource Conditions(USGS): Month
Range: Above Normal Normal Below Normal
Other References Reviewed:
DEP APPROVED FORM-12/07/95 soileval.sam
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. Lot#15 Sunset Rock Road,North Andover-Frank Rossi
File# 1647
On - Site Review
Deep Hole Number OP#97-1 Date May 1, 1997 Time Weather
Location(identify on site plan)
Land Use Woods Slope(%) B Surface Stones
Vegetation Hardwoods
Landform Moraine
Position on landscape(sketch on the back)
Distances from:
Open Water Body feet Drainage way >100 feet
Possible Wet Area >100 feet Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG*
OP #97-1
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
Consistency,%
Gravel)
0"-511 A FSL l0yr 3/2
5"-36" Bw Stoney SL l0yr 5/8
36"-120" C Stoney SL 5y 4/4
96" Observed Ground Water
Could not get in Hole for
REDOX
*MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic) Till Depth to Bedrock: None
Depth to Groundwater: Standing Water in the Hole: 96" Weeping from Pit Face:
Estimated Seasonal High Ground Water: 96"
DEP APPROVED FORM-12/07/95 soileval.sam
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. Lot#15 Sunset Rock Road,North Andover- Frank Rossi
File #1647
On-Site Review
Deep Hole Number OP#97-2 Date May 1, 1997 Time Weather
Location(identify on site plan)
Land Use Woods Slope(%) B Surface Stones
Vegetation Hardwoods
Landform Moraine
Position on landscape(sketch on the back)
Distances from:
Open Water Body Feet Drainage Way >100 Feet
Possible Wet Area >100 Feet Property Line Feet
Drinking Water Well Feet Other
DEEP OBSERVATION HOLE LOG*
OP#97-2
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency,
%Gravel)
0"-5" A FSL 10y 3/2
5"-34" Bw Stoney SL 7.5yr 4/4
34"-50" C 1 Stoney SL, Bldy 2.5y 5/4 Var.
50"-76" C2 BLY SL 5y 4/4
76" CR-
Must Redig
*MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic) Till Depth to Bedrock: 76"
Depth to Groundwater: Standing Water in the Hole: None Weeping from Pit Face: None
Estimated Seasonal High Ground Water:
DEP APPROVED FORM-12/07/95
SOII.EV2.SAM
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. Lot#15 Sunset Rock Rd.,No.Andover-Frank Rossi
File# 1647
On - Site Review
Deep Hole Number OP#97-2 Date 6/16/97 Time Weather
Location(identify on site plan)
Land Use Woods Slope% Surface Stones
Vegetation Woods
Landform Esker
Position on landscape(sketch on the back)
Distances from:
Open Water Body feet Drainage way feet
Possible Wet Area feet Property Line feet
Drinking Water Well feet Other
DEEP OBSERVATION HOLE LOG*
Redug OP #97-2
Depth from Soil Horizon Soil Texture Soil Color Soil Mottling Other
Surface(Inches) (USDA) (Munsel) (Structure,Stones,Boulders„
Consistency,%
Gravel)
To 117" : The same
Extend C2 to 117"
BLDRY SL
89" REDOX
*MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Parent Material(geologic): Depth to Bedrock: none
Depth to Groundwater: Standing Water in the Hole: none Weeping from Pit Face:
Estimated Seasonal High Ground Water: 89"
DEP APPROVED FORM-12/07/95 soilevZsam
t
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. Lot#15 Sunset Rock Rd.,No. Andover-Rossi
I
Determination for Seasonal High Water Table
See Individual Logs
Method Used:
71 Depth observed standing in observation hole See individual logs inches
71 Depth weeping from side of observation hole inches
71 Depth to soil mottles inches
Ground water adjustment feet
Index Well Number Reading Date Index well level
Adjustment factor Adjusted ground water level
Depth of Naturally Occurring Pervious Material Too Wet to conduct Soil Profile Analysis.
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system? Yes, After redug
If not, what is the depth of naturally occuring pervious material?
Certification
I certify that on 11/94 (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me
consistent with the required training, expertise and experience described in 310 CMR
15.017.
Signaturef> Date June 24, 1997
DEP APPROVED FORM-12/07/95 soileval.sam