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North Andover Health Department
Community and Economic Development Division
June 2, 2015
39 Cotuit Street, LLC
733 Turnpike Street #217
North Andover, MA 01845
BL'jCopy
Re: Subsurface Sewage Disposal System Plan for 674 Turnpike Street (Map 98D, Lot 21)
To Whom It May Concern:
The proposed wastewater system design plan for the above site dated January 13, 2015 with a
final revision date of May 1, 2015 and received on May 8, 2015 has been approved.
The design plan has been approved for use in the construction of a new on-site septic system for
a 3 -bedroom home utilizing a Micro FAST secondary treatment unit and a Quick 4 Low Profile
Infiltrator Chamber system. This design plan approval is valid until June 2, 2017.
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.
At a regularly scheduled meeting of the Board of Health, this plan received the following
approvals by the members.
Local Upgrade Approvals:
• To reduce the setback from the soil absorption system to the property line from 10' to 6'
• To reduce the setback from the soil absorption system to the foundation from 20' to 18'
• To reduce the separation distance from the soil absorption system to the estimated
seasonal high ground water table from 4' to 3'
• To use a sieve analysis in lieu of a percolation test
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
674 Turnpike Street June 2, 2015
North Andover Board of Health Variances:
• To reduce the setback from the septic tank to the wetland resource area from 75' to 29'
• To reduce the setback from the soil absorption system to the wetland resource area from
100' to 50'
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 Commission,
Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical
Inspector. The issuance of a Disposal System Construction Permit shall not construe
and/or imply compliance with any of the aforementioned requirements.
3. The proposed secondary treatment unit will be required to be under an operations and
maintenance agreement for the life of the septic system as required by the Massachusetts
Department of Environmental Protection and the North Andover Board of Health
Wastewater Regulations. Prior to installation, a contract will need to be in place with an
individual or firm to provide for routine maintenance. The length of the contract shall be
at least 2 years and must be renewed at least 30 days prior to expiration. Information on
this system, as well as the maintenance requirement, must be recorded with the title of the
property at the Registry of Deeds with proof of such recording provided to the Health
Department.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
_Sincerely,
r�P iry-.
ichele Grant
Health Inspector
Encl. Installers list
cc: Jack Sullivan, PE
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
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Cc: Isaac Rowe; Hughes, Jennifer; Gaffney, Heidi; Sawyer, Susan
Subject: Re: 674 Turnpike, NA - Updated Septic Repair Plans in pdf format
Michele,
Thanks for your input on this site. I am attaching pdfs of the revised plans for everyone's records. I
will be mailing 3 original stamped copies with a $75 check to the Board of Health tomorrow. I will be
mailing 2 original stamped full size plans with 7 reduced size copies to the Conservation Commission
tomorrow.
My plan is to proceed with Conservation. I understand you will forward my plans to Issac at Mill River
for another review and then if everything looks good I would need to appear before the Board of
Health for the variance and local upgrade approvals.
Jennifer ... can you let me know when the next Con. Comm meeting is ... I will have plans to you by
monday at the latest. I am not sure if you had a chance to review the wetland line by Norse
Environmental yet ... but my plan accurately reflects the wetland flags Norse delineated.
Thank you for everyone's help and assistance on a truly difficult site....
Jack Sullivan
781-854-8644
From: "Michele Grant" <mqrant -townofnorthandover.com>
To: "Jack Sullivan" net>
Cc: "Isaac Rowe" <irowe _millriverconsulting.com>
Sent: Tuesday, May 5, 2015 12:13:04 PM
Subject: FW: 674 Turnpike - Septic Plan - Need for Town Input
Hi Jack,
Please see Isaac's response. Please feel free to contact Isaac, his phone is listed below. Keep me apprised of
any conversation and changes to the plan.
Thank you
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgrant@townofnorthandover.com
Web www.TownofNorthAndover.com
From: Isaac Rowe [ma i Ito: i rowe0)miIIriverconsulting.com]
Sent: Monday, May 04, 2015 3:05 PM
To: Grant, Michele
Cc: Isaac Rowe
Subject: RE: 674 Turnpike - Septic Plan - Need for Town Input
I would recommend the designer resubmit the revised design plan with the new wetland line and additional variance
requests noted on the plan. MRC will review the revised plan and submit any questions/comments to the Health
Department.
Even though Title 5 variances will be requested the applicant does not need to submit a variance request application to
DEP. The review of variances by DEP has been removed from Title 5 regulations and is no longer required expect in
particular situations.
Thanks,
Isaac M. Rowe, R.S.
Project Manager
Mill River Consulting
6 Sargent Street
Gloucester, MA 01930-2719
Phone: 978-282-0014 ext.804
Fax: 978-282-1318
irowe(a),millriverconsulting.com
www.miliriverconsulting.com
From: Grant, Michele[mailto:mgrant(cbtownofnorthandover.coml
Sent: Monday, May 04, 2015 2:35 PM
To: 'Isaac Rowe'
Subject: FW: 674 Turnpike - Septic Plan - Need for Town Input
Hi Isaac,
Please see below and the attached..... What are your thoughts?
Thank you
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgrant@townofnorthandover.com
Web www.TownofNorthAndover.com
From: Jack Sullivan [mailto:jacksull53(-Ocomcast.net]
Sent: Friday, May 01, 2015 6:28 PM
To: M Yamin
Cc: Sawyer, Susan; Grant, Michele; Hughes, Jennifer; Gaffney, Heidi; Willett, Tim
Subject: Re: 674 Turnpike - Septic Plan - Need for Town Input
Mohammad & Town Staff;
I recently had Norse Environmental come out to the above property to clarify the wetland line based
on in-depth soil probes to determine the limit of hydric soils. The previous wetland line used was
taken from a plan by others for a proposed redevelopment of this property as a Roast Beef restaurant
which never materialized. Upon review mutual review of the wetland line with Jennifer and myself it
appeared the wetland line would need to be brought more upgradient, which was confirmed by Norse
Environmental.
The result of the wetland delineation performed by Norse Environmental presents a problem for use
of an upgraded septic system... specifically almost the entire site is within the 50 foot buffer to the
wetlands. State Title 5 code requires 50 feet from a wetland to a soil absorption system and North
Andover requires 100 feet .... thus the problem. The existing septic system is failed and as you can
see from the attached plan it appears at least one of the leaching pits is in the wetland area. So this
email might be more appropriate for the Board of Health to comment on, but I wanted to keep all
departments in the loop since this is an active wetland filing.
I have never had a situation where I was unable to fit a septic system onsite. The Town sewer is over
400 feet away and furthermore individual sewer force mains are not allowed per DPW.
Susan & Michelle .... I am not sure if you have run into this situation before. MY THOUGHT IS WITH
THE MICRO FAST UNIT PROVIDING DE-NITROFICATION THE DEP WOULD PROBABLY
GRANT A VARIANCE FROM THE 50 FOOT WETLAND SETBACK REQUIREMENT. This would
also require a variance from the North Andover BOH and Conservation. I do not think DEP would
allow a tight tank since they typically want to see some sort of soil absorption field if there is any land
area that would allow some treatment, even with a setback variance. If you could forward this email
and plan to Mill River for comment that might be helpful. If everyone agrees the best option is to
pursue the DEP variance on wetland setback I can look to prepare the application and continue the
public hearing process with Conservation. I would look to submit the variance paperwork to the NA
BOH at the same time the DEP variance request is submitted.
The owner and I would like to try to finalize some type of design to finally remedy the failed septic
system... please let me know the best course of action to take.
Thank you.
rg
ONSITE W C
LOCATION INFI -16'
ADDRESS: 67, O �r
INSTALLER:
DESIGNER: Ja(
PLAN DATE: -
BOH APPROVAL DATE ON PLAN:
INSPECTIONS
TANK INSPECTION:
DATE OF BED BOTTOM INSPECTION:
DATE OF FINAL CONSTRUCTION INSPECTION:
DATE OF FINAL GRADE INSPECTION:
SITE CONDITIONS
Comments:
SEPTIC TANK
UCTION NOTES
3.D LOT: 0021
❑ Contractor reports any changes to design plan
❑ Existing septic tank properly abandoned
❑ Internal plumbing all to one building sewer
❑ Topography not appreciably altered
❑ Building sewer in continuous grade, on
compacted firm base
❑ Cleanouts per plan
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 gallon tank has been installed
H-10 loading
❑ Monolithic tank construction
❑ Water tightness of tank has been achieved by
visual testing
❑ Inlet tee installed, centered under access port
North Andover Health Department
fommunity and Economic Development Division
ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 674 Turnpike St. MAP: 098.D LOT: 0021
INSTALLER:
DESIGNER: Jack Sullivan
PLAN DATE:
BOH APPROVAL DATE ON PLAN:
INSPECTIONS
TANK INSPECTION:
DATE OF BED BOTTOM INSPECTION:
DATE OF FINAL CONSTRUCTION INSPECTION:
DATE OF FINAL GRADE INSPECTION:
SITE CONDITIONS
Comments:
SEPTIC TANK
❑ Contractor reports any changes to design plan
El Existing septic tank properly abandoned,'
❑ Internal plumbing all to one building sewer
❑ Topography not appreciably altered
❑ Building sewer in continuous grade, on
compacted firm base
❑ Cleanouts per plan
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 gallon tank has been installed
H-10 loading
❑ Monolithic tank construction
❑ Water tightness of tank has been achieved by
visual testing
❑ Inlet tee installed, centered under access port
❑ Outlet tee installed, centered under access port
(gas baffle/effluent filter)
❑ inch cover to within 6" of finish grade
installed over one access port
❑ Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 gallon Pump Chamber installed
❑ H-10 loading
❑ Monolithic tank 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
❑ cover at final grade installed over pump
access port
❑ Water tightness of tank has been achieved by
testing
❑ Hydraulic cement around inlet & outlet
Comments:
CONTROLPANEL
❑ Alarm & Pump are on separate circuits
❑ Alarm sounds when float is tripped
❑ Location of control panel: basement
❑ Alarm signal located inside: basement
Comments:
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
❑ Speed levelers provided (not required)
❑ Schedule 40 PVC Pipe
Comments:
SOIL ABSORPTION SYSTEM (General)
❑ Bottom of SAS excavated down to C soil layer,
as provided on plan
❑ Size of SAS excavated as per plan
❑ Title 5 sand installed, if specified on plan
❑ 40 Mil HDPE barrier installed
❑ Laterals installed and ends connected to
header (and vented if impervious material
above)
❑ Elevations of laterals and chambers installed as on
approved plan
❑ Retaining wall (boulder / concrete / timber/ block)
❑ Final cover as per plan
Comments:
SOIL ABSORPTION SYSTEM (Gravel -less Chambers)
❑ Brand and Model of Chamber: Standard Quick
4 Infiltrator Chambers
❑ Number of chambers per row:
❑ Number of rows (trenches):
Comments: Total Chambers =
FINAL GRADE
❑
Loamed
❑
Seeded
❑
Cover per plan
Comments:
DOCUMENTS NEEDED
❑ Certification of Installation Form submitted
By engineer and signed and dated by
Engineer and installer
❑ As -Built Plan
BM =
HR=
HI =
SYSTEM ELEVATIONS
SKETCH PLAN
ROD
ELEVATION
AS -BLT INVERT
ELEV
DESIGN INVERT
ELEV
Benchmark
Building Sewer OUT
Septic Tank IN
Septic Tank OUT
Pump Chamber IN
Pump Chamber OUT
Distribution Box IN
Distribution Box OUT
Lateral 1 TOP
Lateral 1 INVERT
Lateral 2 TOP
Lateral 2 INVERT
Lateral 3 TOP
Lateral 3 INVERT
Lateral 4 TOP
Lateral 4 INVERT
Lateral 5 TOP
Lateral 5 INVERT
Lateral 6 TOP
Lateral 6 INVERT
Top of Chamber
Bottom of Bed/Chamber
SKETCH PLAN
CRITICAL SETBACK DISTANCES
Mark those distances checked in the field against the design plan and regulatory
setback
® Wetlands bordering surface
water supply or trib. (in Watershed)
Tank
SAS Sewer
®
Property line
10
10 --
®
Cellar wall
10
20 --
®
Inground pool
10
20 --
®
Slab foundation
10
10 --
®
Deck, on footings, etc
5
10 --
®
Waterline
10
10 10'
®
Private drinking well
75
1002 50
®
Irrigation well
75
100
®
Surface Water
25
50
®
Bordering Vegetated Wetland ,
Salt Marsh, Inland / Coastal Banka
75
100
® Wetlands bordering surface
' 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
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
Grant, Michele
From: Blackburn, Lisa
Sent: Wednesday, May 13, 2015 11:27 AM
To: Grant, Michele
Subject: FW: 674 Turnpike Road
From: Blackburn, Lisa
Sent: Wednesday, May 13, 2015 11:26 AM
To: 'Isaac Rowe'
Subject: RE: 674 Turnpike Road
Michele,
Are you letting Jack know about this? Is he coming back before the Board? I know he probably needs to inform
the abutters.
From: Isaac Rowe[ma iIto: irowe(a-)milIriverconsulting.coml
Sent: Wednesday, May 13, 2015 11:04 AM
To: Grant, Michele; Blackburn, Lisa
Cc: Isaac Rowe; Pam Lally
Subject: 674 Turnpike Road
Michele/Lisa,
I have completed my review of the revised design plan for the above referenced property. The items from the
disapproval letter dated 3/15/15 have been addressed and the variance requests modified as needed due to the new
wetland edge.
The applicant is requesting (2) local variances for a reduction in wetland setbacks and (4) local upgrade approval
requests. These are shown on the top of sheet 1. The (2) local variance requests and LUA #4 DO require abutter
notification per the BOH Septic regs section 8 and Title 5. Please review this section of the BOH septic regs. I would
interpret "all abutters" as all direct abutters to the subject property, this includes abutters directly across the street too.
Please let me know if you have any questions.
Thanks,
Isaac M. Rowe, R.S.
Project Manager
Mill River Consulting
6 Sargent Street
Gloucester, MA 01930-2719
Phone: 978-282-0014 ext.804
Fax: 978-282-1318
irowe anmillriverconsultina.com
www.millriverconsulting.com
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
May 8, 2015
Town of North Andover Health Dept. RECEIVED
c/o Michele Grant MAY 12 2015
1600 Osgood Street, Suite 2035
North Andover, MA 01845 TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Re: Septic Upgrade Plans (Revised)
674 Turnpike Street, North Andover
Ms. Grant;
Due to a typo error on the submitted Sheet 1 on 5/7/15 to your office, a new Sheet 1 is being submitted.
Please look to discard the previous Sheet 1 on all sets and replace with this new sheet.
You will find two (2) new Sheet 1 enclosed.
I have mailed under separate cover the following:
1) One (1) Sheet 1 to Issac Rowe at Mill River Consulting
2) Two (2) Sheet 1 plans (full size) and seven (7) reduced size to the Conservation Commission
Sorry for the confusion.
Cc: Jennifer Hughes, Conservation Agent
Issac Rowe, Mill River Consulting (Review Agent for NA BOH)
PO Box 2004 Woburn, MA 01888 (781) 854-8644
Blackburn, Lisa
From: Jack Sullivan <jacksull53@comcast.net>
Sent: Monday, May 18, 2015 10:57 AM
To: Blackburn, Lisa
Cc: Grant, Michele
Subject: Re: 674 Turnpike, NA - Request for Public Hearing with Board of Health
Lisa,
The following is a summary of the Local Upgrade Approvals required and Variances requested:
Local Upgrade Approvals Request:
1) To allow a three foot separation between the bottom of the infiltrator units.and the seasonal high
groundwater table (4 feet required)
2) A sieve analysis in lieu of field percolation test due to the amount of fill onsite and the high
seasonal ground ater table
3) To allow a^ffQo setback from the building foundation to the soil absorption system (20 feet
required) --W
4) To allow a 6 foot setback from the property line to the soil absorption system (10 feet required)
Variances Request:
1) Setback distance from wetlands to septic tank (29 feet requested, 75 feet required under local
bylaw)
2) Setback distance from wetlands to soil absorption system (50 feet requested, 100 feet required
under local bylaw, 50 feet under Title 5)
Thank you.
Jack Sullivan
781-854-8644
From: "Lisa Blackburn"<LBlackburnC�townofnorthandover.com>
To: "Jack Sullivan" <iacksuII53Ca)_comcast.net>
Cc: "Michele Grant" <mgrant townofnorthandover.com>
Sent: Monday, May 18, 2015 8:16:30 AM
Subject: RE: 674 Turnpike, NA - Request for Public Hearing with Board of Health
Good Morning,
Could you possibly send another email that spells out for the Board Members exactly what you are requesting
from them at the next meeting? I want them to be sure what is being asked of them. Thanks.
From: Jack Sullivan [mailto:jacksu1153@comcast.netI
Sent: Friday, May 15, 2015 10:38 AM
To: Grant, Michele
Blackbbrn, Lisa
From: Jack Sullivan <jacksu1153@comcast.net>
Sent: Friday, May 15, 2015 10:38 AM
To: Grant, Michele
Cc: Isaac Rowe; Sawyer, Susan; Blackburn, Lisa; M Yamin
Subject: Re: 674 Turnpike, NA - Request for Public Hearing with Board of Health
Michele,
Please accept this email as a written request to be heard at the May 28th North Andover Board of
Health meeting to discuss local upgrade approvals and variances associated with the Septic Upgrade
plan for 674 Turnpike Street. As you know, the Conservation Commission has already approved the
project, including variances, under the Wetland Protection Act and local Con. Comm. bylaws. I will
prepare the notice to abutters as required for the May 28th meeting at Town Hall for 7:00 pm.
Thank you. I have copied the owner on this email as well.
Jack Sullivan
781-854-8644
Grant; Michele
To: Jack Sullivan
Cc: Isaac Rowe
Subject: RE: 674 Turnpike, NA - Updated Septic Repair Plans in pdf format
Thank you Jack,
Question .... Is that well being utilized???
Thx
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgrant@townofnorthandover.com
Web www.TownofNorthAndover.com
From: Jack Sullivan [mailto:jacksu1153@comcast.net]
Sent: Thursday, May 07, 2015 10:53 AM
To: Grant, Michele
Cc: Isaac Rowe; Hughes, Jennifer; Gaffney, Heidi; Sawyer, Susan
Subject: Re: 674 Turnpike, NA - Updated Septic Repair Plans in pdf format
Michele,
Thanks for your input on this site. I am attaching pdfs of the revised plans for everyone's records.
will be mailing 3 original stamped copies with a $75 check to the Board of Health tomorrow. I will be
mailing 2 original stamped full size plans with 7 reduced size copies to the Conservation Commission
tomorrow.
My plan is to proceed with Conservation. I understand you will forward my plans to Issac at Mill River
for another review and then if everything looks good I would need to appear before the Board of
Health for the variance and local upgrade approvals.
Jennifer ... can you let me know when the next Con. Comm meeting is ... I will have plans to you by
monday at the latest. I am not sure if you had a chance to review the wetland line by Norse
Environmental yet—but my plan accurately reflects the wetland flags Norse delineated.
1
Thank you for everyone's help and assistance on a truly difficult site....
Jack Sullivan
781-854-8644
From: "Michele Grant" <mgrant townofnorthandover.com>
To: "Jack Sullivan" <*acksu1153a-comcast.net>
Cc: "Isaac Rowe" <irowe �millriverconsulting.com>
Sent: Tuesday, May 5, 2015 12:13:04 PM
Subject: FW: 674 Turnpike - Septic Plan - Need for Town Input
Hi Jack,
Please see Isaac's response. Please feel free to contact Isaac, his phone is listed below. Keep me apprised of
any conversation and changes to the plan.
Thank you
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgrant@townofnorthandover.com
Web www.TownofNorthAndover.com
From: Isaac Rowe[maiIto: irowePmilIriverconsulting.coral
Sent: Monday, May 04, 2015 3:05 PM
To: Grant, Michele
Cc: Isaac Rowe
Subject: RE: 674 Turnpike - Septic Plan - Need for Town Input
I would recommend the designer resubmit the revised design plan with the new wetland line and additional variance
requests noted on the plan. MRC will review the revised plan and submit any questions/comments to the Health
Department.
Even though Title 5 variances will be requested the applicant does not need to submit a variance request application to
DEP. The review of variances by DEP has been removed from Title 5 regulations and is no longer required expect in
particular situations.
Thanks,
Isaac M. Rowe, R.S.
Project Manager
Mill River Consulting
6 Sargent Street
Gloucester, MA 01930-2719
Phone: 978-282-0014 ext.804
Fax: 978-282-1318
irowe D,rnillriverconsulting.com
www.miliriverconsulting.com
From: Grant, Michele [ma iIto: mgrant(&townofnorthandover.com]
Sent: Monday, May 04, 2015 2:35 PM
To: 'Isaac Rowe'
Subject: FW: 674 Turnpike - Septic Plan - Need for Town Input
Hi Isaac,
Please see below and the attached.....What are your thoughts?
Thank you
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mmgrant@townofnorthandover.com
Web www.TownofNorthAndover.com
From: Jack Sullivan [mailto:jacksu1153(a)comcast.net1
Sent: Friday, May 01, 2015 6:28 PM
To: M Yamin
Cc: Sawyer, Susan; Grant, Michele; Hughes, Jennifer; Gaffney, Heidi; Willett, Tim
Subject: Re: 674 Turnpike - Septic Plan - Need for Town Input
Mohammad & Town Staff;
I recently had Norse Environmental come out to the above property to clarify the wetland line based
on in-depth soil probes to determine the limit of hydric soils. The previous wetland line used was
taken from a plan by others for a proposed redevelopment of this property as a Roast Beef restaurant
which- never materialized. Upon review mutual review of the wetland line with Jennifer and myself it
appeared the wetland line would need to be brought more upgradient, which was confirmed by Norse
Environmental.
The result of the wetland delineation performed by Norse Environmental presents a problem for use
of an upgraded septic system... specifically almost the entire site is within the 50 foot buffer to the
wetlands. State Title 5 code requires 50 feet from a wetland to a soil absorption system and North
Andover requires 100 feet .... thus the problem. The existing septic system is failed and as you can
see from the attached plan it appears at least one of the leaching pits is in the wetland area. So this
email might be more appropriate for the Board of Health to comment on, but I wanted to keep all
departments in the loop since this is an active wetland filing.
have never had a situation where I was unable to fit a septic system onsite. The Town sewer is over
400 feet away and furthermore individual sewer force mains are not allowed per DPW.
Susan & Michelle .... I am not sure if you have run into this situation before. MY THOUGHT IS WITH
THE MICRO FAST UNIT PROVIDING DE-NITROFICATION THE DEP WOULD PROBABLY
GRANT A VARIANCE FROM THE 50 FOOT WETLAND SETBACK REQUIREMENT. This would
also require a variance from the North Andover BOH and Conservation. I do not think DEP would
allow a tight tank since they typically want to see some sort of soil absorption field if there is any land
area that would allow some treatment, even with a setback variance. If you could forward this email
and plan to Mill River for comment that might be helpful. If everyone agrees the best option is to
pursue the DEP variance on wetland setback I can look to prepare the application and continue the
public hearing process with Conservation. I would look to submit the variance paperwork to the NA
BOH at the same time the DEP variance request is submitted.
The owner and I would like to try to finalize some type of design to finally remedy the failed septic
system... please let me know the best course of action to take.
Thank you.
Jack Sullivan
781-854-8644
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.
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rinrth Andover Health Department
March 18, 2015
Jack Sullivan, P.E.
Sullivan Engineering Group
22 Mount Vernon Road
Boxford, MA 01921
Re: Subsurface Sewage D
Dear Mr. Sullivan:
The proposed wastewater
dated March 3, 2015 and j
plan cannot be approved 1
310 CMR 15.000, or Nor
where applicable.
1. On sheet 1 of 3, `
(8.49' wide x 44:
2. On sheet 2 of 3,
above the finish -
covers to better
3. Section II (20)((`
for Remedial U
Absorption Sys
is required by t_
document in a
for reference:
got 21
revision
ly, the
.n Title 5:
;ach item
icorrect
s depicted
—s Approved
-mative Soil
medial Use"
urate
,ided below
I certify that this design contornis L%j «., _ ,for Secondary
Treatment Units Approved for Remedial Use, the Insertt-treatmeIlL technology
name design guidance and 310 CMR 15.000 except as noted.
Designer Name
liate
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
North Andover Health Department
(ommunity Development Division
March 18, 2015
Jack Sullivan, P.E.
Sullivan Engineering Group, LLC
22 Mount Vernon Road
Boxford, MA 01921
Re: Subsurface Sewage Disposal System Plan for 674 Turnpike Street, Map 98D, Lot 21
Dear Mr. Sullivan:
The proposed wastewater system design plan for the above site dated January 13, 2015 revision
dated March 3, 2015 and received on March 18, 2015 has been reviewed. Unfortunately, the
plan cannot be approved until the following items are corrected. The specific section in Title 5:
310 CMR 15.000, or North Andover regulation that is not met by this design follows each item
where applicable.
1. On sheet 1 of 3, "Design Analysis" the size of the proposed leaching field is incorrect
(8.49' wide x 44' long = total of 33 infiltrator units).
2. On sheet 2 of 3, the manhole cover above the outlet of the Micro FAST unit is depicted
above the finish grade. Also indicate the size and material of the proposed manhole
covers to better assist the installer.
3. Section II (20)(c) of the "Standard Conditions for Secondary Treatment Units Approved
for Remedial Use" and section 11(l 8)(e) of the "Standard Conditions for Alternative Soil
Absorption Systems with General Use Certification and/or Approved for Remedial Use"
is required by the designer. This can be added to the design plan or on a separate
document in a statement form. An example for an STU certification is provided below
for reference:
I certify that this design conforms to the DEP Standard Conditions for Secondary
Treatment Units Approved for Remedial Use, the Insert treatment technology
naive design guidance and 310 CMR 15.000 except as noted.
Designer Name Date
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
4. The owner's certification will be required to be signed and submitted to the Health
Department office prior to final approval of the design plan.
Please feel free to contact the office or Mill River Consulting at 978-282-0014. We look forward
to working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely,
L4,
Michele Grant
Health Inspector
cc: 39 Cotuit Street, LLC
File
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540
Page 2 of 2
Fax: 978.688.8476
Grant, Michele
From:
Jack Sullivan <jacksull53@comcast.net>
Sent:
Wednesday, March 18, 2015 12:32 PM
To:
Sawyer, Susan
Cc:
Grant, Michele
Subject:
re: 674 Turnpike Street - Revised Septic Plans
Susan & Michele,
I submitted revised septic plans today.
As I read Section 3.8 of the NA BOH regs... the setback variance distances can be granted by the
Health Dept, since a Micro FAST is proposed. If I am incorrect, please let me know and let me know
what I need to do to get in front of the Board for relief.
Hope all is well.
Sullivan Engineering Group, LLC
Jack Sullivan
P.O. Box 2004
Woburn, MA 01888
781-854-8644
1
Blackburn, Lisa
From: Isaac Rowe <irowe@millriverconsulting.com>
Sent: Wednesday, March 18, 2015 4:51 PM
To: Grant, Michele; Blackburn, Lisa
Cc: Pam Lally; Isaac Rowe
Subject: RE: 674 Turnpike st.Additional paperwork
Attachments: 674 Turnpike Street - Disapproval Letter 3-18-15.docx
Michele,
Attached is the plan review letter for the revised plan.
The applicant is requesting the (2) local variances for a reduction in wetland setbacks and (2) local upgrade approval
requests. The (2) local variance requests DO require abutter notification per the BOH Septic regs section 8. Please review
this section. I would interpret "all abutters" as all direct abutters to the subject property, this includes abutters directly
across the street too.
Please let me know if you have any questions.
Thanks,
Isaac M. Rowe, R.S.
Project Manager
Mill River Consulting
6 Sargent Street
Gloucester, MA 01930-2719
Phone: 978-282-0014 ext.804
Fax: 978-282-1318
irowe@millriverconsultine.com
www.millriverconsulting.com
-----Original Message -----
From: Grant, Michele [mailto:mgrant@townofnorthandover.com]
Sent: Wednesday, March 18, 20151:49 PM
To: 'Isaac Rowe'
Subject: 674 Turnpike st.Additional paperwork
-----Original Message -----
From: noreply@townofnorthandover.com [mailto:noreply townofnorthandover.com]
Sent: Wednesday, March 18, 2015 12:44 PM
To: Grant, Michele
Subject: Message from "ComDev-Health-Ricoh"
This E-mail was sent from "ComDev-Health-Ricoh" (Aficio MP C3002).
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Commonwealth of Kpissachusetts
City/Town of /VOA /q*a
Percolation Test
Form 92
wM
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
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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.
A. Site Information
Mohammad Yamin
Owner Name
674 Turnpike Street
Street Address or Lot #
North Andover
City/Town
MA
State
978-821-0233
01845
Zip Code
Contact Person (if different from Owner)
Telephone Number
B. Test Results
9/9/14
10:00 a.m.
Date
Time Date Time
Observation Hole # PT -1
Depth of Perc 6211-8011
Start Pre -Soak
End Pre -Soak
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rate (Min./Inch) 20 MPI (Assigned)
Test Passed:
® Test Passed: ❑
Test Failed:
❑ Test Failed: ❑
John D. Sullivan III, P.E. SE2378
Test Performed By:
Issac Rowe - Mill River Consultants
Witnessed By:
Comments:
Soil sample taken at perc depth due to water table and sample was sent to WASS laboratory for
sieve analysis (See attached laboratory report)
t5form12.doc• 06/03 Perc Test • Page 1 of 1
UMassSoil and Plant Tissue Testing Laboratory
,)n2 ozigp (�{�nraYnnr
161 Holdsworth Way
Extension University of Massachusetts
Amherst, MA 01003
Phone: (413) 545-2311
CEN TER FOR AGRICULTURE website:soiltesat..umass.edu
Particle Size Analysis - Complr,,*,hen�%!�
Prepared For:
Jack Sullivan
Sullivan Eng. Group, LLC
115 River Pointe Way, Apt. 6304
Lawrence, MA 01843
jacksuUS3@comcast~net
978-352-7871
I
1Yc-u�ats-ti'�
5ampie jntormanon:
Sample ID: 01843
Order Number:
9903
Lab Number:
X140919-106
Received:
9/19/2014
Reported:
1/14/2015
USDA Size Fraction
Percent
I
of Whole
Sample Passim
Main Fractions
Sie &-Wl
Percen
-
Whole Sample % of
Sand
0.05-2.0
53.9
S' mm
SieveSample
Passing
Silt
0.002-0.05
36.7
2.00
#10
92.8
1.00
#18
89.0
Clay
<0.002
9.4
0.50
#35
82.3
0.25
#60
72,6
Sand Fractions
Size from)
Percent
0.10
#140
55.8
Very Coarse
1.0-2.0
4.2
0.053
#270
42.8
Coarse
0.5-1.0
7.2
0.02
20 um
24.9
Medium
0.25-0.5
10.5
0.005
5 um
11.8
Fine
0.10-0.25
18.1
0.002
2 um
8,7
Very Fine
0.05-0.10
14.0
Silt Fractions
Size (rom)
percent
Coarse
0.02-0.05 -
19.3
Mum
0.005-0:02-
14.1
Fine
0.0024005
3.3
USDA Textural Class: fine sandy loam
Gravel Content: (%) 7.2
1 of 1 Sample ID: 01843 Lab Number X140919-106
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF fENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617-292-5500
DEVAL L. PATRICK
Governor IAN A. BOWLES
Secretary
TIMOTHY P. MURRAY LAURIE BURT
Lieutenant Governor Commissioner
CERTIFICATION FOR GENERAL USE
Pursuant to Title 5, 310 CMR 15.000
Name and Address of Applicant:
Bio-Microbics, Inc.
8450 Cole Parkway
Shawnee, KS 66227
Trade name of technology and models:
FAST Treatment Systems with Nitrogen Reduction including models MicroFASM 0. 5, 0.75, 0.9,
1.5, 3.0, 4.5, 9. 0, HighStrengthFAST01.0, 1.5, 3.0, 4.5, 9.0 and NitriFASM 0.5, 0.75, 1.0, 1.5,
3.0, 4.5, 9.0 (all hereinafter the "System") for facilities with design flows less than 2,000 gallons
per day (GPD). Schematic drawings illustrating the models and an Inspection Checklist are part of
this Certification.
Transmittal Number: X232831
Date of Issuance: December 29, 2010
Renewal Date: December 29, 2015
Authority for Issuance
Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of
Environmental Protection (hereinafter "the Department") hereby issues this General Use Approval
to: Bio-Microbics, Inc., 8450 Cole Parkway, Shawnee, KS 66227 (hereinafter "the Company"),
approving the above referenced FAST technology (hereinafter "the Technology" or "System") for
use in the Commonwealth of Massachusetts subject to the conditions herein. Sale and use of the
Technology are subject to compliance by the Company, the Designer, the System Installer, the
Operator, and the System Owner with the terms and conditions herein. Any noncompliance with
the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000.
David Ferris, Director
Wastewater Management Program
Bureau of Resource Protection
December 30, 2010
Date
This information is available in alternate format. Call Donald M. Gomes, ADA Coordinator at 617-556-1057. TDD Service -1-800-298-2207.
MassDEP on the World Wide Web: http:/Avww.mass.gov/dep
Certification for General Use Page 2 of 10
Bio-Microbics FAST <2,000 GPD Nitrogen Reducing
I. Purpose
1. Subject to the conditions of this Approval and any other local requirements, the purpose of
this Approval is to allow the use of the System in Massachusetts on a General Use basis.
With the necessary permits and approvals required by 310 CMR 15.000, this Certification
authorizes the installation and use of the System in Massachusetts.
2. The System may be installed for residential facilities with design flow less than 2,000 GPD
where a system in compliance with 310 CMR 15.000 exists on-site or could be built and for
which a site evaluation in compliance with 310 CMR 15.000 has been approved by the local
approving authority; or by the Department if Department approval is required by 310 CMR
15.000. This Approval allows for the use of the System as an equivalent alternative
technology in accordance with 310 CMR 15.202 on facilities for nitrogen reduction in a
Department designated nitrogen sensitive or limited area as defined in 310 CMR 15.214 and
15.215.
Non-residential facilities are not allowed under this approval. Non-residential facilities
include properties with businesses and/or commercial establishments.
3. The technology shall meet or exceed the following effluent discharge requirements:
• Effluent Total Nitrogen (TN) concentration of 19 mg/L (for 660 gallons per day per acre
-gpda- loading) or 25 mg/L (for 550 gpda loading).
• Effluent pH range shall be 6.0 to 9.0.
• The System is approved for use at facilities with a maximum design flow less than 2,000
GPD.
4. The System Owner or the designated System Operator (or `Operator') has responsibility for
oversight and sampling of the System if the property served was allowed to increase the
discharge rate per acre above 440 gpda in an area subject to Nitrogen Loading Limitations.
The System Owner will be required to repair, replace, modify or take any other action as
required by the Department or the local approving authority, if the Department or the local
approving authority determines that the System is not capable of meeting the required
reduction in nitrogen in the effluent.
The Company is responsible for the approved technology as described below.
II. General Description of the Technology and Design Standards
1. The tank containing the FAST® insert is installed between the building sewer and the soil
absorption system (SAS). The SAS shall be designed and constructed in accordance with
310 CMR 15.100 - 15.279 and subject to the provisions of this Certification.
2. Technology Description - The FAST® system is an aerobic wastewater treatment system
that utilizes a completely submerged fixed film process to treat organics and nitrify, and a
passive recycle system for denitrification. Each model contains submerged media specific
to the application. Microorganisms grow on the media and remove soluble contaminants
from the wastewater, utilizing them as a source of energy for growth and production of new
microorganisms. The FAST® system insert consists of a liner around the media and an
airlift to provide aeration and mixing within the confines of the liner. The area outside the
Certification for General Use Page 3 of 10
Bio -N icrobics FAST <2,000 GPD Nitrogen Reducing
liner in the septic tank remains anoxic for denitrification and a passive recirculation system
moves the aerated wastewater to the outside of the liner to obtain denitrification. The
aeration and circulation inside the liner are provided by a blower that pumps air into a draft
tube that extends down the center of the media. Treated effluent passes out of the aerobic
zone of the treatment plant through a pipe connected directly to a baffled quiescent area in
the liner. Final effluent is discharged to a soil absorption system. Specific model
considerations are as follows:
• The MicroFAST® 0.5, 0.75 and 0.9, HighStrengthFAST® 1.0 and NitriFAST® 0.5,
0.75 and 0.9 are installed in the second compartment of a two-compartment tank with a
total liquid capacity of at least 1,500 gallons constructed in accordance with 310 CMR
15.226.
• The MicroFAST®, HighStrengthFAST® and NitriFAST® 1.5 are installed in the
second compartment of a two compartment 3000 -gallon tank constructed in
accordance with 310 CMR 15.226.
• The MicroFAST®, HighStrengthFAST® and NitriFAST® 3.0 is installed in a separate
tank constructed in accordance with 310 CMR 15.226 and located between a standard
Title 5 septic tank, designed in accordance with 310 CMR 15.223 and 15.224, and the
soil adsorption system (SAS). In this larger system, an additional recycle pump may
be needed to send nitrified effluent back to the septic tank for added denitrification.
Consult the Company for proper layout.
• The NitriFAST® models can also be used for additional nitrification in series after the
MicroFAST® models or HighStrengthFAST® models. In this configuration the tanks
used for the NitriFAST® shall be constructed in accordance with 310 CMR 15.226
and meet the minimum dimensions and volumes required by the Company.
• Flow equalization may also be employed prior to the FAST® system depending on the
type of facility. Consult Company for proper layout.
3. All access ports and manhole covers shall be readily removable, of durable material and
installed and maintained at grade to allow for maintenance of the System. No structures shall
be located directly upon or above the access locations which could interfere with
performance, access, inspection, pumping, or repair. Sufficient access for infrequent
maintenance of the System treatment media and all other treatment works shall be evaluated,
and addressed in the System design if necessary, by the designer. System control panel(s)
including alarms shall be mounted in a location accessible to the operator of the System.
4. Wastewater Loading and Effluent Concentration Design Standards
For new residential construction in an area subject to the Nitrogen Loading Limitations of
310 CMR 15.214, and the facility does not meet with the Nitrogen Loading Limitations
pursuant to the aggregation provisions of 310 CMR 15.216, an increase in calculated
nitrogen loading per acre is allowed for facilities with design flow less than 2000 gpd with
limitations as follows:
• The design flow shall not exceed 660 gallons per day per acre (gpda) and the total
nitrogen (TN) concentration in the effluent shall not exceed 19 milligrams per liter
(mg/L); or
Certification for General Use Page 4 of 10
Bio-Microbics FAST <2,000 GPD Nitrogen Reducing
• The design flow shall not exceed 550 gallons per day per acre (gpda) and the total
nitrogen (TN) concentration in the effluent shall not exceed 25 milligrams per liter
(mg/4
• TN is measured as the total of TKN (Total Kjeldhal Nitrogen), NO3-N (Nitrate
nitrogen) and NO2-N (Nitrite nitrogen).
111. General Conditions
1. The provisions of 310 CMR 15.000 is applicable to the use and operation of this
System, the System owner and the Company, except those that specifically have been
varied by the terms of this Certification.
2. Any required operation and maintenance, monitoring and testing shall be performed in
accordance with a Department approved plan. Any required sample analysis shall be
conducted by an independent U.S. EPA or DEP approved testing laboratory, or a DEP
approved independent university laboratory, unless otherwise provided in the
Department's written approval. It shall be a violation of this Certification to falsify any
data collected pursuant to an approved testing plan, to omit any required data or to fail
to submit any report required by such plan.
3. The facility served by the System and the System itself, shall be open to inspection and
sampling by the Department and the local approving authority at all reasonable times.
4. In accordance with applicable law, the Department and the local approving authority
may require the System owner to cease operation of the system and/or to take any
other action as it deems necessary to protect public health, safety, welfare or the
environment.
5. The Department has not determined that the performance of the System will provide a
level of protection to public health and safety and the environment that is at least
equivalent to that of a sanitary sewer system. Accordingly, no System shall be
upgraded or expanded, if it is feasible to connect the facility to a sanitary sewer, unless
as allowed by 310 CMR 15.004.
6. Design, installation, and use of the System shall be in strict conformance with the
Company's DEP approved plans and specifications and 310 CMR 15.000, subject to
this Certification.
IV. Conditions Applicable to the System Owner
1. The System owner shall at all times have the System properly operated and maintained
by a Company approved Operator in accordance with this Certification, the designer's
operation and maintenance requirements and the Company's approved procedures.
2. The System is certified only in connection with the discharge of sanitary wastewater
from facilities with a design flow of less than 2000 gpd. Any non -sanitary wastewater
generated and/or used at the facility served by the System shall not be introduced into
the System and shall be lawfully disposed of.
Certification for General Use Page 5 of 10
Bio-Microbics FAST <2,000 GPD Nitrogen Reducing
3. The System Owner shall provide access to the site for the System Operator to perform
inspections, maintenance, repairs, responding to alarm events, field testing, and
sampling as may be required by the Approval.
Operation and Monitoring Requirements
4. System effluent total nitrogen (TN) concentrations shall not exceed 19 or 25 mg/L and
effluent pH shall not be less than 6.0 or more than 9.0. Field test observations of
dissolved oxygen (DO) shall equal or exceed 2 mg/L and for Turbidity shall be equal
or less than 40 NTU.
5. All samples shall be taken at a flowing discharge point, i.e. distribution box, pipe
entering a pump chamber or other Department approved location from the treatment
unit.
6. . Inspection, operation and maintenance (O&M), sampling, and field testing of the
System required by the Approval shall be performed by a Company approved Operator
who has been certified at a minimum of Grade Level 4 (four) by the Board of
Registration of Operators of Wastewater Treatment Facilities, in accordance with
Massachusetts regulations 257 CMR 2.00, and is an approved Title 5 System Inspector
in accordance with 310 CMR 15.340.
7. Prior to commencement of construction of the System, the System Owner shall
provide to the local approving authority a copy of a signed O&M Agreement that
meets the requirements of paragraph IV (8).
The System Owner shall maintain, at all times, an O&M Agreement with a qualified
System Operator approved by the Company. The Agreement shall be at least for one
year anti, include the following provisions:
a) The name of a System Operator who is an approved System Inspector in
accordance with 310 CMR 15.340 and who meets any additional qualification
requirements specified in the Approval;
b) The System Operator must inspect the Alternative System as required by
paragraph IV (9) and (12);
c) The System Operator shall be responsible for submitting the monitoring results to
the System Owner in accordance with paragraph IV (13) and to the local
approving authority in accordance with paragraph IV (14); and
d) In the case of a System failure, an equipment failure, alarm event, components not
functioning as designed, or violations of the Approval, procedures and
responsibilities of the System Operator and System Owner shall be clearly defined
for corrective measures to be taken immediately. The System Operator shall
agree to provide written notification within five days, describing corrective
measures taken, to the System Owner and the local board of health.
9. The System Owner shall comply with the following monitoring requirements if the
System is subject to a TN concentration limit in accordance with paragraph H (4):
Certification for General Use Page 6 of 10
Bio-Microbics FAST <2,000 GPD Nitrogen Reducing
a) Year-round installations shall be inspected and have effluent sampled for at least
the TN parameter quarterly for the first year, then a minimum of twice/year
thereafter, at least 5 months apart and with at least one sample taken between
December 1 and March 1 of each year. Field testing shall be completed per
paragraph IV (11) below, and as determined necessary by the System Operator.
See DEP Field Testing Protocol at http://www.mass.govldep/water/ laws/policies.
htm#t5pols. Wastewater flow shall be recorded at each inspection, see `Flow
Metering' paragraph IV (10).
b) Seasonal installations shall be inspected and have effluent sampled fo ° at 'least the
TN parameter a minimum of twice/year. At least one sample must be taken 30 to
60 days after each seasonal occupancy begins. A second sample must be taken no
less than 2 months after the first sample. Field testing shall be completed per
paragraph IV (11) below, and as determined necessary by the System Operator.
Wastewater flow shall be recorded at each inspection, see `Flow Metering'
paragraph IV (10).
c) Systems in operation prior to issuance of this Approval, which have received
approval of sampling reduction from the Department may continue with that
System monitoring frequency.
Properties occupied at least 6 months per year are considered year-round properties.
Properties occupied less. than 6 months per year are considered seasonal properties.
TN is measured as the total of TKN (Total Kjeldhal Nitrogen), NO3-N (Nitrate
nitrogen) and NO2-N (Nitrite nitrogen).
10. Flow Metering: Reporting of residential System water use is not required, however it
is recommended the Operator record water meter readings if available at all
inspections, or otherwise estimate System flow, to assist in addressing possible
operational problems or issues. Flow measurement when recorded shall be based on:
a) actual metering data of wastewater flow to the System or actual water meter data of
flow to fixtures that discharge to the wastewater system; or
b) actual water meter data for the total facility with either actual meter data or
estimated flows for non -wastewater usage subtracted from the total facility water
usage. If estimating the wastewater portion of metered water usage, the System
Operator shall provide a best estimate of wastewater discharged to the System with
the method of estimating, such as pump run times, occupancy rates, adjustment due
to seasonal outdoor watering use, etc.; or
c) for Systems installed under a prior Approval that did not include a wastewater flow
data reporting requirement, if no flow meters are available, the System Operator
shall provide a best estimate of wastewater discharged to the System with the
method of estimating, such pump run times, occupancy rate, etc.
11. Field Testing: Temperature, turbidity, pH and DO shall be measured and recorded in
the field whenever the effluent is sampled for TN. See applicable sections of the
Department's Field Testing Protocol at http://Www.mass.govldeplwater/lawsl
policies. htm#t5pols.
Certification for General Use Page 7 of 10
Bio-Microbics FAST <2,000 GPD Nitrogen Reducing
12. At a minimum, the System Operator shall inspect the System:
a) quarterly for the first year then two times per year thereafter;
b) in accordance with the approved O&M manual, the Designer's operation and
Mnintanance requirements, and the requirements of the local approving authority;
and
c) any time there is an alarm event, equipment failure, or system failure.
Recordkeeping and Reporting
13. Within 60 days of any site visit, the System Operator shall submit an O&M report and
inspection checklist to the System Owner and the Company. It is recommended the
System Owner and Company maintain copies of these items for possible Department
audit. The O&M report shall include, at a minimum:
a) for a System failing, any corrective actions taken;
b) wastewater analyses, wastewater flow data, field testing results and inspection
checklists;
c) any violations of the Approval;
d) any determinations that the System or its components are not functioning as
designed or in accordance with the Company specifications; and
e) any other corrective actions taken or recommended.
14. By February 15th of each year the System Owner or the System Operator if designated
by the owner, shall submit to the local approving authority all monitoring results with
all O&M reports and inspection checklists completed by the System Operator during
the previous 12 months.
15. Upon determining that the System has failed, as defined in 310 CMR 15.303, the
System Operator shall notify the System Owner immediately.
16. Upon determining that the System has failed, as defined in 310 CMR 15.303, the
System Owner and the System Operator shall be responsible for the notification of the
local approving authority within 24 hours of such determination.
17. The System Owner shall notify the Approving Authority and the Company in writing
within seven days of any cancellation, expiration or any other change in the terms
and/or conditions of the O&M Agreement required by Paragraph IV (8).
18. Violations of the TN concentration in the System effluent shall not constitute a failure
of the System for the purposes of 24-hour notification or 5 -day written reporting as
required in Paragraphs IV (16) and (8).
19. The System owner shall provide a copy of this Approval, prior to the signing of a
purchase and sale agreement for the facility served by the System or any portion
thereof, to the proposed new owner.
Certification for General Use Page 8 of 10
13io-Microbics VAST <2,000 GPD Nitrogen Reducing
20. The System owner shall furnish the Department any information that the Department
requests regarding the System, within 21 days of the date of receipt of that request.
21. Prior to issuance of a Certificate of Compliance of the System, and after recording
and/or registering the Notice required by 310 CMR15.287(10), the System Owner
shall provide to the Local Approving Authority a copy o£ (i) a certified Registry copy
of the Notice bearing the book and page/or document number; and (ii) if the property
is unregistered land, a Registry copy of the System Owner's deed to the property,
bearing a marginal reference on the System Owner's deed to the property. The Notice
to be recorded shall be in the form of the Notice provided by the Department.
22. Prior to signing any agreement to transfer any or all interest in the property served by
the System, or any portion of the property, including any possessory interest, the
System Owner shall provide written notice of all conditions contained in the Approval
to the transferee(s). Any and all instruments of transfer and any leases or rental
agreements shall include as an exhibit attached thereto and made a part of thereof a
copy of the Approval for the System. The System Owner shall send a copy of such
written notification(s) to the Local Approving Authority within 10 days of giving such
notice to the transferee(s).
V. Conditions Applicable to the Company
By February 15"' of each year, the Company shall submit to the Department, a
report, signed by a corporate officer, general partner or Company owner that
contains information on the System for the previous calendar year. The report shall
state: the number of units of the System sold for use in Massachusetts during the
previous year; the address of each installed System, the owner's name and address,
the type of property or use and the design flow; and for all Systems installed since
the first issuance of Certification for the System, all known failures or malfunctions,
corrective actions taken and the address of each such event and a list of all Systems
not in compliance with effluent TN limits.
2. The Company shall notify the Director of the Wastewater Management Program at
least 30 days in advance of the proposed transfer of ownership of the technology for
which this Certification is issued. Said notification shall include the name and
address of the proposed new owner and a written agreement between the existing and
proposed new owner containing a specific date for transfer of ownership,
responsibility, coverage and liability between them. All provisions of this
Certification applicable to the Company shall be applicable to successors and assigns
of the Company; unless the Department determines otherwise.
3. The Company shall develop maintain and update as necessary the following:
minimum installation requirements; an operating manual, including information on
substances that should not be discharged to the System; a maintenance checklist; and
a recommended schedule for maintenance of the System consistent with the
Department's requirements essential to consistent successful performance of the
installed Systems.
4. The Company shall institute and maintain a program of operator training and
continuing education. The Company shall maintain and annually update, and make
Certification for General Use Page 9 of 10
Bio-Microbies FAST <1,000 GPD Nitrogen Reducing
available the list of qualified operators by February 15th and make the list known to
local approving authorities, the Department and to users of the technology.
5. The Company shall furnish the Department any information that the Department
rcKucsts regarding the System, within 21 days of the date of receipt of that request.
6. The Company shall include copies of this Certification and the procedures described
in Section V (3) with each System that is sold. In any contract executed by the
Company for distribution or re -sale of the System, the Company shall require the
distributor or re -seller to provide each purchaser of the System with copies of this
Certification and the procedures described in Section V (3).
7. A copy of the wastewater analyses, wastewater flow data, field testing results, and
System Operator O&M reports and inspection checklists from each installed System
shall be maintained by the Company or its designee for possible Department audit.
If the Company wishes to continue this Certification after its expiration date, the
Company shall apply for and obtain a renewal of this Certification. The Company
shall submit a renewal application at least 180 days before the expiration date of this
Certification, unless written permission for a later date has been granted in writing
by the Department. This Certification shall continue in force until the Department
has acted on the renewal application.
Vl. Conditions Applicable to the System Designer
1. Upon submission of an application for a DSCP, the Designer shall provide to the local
approving authority:
a) a certification, signed by the owner of record for the property to be served by the
System, stating that the property owner:
i) has been provided a copy of the Approval, the Owner's Manual, and the
Operation and Maintenance Manual, if applicable, and the Owner agrees to
comply with all terms and conditions;
ii) has been informed of all the owner's costs associated with the operation
including, when applicable: power consumption, maintenance, sampling,
recordkeeping, reporting, and equipment replacement;
iii) understands the requirement for a service contract;
iv) agrees to fulfill his responsibilities to provide a Deed Notice as required by 310
CMR 15.28'1(10) and the Approval;
v) agrees to fulfill his responsibilities to provide written notification of the
Approval to any new owner, as required by 310 CMR 15.287(5);
vi) if the design does not provide for the use of garbage grinders, the restriction is
ttnderstQod and accepted;
vii) if the design is for an upgrade of failed or nonconforming system, the System
Owner has been provided a copy of the evaluation of the existing system;
viii) whether or not covered by a warranty, the System Owner understands the
requirement to repair, replace, modify or take any other action as required by
the Department or the local approving authority, if the Department or the local
Certification for General Use i'e .1i j1 Page 10 of 10
___ ,. r_ _R !!49466 i '� y` ,i G fir! G! 1�!l.�.tiL�1t ��uui.�i►�
approving authority determines that the Alternative System is not capable of
meeting the performance standards; and
b) a certification. signed by the Designer that the .design conforms to the Annrnval wirb
(rnr �;4i n+ln .l,Ga Z 1 i�71 af.D a S .nnn
VII. Reporting
1. All notices and documents required to be submitted to the Department by this
I `Prhtwntinn chatt hP ci►hmtttP(i Q'
Director
Wastewater Management Program
Department of Environmental Protection
\711iJ �1-llllVa GSLIVVa Jilt Si`i'GSY
Boston, Massachusetts 02108
VIII. Rights of the Department
The Department may suspend, modify or revoke this Certification for cause,
non-payment of the annual compliance assurance fee, for obtaining the Certification
by misrepresentation or failure to disclose fully all relevant facts or any change in or
discovery of conditions that would constitute grounds for discontinuance of the
Certification, or as necessary for the protection of public health, safety, welfare or
the environment, and as authorized by appficabu taw. The apartment 1,05m vis i is
rights to take any enforcement action authorized by law with respect to this
Certification and/or the System against the owner or operator of the System and/or
the Company.
IX. Expiration Date
Noiwiihstanding the expiration date of this Certification, any System sold and
installed prior to the expiration date of this Certification, and approved, installed and
maintained in compliance with this Certification (as it may be modified) and 310
CMR 15.000, may remain in use unless the Department, the local approval authority,
or a court requires the System to be modified or removed, or requires discharges to
the System to cease.
Transmittal: X232831 (formerly W101238)
D Commonwealth of Massachusetts
Executive Office of Energy & Environmental Affairs
Department of Environmental Protection
One Winter Street Boston, MA 02108.617-292-5500
DEVAL L. PATRICK RICHARD K. SULLIVAN JR.
Governor Secretary
APPROVAL FOR GENERAL USE
Pursuant to Title 5, 310 CMR 15.000
Name and Address of Applicant:
Infiltrator Systems, Inc.
P.O. Box 768
6 Business Park Road
Old Saybrook, CT 06475
DAVID W. CASH
Commissioner
Trade name of technology and model: High Capacity chamber, Quick4 High Capacity chamber, Quick4
High Capacity HD chamber, Quick4 Plus High Capacity chamber (8 -inch invert), Quick4 Plus High
Capacity chamber (13 -inch invert), Standard chamber, Quick4 Standard chamber, Quick4 Standard HD
chamber, Quick4 Plus Standard chamber (5.3 -inch invert), Quick4 Plus Standard chamber (8.0 -inch
invert), Quick4 Plus Standard LP (Low Profile) chamber (3.3 -inch invert), Quick4 Plus Standard LP
(Low Profile) chamber (8 -inch invert), Infiltrator 3050 (Storm Tech SC -740) chamber, Equalizer 24
chamber, Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, Quick4
Equalizer 24 LP (Low Profile) chamber (6 inch invert), and Quick4 Equalizer 24 LP (Low Profile)
chamber (2 inch invert) (hereinafter the "System"). Schematic drawings of the System and a design and
installation manual are a part of this Certification. This approval allows the installation of the above
identified chambers without aggregate.
Transmittal Number: X259183
Date of Revision: May 22, 2014
Authority for Issuance
Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental
Protection hereby issues this Certification to: Infiltrator Systems, Inc., P.O. Box 768, 6 Business Park
Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described
herein. The sale, design, installation, and use of the System are conditioned on compliance by the
Company, the Designer, the Installer and the System Owner with the terms and conditions set
forth below. Any noncompliance with the terms or conditions of this Approval constitutes a
violation of 310 CMR 15.000.
David Ferris, Director
Wastewater Management Program
Bureau of Resource Protection
MU 22, 2014
Date
This information is available in alternate format. Call Michelle Waters-Ekanem, Diversity Director, at 617-292-5751. TDD# 1-866-539-7622 or 1-617-574-6868
MassDEP Website: www.mass.gov/dep
Infiltrator Chamber, Infiltrator Inc.
Approval for General Use — May 22, 2014
Page 2 of 6
I. Design Standards
1. The models listed in Table 1 are covered under this Certification.
Table 1: Chamber Dimensions
Model
Dimensions
W x L x H
Inches
Invert
Height
Inches
Equalizer 24
15 x 100 x 11
6
Quick4 Equalizer 24
16 x 48 x 11
6
Quick4 Equalizer 24 LP 6 -inch invert
16 x 48 x 8
6
Quick4 Equalizer 24 LP 2 -inch invert
16 x 48 x 8
2
Equalizer 36
22 x 100 x 13.5
6
Quick4 Equalizer 36
22 x 48 x 12
6
Standard Chamber
34 x 75 x 12
6.5
Quick4 Standard
34 x 48 x 12
8
Quick4 Standard HD
34 x 48 x 12
8
Quick4 Plus Standard 5.3 -inch invert
34 x 48 x 12
5.3
Quick4 Plus Standard 8 -inch invert
34 x 48 x 12
8
Quick4 Plus Standard LP 3.3 -inch invert
34 x 48 x 8
3.3
Quick4 Plus Standard LP 8 -inch invert
34 x 48 x 8
8
Infiltrator 3050 or StormTech SC -740
51 x 85.4 x 30
2F2--57—
2.25Hi
High
h Capacity Chamber
34 x 75 x 16
11
Quick4 High Capacity
34 x 48 x 16
11.5
Quick4 High Capacity HD
34 x 48 x 16
11.5
Quick4 Plus High Capacity 8 -inch invert
34 x 48 x 14
8
Quick4 Plus High Capacity 13 -inch invert
34 x 48 x 14
13
I Includes Infiltrator MultiportTM invert adapter attached to the side of the end cap.
2 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All -in -
One 8 Endcap.
3 Only systems installed with this invert height shall be allowed to use the effective
leaching area associated with this model in Table 2
4Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All -in -
One 12 Endcap.
2. The System is an open -bottom leaching unit molded from polyolefin resin. It can
be installed without aggregate or distribution pipe as an absorption trench or as a
bed or field. If the System is installed with stone aggregate then the "Effective
Leaching Area" in Tables 2 and 3 is not applicable, and must be designed in
accordance with the provisions of 310 CMR 15.000.
3. The total effective leaching area for any Chamber Model shall be calculated by
multiplying the Effective Leaching Area per square foot of chamber times the
total length of chamber from end cap to end cap including end caps.
Infiltrator Chamber, Infiltrator Inc.
Approval for General Use — May 22, 2014
Page 3 of 6
4. For new construction or upgrades, the applicant can size the System in a trench
configuration, using the effective leaching areas presented in Table 2.
Table 2: Effective Leaching Area in Trench Configuration for New
Construction and Remedial Sites5
Model
Effective
Leaching
Area
SF/LF
Effective
Leaching?
Area
SF/LF
Equalizer 24
3.76
N/A
ick4 Equalizer 24
3.90
N/A
Quick4 Equalizer 24 LP 6 -inch invert
3.90
N/A
uick4 Equalizer 24 LP 2 -inch invert
2.78
N/A
Equalizer 36
4.73
N/A
uick4 Equalizer 36
4.73
N/A
Standard Chamber
6.53
N/A
uick4 Standard
6.96
N/A
uick4 Standard HD
6.96
N/A
uick4 Plus Standard 5.3 -inch invert
6.20
N/A
ick4 Plus Standard 8 -inch invert
6.96
N/A
ick4 Plus Standard LP 3.3 -inch invert
5.65
N/A
ick4 Plus Standard LP 8 -inch invert
6.96
N/A
Infiltrator 3050 or StormTech SC -740
N/A
6.71
High Capacity Chamber
7.79
N/A
ick4 High Capacity
7.93
N/A
ick4 High Capacity HD
7.93
N/A
uick4 Plus High Capacity 8 -inch invert
6.96
N/A
Quick4 Plus High Capacity 13 -inch invert
7.93
N/A
'. Effective April 21, 2006, 310 CMR 15.251(1)(b) maximum trench width is 3 feet.
6 Effective leaching area is equal to 1.67 (bottom width + (2x invert height)) for Systems
3 feet or less in width.
7. Effective leaching area is equal to 1.0 (3 + (2x invert Height)) for Systems with a width
greater than 3 feet.
8. The maximum trench width allowed to calculate effective leaching area is 3 feet.
Systems installed on remedial sites shall be allowed to utilize the effective
leaching areas presented in Tables 2 or 3, or additional reductions in soil
absorption system may be allowed. In no instance shall the reduction in the soil
absorption system required in 310 CMR 15.242 exceed the maximum reduction
allowed for alternative systems approved in accordance with 310 CMR 15.284.
6. For new construction or an upgrade, the applicant can size the System in bed or
field configuration, using the effective leaching areas presented in Table 3.
Infiltrator Cbamber, Infiltrator Inc.
Approval for General Use — May 22, 2014
Page 4 of 6
Table 3: Effective Leaching Area for Bed or Field Configuration New
Construction and Remedial Sites
9. Effective Leaching area is equal to 1.67 times bottom width only.
7. When the System is used with a secondary treatment unit approved in accordance
with 310 CMR 15.284 or 15.288, additional reductions in soil absorption system
may be allowed. In these situations the reduction in the SAS cannot exceed the
maximum allowed under the secondary treatment units approval. In no instance
shall the reduction in the soil absorption system area required in 310 CMR 15.242
exceed the maximum reduction allowed for alternative systems approved in
accordance with 310 CMR 15.284.
II. Special Conditions
1. The System is an approved Alternative Chamber for use as an Alternative Soil
Absorption System. In addition to the Special Conditions contained in this
Approval, the System shall comply with the "Standard Conditions for Alternative
SAS with General Use Certification and/or Approved for Remedial Use" (the
'Standard Conditions'), except where stated otherwise in these Special
Conditions.
2. New Construction This Certification is for the installation of a System to serve
new construction or an existing facility with a proposed increase in flow, for
Effective
Leaching9
Model
Area
ar. n r.
9. Effective Leaching area is equal to 1.67 times bottom width only.
7. When the System is used with a secondary treatment unit approved in accordance
with 310 CMR 15.284 or 15.288, additional reductions in soil absorption system
may be allowed. In these situations the reduction in the SAS cannot exceed the
maximum allowed under the secondary treatment units approval. In no instance
shall the reduction in the soil absorption system area required in 310 CMR 15.242
exceed the maximum reduction allowed for alternative systems approved in
accordance with 310 CMR 15.284.
II. Special Conditions
1. The System is an approved Alternative Chamber for use as an Alternative Soil
Absorption System. In addition to the Special Conditions contained in this
Approval, the System shall comply with the "Standard Conditions for Alternative
SAS with General Use Certification and/or Approved for Remedial Use" (the
'Standard Conditions'), except where stated otherwise in these Special
Conditions.
2. New Construction This Certification is for the installation of a System to serve
new construction or an existing facility with a proposed increase in flow, for
Infiltrator Chamber, Infiltrator Inc.
Approval for General Use — May 22, 2014
Page 5 of 6
which a site evaluation in compliance with 310 CMR 15.000 has been approved
by the Approving Authority and the site meets the siting requirements for new
construction, as provided in Paragraph 6 in section H Design and Installation
Requirements of the Standard Conditions.
Remedial Site This General Use Certification also applies to the installation of a
System for the upgrade or replacement of an existing failed or nonconforming
system, provided that the facility meets the siting requirements for upgrades, as
provided in Paragraph 7 in section H Design and Installation Requirements of the
Standard Conditions
4. The System shall be exempt from the minimum inlet spacing requirements of 310
CMR15.253.
S. The System shall have a minimum of one inspection port through the top of one
of the chambers. The inspection port shall be capped with a screw type cap and
accessible to within three inches of finish grade.
6. When the System is installed in trench configuration, then the system shall
comply with these requirements:
a) Length (each trench) 100 feet maximum (310 CMR 15.251(1)(a));
b) Width (each trench) 2 feet minimum to 3 feet maximum (3 10 CMR
15.251(1)(b)). - Chambers greater than 3 feet wide, when specifically
approved, are subject to other Special Conditions and limitations;
c) The minimum separation distance between any two trenches shall be two
times the effective width or depth of each trench, whichever is greater, or
where the area between trenches is designated as reserve area, three times the
effective width or depth of each trench, whichever is greater (3 10 CMR
15.251(1)(d));
d) The effective leaching area shall be calculated using the bottom area and a
maximum of two feet (per side) of side wall area for each trench (3 10 CMR
15.251(1)(e));
e) Trenches shall be situated, where possible, with their long dimension
perpendicular to the slope of the natural soil. Where possible they shall follow
the contour lines (3 10 CMR 15.251(2));
f) Trenches constructed at different elevations shall be designed to prevent
effluent from the higher trench(es) flowing into the lower trench(es) (3 10
CMR 15.251(3));
g) The area between trenches may be designated as system reserve area only
where the separation distance between the excavation sidewalls of the primary
trenches is at least three times the effective width or depth of each trench,
whichever is greater (3 10 CMR 15.251(4)) - Chambers greater than 3 feet
wide, when specifically approved, shall be separated by three times the actual
width and are subject to other Special Conditions and limitations; and
Infiltrator Chamber, Infiltrator Inc.
Approval for General Use — May 22, 2014
Page 6 of 6
h) Effluent distribution lines exceeding 50 feet in length shall be connected and
venting provided in accordance with 310 CMR 15.241 (3 10 CMR
15.251(11)).
7. When installed in trench configuration, approved Alternative Chambers greater
than 3 feet wide:
a) shall be installed with a minimum separation distance between any two
trenches of two times the actual width of the chamber, or where the area
between trenches is designated as reserve area, three times the actual width of
the chamber; and
b) shall only be entitled to a maximum effective width of 3 feet for the purposes
of calculating total effective leaching area.
When installed in a bed or field configuration, the System may be installed
without distribution piping, but must comply with the following requirements in
310 CMR 15.252:
a) the use of leaching beds or fields is restricted to systems with a calculated
design flow of less than 5,000 gpd per leaching bed or field (3 10 CMR
15.252(1));
b) the maximum length of chambers in series shall be 100 feet (3 10 CMR
15.252(2)(b));
c) separation distance between adjacent beds/fields shall be ten feet (310 CMR
15.252(2)(0); and
d) the effective leaching area shall include only the bottom area, not the
sidewalls (3 10 CMR 15.252(2)(1)).
9. For Systems constructed in fill and installed, the System shall be installed as
specified in 310 CMR 15.255- Construction in Fill, except the minimum 15 foot
horizontal separation distance to be provided between the soil absorption area and
the adjacent side slope shall be measured horizontally from the top of the
chamber.
10. The System is exempt from 310 CMR 15.287, specifically items: (5) requiring
written notification of alternative system prior to property transfer, (6) need for a
certified operator, (9) need for an operation and maintenance contract with an
operator and (10) deed notice requirement.
0
Commonwealth of M fi sachuse
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.
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.
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:y"
% / /► /�
forms on the ��/ pxlal-
only
computer, use rr the tab key Name 6 7
to move your j
cursor - do not Street Address
use.the return
key.
City own �T State Zip Code
M
2. Owner Name and Address (if different from above):
fen ti Name Street Address
City/Town State
Zip Code Telephone Number
3. Type of Facility (check all that apply):
)f - Residential ❑ Institutional Commercial ❑ School
4. Describe� Fili 44Y 6)jwoe
0 5
4—)
ro
5. Type of Existing System:
❑ Privy ❑ Cesspool(s) Conventional ❑ Other (describe below);
6. Type of soil absorption
i (trenches,111 ,�ch/aambers, leach field, pits, etc):
e W/ Y Av-0,&e 4ZLSDp
aDd l'✓_�V
t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 1 of 4
0
Commonwealth ofsachuse
City/Town of�
Form 9A -
Application for Local Upgrade Approval
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.
A. Facility Information (continued)
7. Design Flow per 310 CMR 15.203:
Design flow of existing system:
Design flow of proposed upgraded system
Design flow of facility:
B. Proposed Upgrade of System
330
9Pd
J
56�
9Pd
9Pd
1. Proposed upgrade is (check one):
❑ Voluntary XRequired by order, letter, etc. (attach copy)
❑ Required following inspection pursuant to 310 CMR 15.301:
2. Describe the proposed upgrade to the system:
Pv' uvy U� 04 44'oe ,
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 in separation between the SAS and high groundwater:
Separation reduction /
Percolation rate
Depth to groundwater
ft. ZL;7
min' /inch
tt. /V
date of inspection
% reduction
t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval* Page 2 of 4
Commonwealth of sachusetttst�
City/Town of rV6 �'�L
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.
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
XUse of a sieve analysis as a substitute for a pen; test
❑ Other requirements of 310 CMR 15.000 that cannot be met— describe and specify sections of the
Code:
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 approvingauth rity.
High�groundwater evaluafon determined y f
Evaluator's Nam (type or print) S' at 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 corn ance with 3 0 CMR 15.000 is not f asible-
2.
t5form9a.doc • rev. 7/06 0714WADdd OWT)
,Application for Local Upgrade Approval, Page 3 of 4
v4d
Commonwealt����lr vsachuse�ttsv�
Ci�,iTown of jq�;'tel
Form JA - 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
4. Connection to a public sevypr is not
Ar
Go�LJr�Z ,�r✓J
R
Jai
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
ASite evaluation forms
MA
❑ 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."
Facility w sign ture /
Print
1
Name of'7,7- Mf
Preparer'saddress_
State2lP Code
Date
Date
City/Town „ � � 7 � � � 2 L
Telephone
t5form9a.doc • rev. 7/06 Application for Local Upgrade Approval- Page 4 of 4
March 17, 2015
Town of North Andover Heal'
c/o Susan Sawyer
1600 Osgood Street, Suite 2'
North Andover, MA 01845
Re: Septic Upgrad,
674 Turnpike
Ms. Sawyer;
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
i.h 10 2015 ,
TOIL .
HE
Please find enclosed Tans for the above property. The
revisions to the plans wereb s �L. fice requesting changes/additions.
Specifically the following changes were ma4_ _
1) On Sheet 1 a detail has been provided showing the entim lot boundaries
J2) A benchmark has been added with 50-75 feet of the proposed system.
13) The LTAR was corrected (previous plan used 0.53 gpd/sf) to reflect 0.33 gpd/sf.
4) On Sheet 2 of 3 and 3 of 3 the manhole covers were better clarified to show them extending to finish
lie•
5) No effluent filter 'skneeded FAST system. Therefore it has been eliminated from the
design.
1 6) , Buoyancy calculations have been provided on Sheet 1 for the septic tank and dosing chamber. �e 6v -t C�
7) On Sheet 2 of 3 the pump calculations include the flowback volume. a co rrt(�'
0,8) Both the septic tank and dosing chamber are noted to be monolithic H-10 rated tanks.
, J9) A conventional system sizing and location is shown on Sheet 3 for graphically purposes only (not for
construction)
Based on discussions with J&R Sales & Service, Inc (local representative for Micro Fast) a primary septic
tank housing the Micro Fast system is proposed followed by a separate dosing chamber for the pump system
components. A blower system has been graphically shown and a vent for the Micro FAST insert has been
shown as well. J&R Sales & Service, Inc. reviewed this plan as well prior to issuing the designer certification
letter.
Additionally, Infiltrator Systems provided an email stating Designer certification is "offered" but not required.
J&R Sales and Service, Inc provided a letter certifying the designer training for the Micro FAST system. Both
the email and letter are enclosed.
VeryWVE
Jae
PO Box 2004 Woburn, MA 01888 (781) 854-8644
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
March 17, 2015
Town of North Andover Health Dept.
c/o Susan Sawyer
1600 Osgood Street, Suite 2035
North Andover, MA 01845 ` !
Re: Septic Upgrade Plans (Revised) hAR 18.2015
015
674 Turnpike Street, North Andover M.
HE
Ms. Sawyer;
Please find enclosed three (3) copies of the revised Septic Upgrade Plans for the above property. The
revisions to the plans were based on a 1/29/2015 letter from your office requesting changes/additions.
Specifically the following changes were made:
1) On Sheet 1 a detail has been provided showing the entire lot boundaries
J 2) A benchmark has been added with 50-75 feet of the proposed system.
13) The LTAR was corrected (previous plan used 0.53 gpd/sf) to reflect 0.33 gpd/si
4) On Sheet 2 of 3 and 3 of 3 the manhole covers were better clarified to show them extending to finish
grade.
5) No effluent filter js eeded o FAST system. Therefore it has been eliminated from the
design. P44 d-
1 6) , Buoyancy calculations have been provided on Sheet 1 for the septic tank and dosing chamber. e GLC
7) On Sheet 2 of 3 the pump calculations include the flowback volume. ak
,), 8) Both the septic tank and dosing chamber are noted to be monolithic H-10 rated tanks.
J9) A conventional system sizing and location is shown on Sheet 3 for graphically purposes only (not for
construction)
Based on discussions with J&R Sales & Service, Inc (local representative for Micro Fast) a primary septic
tank housing the Micro Fast system is proposed followed by a separate dosing chamber for the pump system
components. A blower system has been graphically shown and a vent for the Micro FAST insert has been
shown as well. J&R Sales & Service, Inc. reviewed this plan as well prior to issuing the designer certification
letter.
Additionally, Infiltrator Systems provided an email stating Designer certification is "offered" but not required.
J&R Sales and Service, Inc provided a letter certifying the designer training for the Micro FAST system. Both
the email and letter are enclosed.
VeryWE
Ja¢
PO Box 2004 Woburn, MA 01888 (781) 854-8644
r
j8n SALE3 8 SEUICE, {SIC.
March 11, 2015
Mr. lack Sullivan
Sullivan Engineering Group, LLC
22 Mount Vernon Road
Boxford, MA 01921
RE: Designer Certification
Dear Mr. Sullivan,
This letter is to certify that you have been trained in the design of the BioMicrobics FAST Treatment
System. As the New England Representative for BioMicrobics, AR Sales and Service has provided this
training and certification.
Please let me know if you have any questions or would like additional information.
Sincerely,
Lauren D. Usiiton
President
213/2075 XFINITY connect
XF NM connect
RE ISI
From :Michael McLaughlin<MMcLaughlin@infiltratorsystems.net>
jacksu1153@comcast.net
Font Size -
Tue, Feb 03, 2015 04:08 PM
Subject: RE: ISI1 attachment
To : Jack Sullivan <jac1csull53@comcast. net>
Jack, the training is simply offered as an option and not required by Infiltrator Systems, T you would
like training or know anyone that is a designer or installer that would benefit from the training please
let me know.
Thanks,
M ike
Michael McLaughlin
Inside Sales and Technical Service
Infiltrator Systems, Inc.
4 Business Park Road
P.O. Box 768
Old Saybrook, Cr 06475
P: 866.877.7151
P. 860.577.7747
www.infEtratorsystenis.com
www.facebook.com/infiltratorsystemsinc
www.linkedin.com/company/infiltratoMstems-inc
www.youtube.com/user/InfikratorSysInc/videos
From: Jack Sullivan [mailto:jacksull53@comcast.net]
Sent: Tuesday, February 03, 2015 3:30 PM
To: McLaughlin, Michael
Subject: Re: ISI
Mike,
I just designed a residential septic system with infiltrators in North Andover, MA
The Town in reviewing the design asked for
"proof that the Designer has satisfactorily completed any required training by the Company for the
design of the system"
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
March 17, 2015
Town of North Andover Health Dept.
c/o Susan Sawyer
1600 Osgood Street, Suite 2035
North Andover, MA 01845
Re: Owner Certification — Alternative Technology
674 Turnpike Street, North Andover
Ms. Sawyer,
I certify that the following conditions relative to the Micro FAST alternative technology:
i. has been provided a copy of the Approval, the 0vimer's Manual,
and the Operation and Maintenance Manual, and the 01vner
agrees to compo) u4th all terms and cor?ditions;
ii. has been informed of all the Oivner's estimated costs associated
ivith the operation including, 1 -Men applicable: poi -ver
consumption, maintenance, sampling, record keeping, reporting,
and equipment replacement,
iii. understands the requirement for a service contract;
iv. agrees to fulfill his responsibilities to provide a Deed Notice as
required by 310 CMR 15.287(10 and the Approval);
v. agrees to fiilfrll his responsibilities to provide written notification
of the Approval to new 'Otilner, as required by 310 CMR
15.287(5);
vi. if the design does not provide for the use of garbage grinders, the
restriction is understood and ,accepted, and
VIi. whether or not covered by a warranty, the System Chvner
understands the requirement to repair, replace, moth, or take any
other action as required by the Department or the local Approving
Authority; if the-Bepartment or the local Approving Authority
determines the Alternative System is not capable of meeting the
performance standards.
PO Box 2004 Woburn, MA 01888 (781) 854-8644
I fiirther certify that the following conditions relative to the Infiltrator System alternative technology:
1. has been provided a copy of the Title 5 IIA technology Approval,
the Oivner's Manual. and the Overation and Maintenance Manual,
and the Oivner Mrees to comply with all terms and conditions;
°2. for Systems installed under a Remedial. Use Approval, the ommer
agrees to f rlfill his responsibilities to provide 1•vritten notification
of the Approval to any neiv Owner, as required by 310 CMR
15.287(5);
3. if the design does not provide for• the use of garbage grinders, the
restriction is understood and accepted; and
4. iwhether or not covered by a warranty, the System avner
understands the requirement to repair; replace, modify or take any
other- action as required by the Department or the LAA. ifthe
Department or the LAA determines the System to be failing to
protect public health and safety and the environment, as defined in
310 CMR 15.303.
Owners Name: (Print)
Address: (Print)
Date:rmt)
Owner Signature:
PO Box 2004 Woburn, MA 01888 (781) 854-8644
M
North Andover Health Department
(ommunity Development Division
January 29, 2015
Jack Sullivan, P.E.
Sullivan Engineering Group, LLC
22 Mount Vernon Road
Boxford, MA 01921
Re: Subsurface Sewage Disposal System Plan for 674 Turnpike Street, Map 98D, Lot 21
Dear Mr. Sullivan:
The proposed wastewater system design plan for the above site dated January 13, 2015 and
received on January 22, 2015 has been reviewed. Unfortunately, the plan cannot be approved
until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or
North Andover regulation that is not met by this design follows each item where applicable.
`J 1. On sheet 1 of 3, the full legal boundaries of the facility bin served are not shown 310
g Yeg
CMR 15.220(4)(a)).
�i 2. On sheet 1 of 3, a benchmark is needed within 50-75 feet of the proposed facility (3 10
CMR 15.220(4)(q)).
13. On sheet 1 of 3, the LTAR of 0.53 gpd/sf is incorrect based on the "title 5 alternative to
/ percolation jesting guidaff!e for system upgrades".
v 4. On sheet 2 of 3 and 3 of 3, it is unclear the manhole covers that are proposed to be at
finish grade.
5. Annual maintenance is required for the proposed effluent filter (3 10 CMR 15.227(7)).
This should be noted on the design plan.
1 6. Buoyancy calculations are required for the both tanks being proposed (3 10 CMR
15.221(8)).
J7. On sheet 2 of 3, the pump calculations should include the flowback volume of the
forcemain.
J 8. On sheet 2 of 3, indicate if a H-10 or H-20 FAST/pump chamber is proposed.
j9. Although not a reason for disapproval, it appears the primary septic tank could be
eliminated from the design based on the Micro FAST remedial use approval letter.
However, this should be confirmed with the manufacturer before any design changes are
finalized.
Page 1 of 4
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
10. Although not a reason for disapproval, you may wish to create a detail of the FAST/pump
chamber. It is confusing whether only a FAST unit is proposed or only a pump chamber
is proposed.
11. Since the Micro FAST system is proposed as secondary treatment unit the "Standard
Conditions for Secondary Treatment Units Approved for Remedial Use" will apply.
Please provide the following as required by the approval conditions
Section II(10):
a) The record drawings, approved by the LAA, must clearly indicate an area for
the best feasible replacement system that could be installed in the event that the
proposed Alternative Soil Absorption System fails or it is determined that it is not
capable of providing equivalent environmental protection;
Section II(20):
/I
proof that the Designer has satisfactorily completed any required training by
the Company for the design and installation of the Technology;
c) certification by the Designer that the design conforms to the Approval, any
Company Design Guidance, and 310 CMR 15.000; and
d) a certification, signed by the Owner of record for the property to be served by
`— the Technology, stating that the property Owner:
e Approval, the Owner's Manual i. has been provided a copy of th pp ,
and the Operation and Maintenance Manual, and the Owner
agrees to comply with all terms and conditions;
ii. has been informed of all the Owner's estimated costs associated
with the operation including, when applicable: power
consumption, maintenance, sampling, record keeping, reporting,
and equipment replacement;
iii. understands the requirement for a service contract;
iv. agrees to fulfill his responsibilities to provide a Deed Notice as
required by 310 CMR 15.287(10 and the Approval);
V. agrees to fulfill his responsibilities to provide written notification
of the Approval to any new Owner, as required by 310 CMR
15.287(5);
A if the design does not provide for the use of garbage grinders, the
restriction is understood and accepted; and
vii. whether or not covered by a warranty, the System Owner
understands the requirement to repair, replace, modify or take any
other action as required by the Department or the local Approving
Authority, if the Department or the local Approving Authority
determines the Alternative System is not capable of meeting the
performance standards.
Page 2 of 4
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
y
12
Since the Infiltrator Chamber system is proposed as an alternative soil absorption system
the "Standard Conditions for Alternative Soil Absorption Systems with General Use
Certification and/or Approved for Remedial Use" will apply. Please provide the
following as required by the approval conditions
fSection II(7):
e) The record drawings, approved by the LAA, must clearly indicate an area for
the best feasible replacement system that could be installed in the event that the
proposed Alternative Soil Absorption System fails or it is determined that it is not
capable of providing equivalent environmental protection;
Section II(18):
b) proof that the Designer has satisfactorily completed any required training by
the Company for the design and installation of the Technology;
e) certification by the Designer that the design conforms to the Approval, any
Company Design Guidance, and 310 CMR 15.000; and
fi a certification, signed b the Owner o record or the property to be serve
Y f f p p tY d by
the Technology, stating that the property Owner:
1. has been provided a copy of the Title 5 UA technology Approval,
the Owner's Manual, and the Operation and Maintenance Manual,
and the Owner agrees to comply with all terms and conditions,-
2.
onditions;2. for Systems installed under a Remedial Use Approval, the owner
agrees to fulfill his responsibilities to provide written notification
of the Approval to any new Owner, as required by 310 CMR
15.287(5);
3. if the design does not provide for the use of garbage grinders, the
restriction is understood and accepted; and
4. whether or not covered by a warranty, the System Owner
understands the requirement to repair, replace, modify or take any
other action as required by the Department or the LAA, if the
Department or the LAA determines the System to be failing to
protect public health and safety and the environment, as defined in
310 CMR 15.303.
Page 3 of 4
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
r
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
incerely,
Michele Grant
Health Inspector
cc: 39 Cotuit Street, LLC
File
Page 4 of 4
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Blackburn, Lisa
From:
Sawyer, Susan
Sent:
Tuesday, March 17, 2015 3:32 PM
To:
Grant, Michele; Blackburn, Lisa
Subject:
FW: 674 Turnpike Street - Septic Upgrade Plans
Attachments:
Sheetl.pdf, Sheet2.pdf, Sheet3.pdf
From: Jack Sullivan [mailtoJacksull530)comcast.net]
Sent: Tuesday, March 17, 2015 12:43 PM
To: Hughes, Jennifer
Cc: Gaffney, Heidi; Sawyer, Susan
Subject: re: 674 Turnpike Street - Septic Upgrade Plans
Attached are the revised septic upgrade plans pei
dropping off paper copies to each department ton
Jennifer ... we may have to continue the March 2.1
talk early next week.
Sullivan Engineering Group, LLC
Jack Sullivan
P.O. Box 2004
Woburn, MA 01888
781-854-8644
— ",11th review memorandum. I will be
Blackburn, Lisa
From: Sawyer, Susan
Sent: Tuesday, March 17, 2015 3:32 PM
To: Grant, Michele; Blackburn, Lisa
Subject: FW: 674 Turnpike Street - Septic Upgrade Plans
Attachments: Sheetl.pdf; Sheet2.pdf, Sheet3.pdf
From: Jack Sullivan[mailto:jacksull53Caacomcast.net]
Sent: Tuesday, March 17, 2015 12:43 PM
To: Hughes, Jennifer
Cc: Gaffney, Heidi; Sawyer, Susan
Subject: re: 674 Turnpike Street - Septic Upgrade Plans
Attached are the revised septic upgrade plans pei
dropping off paper copies to each department ton
Jennifer ... we may have to continue the N
talk early next week.
Sullivan Engineering Group, LLC
Jack Sullivan
P.O. Box 2004
Woburn, MA 01888
781-854-8644
- - ^f Health review memorandum. I will be
1
Blackburn, Lisa
From: Sawyer, Susan
Sent: Tuesday, March 17, 2015 3:32 PM
To: Grant, Michele; Blackburn, Lisa
Subject: FW: 674 Turnpike Street - Septic Upgrade Plans
Attachments: Sheetl.pdf; Sheet2.pdf, Sheet3.pdf
From: Jack Sullivan [mailto:jacksu1153@comcast.net]
Sent: Tuesday, March 17, 2015 12:43 PM
To: Hughes, Jennifer
Cc: Gaffney, Heidi; Sawyer, Susan
Subject: re: 674 Turnpike Street - Septic Upgrade Plans
Attached are the revised septic upgrade plans per the Board of Health review memorandum. I will be
dropping off paper copies to each department tomorrow morning.
Jennifer ... we may have to continue the March 25 hearing until we lose some more snow ... but we can
talk early next week.
Sullivan Engineering Group, LLC
Jack Sullivan
P.O. Box 2004
Woburn, MA 01888
781-854-8644
O\VNER /APPLICANT
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8
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Town of North Andover
HEALTH DEPARTMENT
SACHUSt I/
CHECK #:' 0Q 0 DATE: JSI`` I,
LOCATION:l)(01 rt
H/O NAME:
CONTRACTOR NAME:, mfl
F1 _f),
Type
of Permit or License: (Check box)
,_ �u
$ �_
❑
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 Sustems:
❑
Septic -Soil Testing .
$
',_� Septic -Design Approval Q�b(,{,�`3jl_
,_ �u
$ �_
❑
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑
Title 5 Report
$
❑
Other: (Indicate)
$
W)
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
f MOR71�y 6923
O 1te , yo
Town of North Andover
;'••,,,,, �. HEALTH DEPARTMENT
,SSACMU+t4
1 l �
CHECK #: 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
$
Septic - Design Approval
$
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑
Title 5 Report
$
❑
Other. (Indicate)
$
(/-04
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
Sullivan Engineering Group, LLC
�i vrr' r,i.tecrs a�iu ' velopment Consultants
January 16, 2015
Town of North Andover Health Dept.
c/o Susan Sawyer
1600 Osgood Street, Suite 2035
XT�«ttk nn.�e�.o. 1k 4, n n181c
i, .
Re: Septic Upgrade Plans
674 Turnpike Street, North Andover
Ms. Sawyer;
Please find enclosed materials for the submission of septic upgrt
The following materials are part of this submission:
1) A check for $225.00 payable to "Town of North Andover" for septic review fee
2) A completed "Septic Plan Submittal Form"
3) Completed Soil Evaluator Forms
4) Three (3) sets of original stamped Septic Upgrade Plans (3 sheets per set)
5) Completed Form 9A -Application for Local Upgrade Approval
f- 11 CcY�r of "General Use" approval letter for Microfast 0.5 denitrofication unit
7) Copy of "General Use" approval for Infiltration Chambers
Additionally, the owner is seeking a variance from the Board of Health:
1) Setback from septic tank to wetlands (75 feet required 52 feet provided)
2) Setback from soil absorption field to wetlands (100 feet required 61.6 feet required)
Note: Under Section 3.8 of the North Andover BOH regulations, revised 2/25/2010, these variances can
be granted by the Health Department (without a public hearing) since a MassDEP approved device
(Microfast 0.5) is being proposed to reduce wastewater levels.
A Notice of Intent application has been filed with the North Andover Conservation Commission for this work.
If you should have any questions or comments please feel free to contact me.
Cc: Mill River Consulting
22 Mount Vernon Road — Boxford, Massachusetts 01921 — (978) 352 -7871 -Phone — 978 352-7871 - Fax
Sullivan Engineering Group, LLC
r vii err,YiIJMr a i dIJU LIU✓L4 OP llEllf COr]Sll%fBrlfS
January 16, 2015
Town of North Andover Health Dept.
c/o Susan Sawyer
1600 Osgood Street, Suite 2035
Re: Septic Upgrade Plans
674 Turnpike Street, North Andover
Ms. Sawyer;
Please find enclosed materials for the submission of septic upgrade plans for the above property.
The following materials are part of this submission:
1) A check for $225.00 payable to "Town of North Andover" for septic review fee
2) A completed "Septic Plan Submittal Form"
3) Completed Soil Evaluator Forms
4) Three (3) sets of original stamped Septic Upgrade Plans (3 sheets per set)
5) Completed Form 9A -Application for Local Upgrade Approval
5) Copy of "General Use" approval letter for Microfast 0.5 denitrofication unit
7) Copy of "General Use" approval for Infiltration Chambers
Additionally, the owner is seeking a variance from the Board of Health:
1) Setback from septic tank to wetlands (75 feet required 52 feet provided)
2) Setback from soil absorption field to wetlands (100 feet required 61.6 feet required)
2 x:-2015
70\
Note: Under Section 3.8 of the North Andover BOH regulations, revised 2/25/2010, these variances can
be granted by the Health Department (without a public hearing) since a MassDEP approved device
(Microfast 0.5) is being proposed to reduce wastewater levels.
A Notice of Intent application has been filed with the North Andover Conservation Commission for this work.
If you should have any questions or comments please feel free to contact me.
Cc: Mill River Consulting
22 Mount Vernon Road — Boxford, Massachusetts 01921 — (978) 352 -7871 -Phone — 978 352-7871 - Fax
TOWN OF NORTH ANDOVER '
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
NORTH ANDOVER, MASSACHUSETTS 01845
978.688.9540 — Phone
Susan Y. Sawyer, REHS/RS 978.688.8476— FAX
Public Health Director E-MAIL: healthdeptaa,townofnorthandover.com
WEBSITE: http://www.townofnorthandover.com
SEPTIC PLAN SUBMITTAL FORM
Date of Submission: January 20, 2015
Site Location: 674 Turnpike Street
Engineer: Jack Sullivan
New Plans? Yes X $225/Plan Check # (includes 1St submission and one re-
review only)
Revised Plans?Yes $75/Plan Check #
Site Evaluation Forms Included? Yes X
Local Upgrade Form Included? Yes X
Telephone #: 978-352-7871
E-mail: jacksu1153@comcast.net
No
No
Fax #: 978-352-7871
Homeowner �, OZ 73
Name: Mohammad Yamin E-mail: moyamin@yahoo.com (j �
OFFICE USE ONLY
When the submission is complete (including check):
➢ Date stamp plans and letter
➢ Complete and attach Receipt
➢ Copy File; Forward to Consultant
➢ Enter on Log Sheet and Database
"IM&T Banlc
Rehabilitation Loan Permit Certification
(To be completed by local municipality or HUD Consultant)
Property: 976 Turnpike Street, North Andover, MA 01845 Applicant(s): Lindon & Tina Pulley
Rehab Type:
Municipality Type:
Name of Municipality:
❑ Full 203K VIStreamline 203k
❑ County ❑ Town ❑ City
Loan #:
❑ Fnma Homestyle ❑ SONYMA
❑ Village ❑ Other
1 1 6 •� ' - v\ k 1� C d 11 e) C Phone No: (
❑ other
❑ Refinance Borrower(s) must provide written evidence, prior to VIPurchase Borrower does not own subject property yet, but must
closing, from local municipality (county/city/town/village, etc.) that they validate, prior to closing, with local municipality (county /
have applied for (and when possible, been granted) permits for all work city/town/village, etc.) which permits (if any) will be required for all work
items listed in their 203K plan which require permits items listed in their 203K plan.
ATTN: BUILDING DEPARTMENT/INSPECTOR:
The property listed above is subject to renovations. Lending guidelines require that all necessary permits and inspections be
obtained from local municipality authorities. Please review the attached plans & specifications to determine if any permits are
reauired for the outlined work. Please indicate below which permits/inspections will be required, or if already issued.
CONTRACTOR NAME
ANTICIPATED WORK (General Description)
APPROX. COST
INSPECTION
COST OF EACH?
PERMIT TYPE:
REQUIRED?
REQUIRED?
-Please use the back of this form to include additional information -
MUNICIPALITY TO COMPLETE
PERMIT
INSPECTION
COST OF EACH?
PERMIT TYPE:
REQUIRED?
REQUIRED?
if an
GENERAL BLDG PERMIT
Y / N
Y / N
$
HVAC
y / N
Y / N
$
ROOFING
Y / N
Y / N
$
ELECTRICAL
Y / N
Y / N
$
PLUMBING
Y / N
Y / N
$
OTHER-
�J N
Q/ N
$
NO PERMITS REQUIRED
Y / N
Y / N
$
FOR INTERNAL M&T USE ONLY
Financed into Permit obtained Permit to be
, — A—+7 I by customer prior obtained/coordinat
bt\ 'e3Lr0 Vo a,aS - ywi Aca '—
, iwr` 1 V`t'yit(G�Q
Signature: &0 Date: -
❑ 203K Consultant* ID # (*By Signing, HUD Consultant certifies that s/he has verified the above information w/the municipality)
❑ City/Town/County Bldg Inspector/Code Enforcement Officer -
Borrower Acknowledgment/Notice to Mortgage Applicant: You must take this form to your local municipality to be completed, or your HUD 203k
Consultant, if applicable. M&T will not permit the scheduling of your closing without verification of required permits, for refinance or purchase
transactions.
4 Borrower(s) SELECT ONE: ❑ I DO / ❑ I DO NOT request the sum of all permits to be financed into my 203k Rehabilitation Escrow. F
/-b-s—
Bo;Wwer Signature Date
Borrower Signature
Rehabilitation Loan Permit Certification
M&T Form 8000,/ Rev. 10-21-11
N-OR-TH eun0YER W TH DEPT.
Date 1600 Osgood Street, Suite 2035
North A,ndovgr,:MA 01845
Borrower:
Blackburn, Lisa
From: Isaac Rowe <irowe@millriverconsulting.com>
Sent: Tuesday, September 09, 2014 3:59 PM
To: Sawyer, Susan; Blackburn, Lisa
Cc: 'Pam Lally'; 'Isaac Rowe'
Subject: RE: 674 Turnpike St.
Attachments: 674 Turnpike Street - Soil testing results 9-9-14.PDF
Susan,
Attached is the soil testing result for the above referenced property. As you will see, Jack attempted a perc test even
though there was water in the bottom of the perc test hole. The water level did not drop much during the presoak and
45 minutes into the test. I allowed him to abandon the perc test and take a soil sample for a sieve analysis due to
saturated soil conditions.
This entire site and general area appears to be a filled in wetland resource area based on the water table, color of soil
layers and amount of fill material present.
Please let me know if you have any questions.
Thanks,
Isaac M. Rowe, R.S.
Project Manager
Mill River Consulting
6 Sargent Street
Gloucester, MA 01930-2719
Phone: 978-282-0014 ext.804
Fax: 978-282-1318
irowe@millriverconsulting.com
www.millriverconsulting.com ►•i
I
-----Original Message----- k
From: Blackburn, Lisa [mailto:LBlackburn@townofnorthandover.com]
Sent: Friday, August 15, 201411:42 AM
To: Dan Ottenheimer; Isaac Rowe; Pam Lally
Subject: 674 Turnpike St.
Please schedule soil testing with Jack Sullivan 978.352.7871.
-----Original Message -----
From: noreply@townofnorthandover.com fmailto:noreply@townofnorthandover.com]
Sent: Friday, August 15, 201411:49 AM
To: Blackburn, Lisa
Subject: Message from "ComDev-Health-Ricoh"
This E-mail was sent from "ComDev-Health-Ricoh" (Aficio MP C3002).
Blackburn, Lisa
From: Pam Lally<plally@millriverconsulting.com>
Sent: Wednesday, August 20, 2014 9:40 AM
To: Blackburn, Lisa; 'Dan Ottenheimer'; 'Isaac Rowe'
Subject: RE: 674 Turnpike St.
Hi Lisa,
We've schedule this with Jack Sullivan for Tuesday, Sept. 9th. Isaac will be there at 9am.
Let us know if you have any questions.
Pam
-----Original Message -----
From: Blackburn, Lisa [ma iIto: LBlackburn @townofnorthandover.com]
Sent: Friday, August 15, 201411:42 AM
To: Dan Ottenheimer; Isaac Rowe; Pam Lally
Subject: 674 Turnpike St.
Please schedule soil testing with Jack Sullivan 978.352.7871.
-----Original Message -----
From: norepiy@townofnorthandover.com [mailto:noreply@townofnorthandover.com]
Sent: Friday, August 15, 201411:49 AM
To: Blackburn, Lisa
Subject: Message from "ComDev-Health-Ricoh"
This E-mail was sent from "ComDev-Health-Ricoh" (Aficio MP C3002).
Scan Date: 08.15.201411:48:53 (-0400)
Queries to: noreply@townofnorthandover.com
N0Rf1� / 9/
� � 9
Town of North Andover
+�,�'•+� HEALTH DEPARTMENT
,SSwC NU5t4 j
CHECK DATE: 14
LOCATION:DODO(
H/O NAME: qr,
CONTRACTOR NAME:
Type
of Permit or License: (Check box)
x
❑
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
affi-11
❑
Septic - Design Approval
$
❑
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑
Title 5 Report
$
❑
Other: (Indicate)
$
LE -2
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
TOWN OF NORTH ANDOVER
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
NORTH ANDOVER, MASSACHUSETTS 01845
Susan Y. Sawyer, RENS, RS
Public Health Director
APPLICATION FOR SOIL TESTS
DATE: August 14, 2014
978.688.9540 – Phone
978.688.8476 – FAX
pF t4oR7M qy
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www.townofnorthandover.com
MAI, & PARCEL: Map 98D Lot 21
RECEIVED
5 2014
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
LOCATION OF SOIL TESTS: 2 Testholes in Front Yard to Right of House
OWNER: Mohammad Yamin
APPLICANT: Same as Owner
Contact #: 978-989-9892
Contact #:
ADDRESS: 674 Turnpike Street North Andover, MA 01845
ENGINEER: Jack Sullivan, PE
contact #: 978-352-7871
CERTIFIED SOIL EVALUATOR: Jack Sullivan, PE SE#:2378
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_EWA. OWING MUST BE INCLUDED WITH THIS FORM
➢ Proof of land ownership (Tax bill, or letter from owner permitting test)
➢ 8.5"x 11 "Plot plan & Location of Testing (please indicate test nit sites on the plan)
➢ Fee of $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. 7
Signature of Conservation Agent. y— 1�7,C�
Date back to Health Department: (stamp in): PV -'P o e'NjL C*-er A I r
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SEE REVERSE SIDE FOR IMPORTANT INFORMATION
THE COMMONWEALTH OF MASSACHUSETTS
TOWN OF NORTH ANDOVER
Fiscal Year 2015 1st Quarter
Preliminary Real Estate Tax Bill
Office of Collector of Taxes
Jennifer Yarid, Treasurer/Collector
qc#100407 NoAndREMul
39 COTUIT STREET, LLC
32 PALOMINO DRIVE
NORTH ANDOVER, MA
01845
LOC:674 TURNPIKE STREET
MAP -LOT -PLOT: 210-098.D-0021-0000.0
BOOK/PAGE: /
RES. EXEMPT: $0
TOT TAXABLE VAL: 303400
Assessed Owner as of January 1, 2014:
39 COTUIT STREET, LLC
32 PALOMINO DRIVE
NORTH ANDOVER, MA
01845
fir. �O
�s'�4q{UafF�-N
Page 2 of 4
Bill No. 1 6151
Make checks Payable To.
Town of North Andover
Collector of Taxes
P.O. Box 184
Medford, MA 02155-0002
Office Hours:
Mon. 8:30 - 4:30 Tues. 8:00 - 6:00
Wed. 8:00 - 4:30 Thurs. 8:00 - 4:30
Fri. 8:00 - 12:00
TAX COLLECTOR: 978-688-9550
ASSESSOR: 978-688-9566
Pay online at
www.townofnorthandover.com
Please use the enclosed lockbox envelope to
expedite your payment. This will assist us in
processing your payments more efficiently.
The Tax Collector's Office is located at 120 Main Street.
Town of North Andover
Fiscal Year 20151st Quarter
Preliminary Real EstateTax Bill
Jennifer Yarid, Collector of Taxes
Interest at the rate of 14% per annum will accrue
on overdue payments from the due date until
payment is made.
gp I I / / L�
1st Quarter Receipt
Bill No.
6151
Preliminary RE Tax
$2186.00
Preliminary CPA
$43.97
Subtotal
$2229.97
1st Qtr. Due 8/01/2014
$1114.99
2nd Qtr. Due 11/03/2014
$1114.98
Payments Made
$0.00
AMi
$1114.99
i14UE
C
OI
P
Y
FISCAL YEAR 2015 PRELIMINARY TAX: This bill shows the amount of preliminary tax you owe for fiscal year 2015 (July 1, 2014 - June 30, 2015)
PRELIMINARY TAX AMOUNT: As a general rule, your preliminary tax will not exceed 50% of your adjusted fiscal year 2014 tax (including any betterments, special
assessments and other charges added to the tax). Adjustments are made for abatements or exemptions granted for fiscal year 2014, and tax increases allowed under
Proposition 2'/1 in fiscal year 2015. Under certain circumstances, your preliminary tax may exceed 50% of the adjusted amount.
PAYMENT DUE DATES / INTEREST CHARGES: If preliminary bills were mailed on or before August 1, 2014, your preliminary tax is payable in two equal installments. Your first
payment is due August 1, 2014, or 30 days after the bills were mailed, whichever is later. Your second payment is due November 1, 2014. However, if preliminary bills were mailed
after August 1, 2014, your preliminary tax is due as a single installment on November 1, 2014, or 30 days after the bills were mailed, whichever is later. If your payments are not
made by their due dates, interest at the rate of 14% per annum will be charged on the unpaid and overdue amount. If preliminary bills were mailed on or before August 1, 2014, interest
will be computed on overdue first payments from August 1, 2014, or the payment due date, whichever is later, and on overdue second payments from November 1, 2014, to the
date payment is made. If preliminary bills were mailed after August 1, 2014, interest will be computed on overdue payments from November 1, 2014, or the payment due date,
whichever is later, to the date payment is made. You will also be required to pay charges and fees incurred for collection if payments are not made when due. Payments are
considered made when received by the Collector. To obtain a receipted bill, enclose a self- addressed stamped envelope and both copies of the bill with your payment.
FISCAL YEAR 2015 ACTUAL TAX BILLS: You will receive your actual fiscal year 2015 tax bill based on January 1, 2014 assessments after the tax rate is set. Any preliminary tax
payments made will be credited toward payment of your fiscal year 2015 tax. Your actual tax bill will provide you with more detailed information on payment due dates.
ABATEMENT / EXEMPTION APPLICATIONS: Your right to seek an abatement of or exemption from your fiscal year 2015 tax is not prejudiced by the issuance of preliminary tax
bills. Once the actual tax bills are issued, you will be able to apply for an abatement or exemption. The deadline for filing your abatement or exemption application will be measured
from the date the actual tax bills are mailed, not the date preliminary tax bills were mailed. Your actual tax bill will provide you with more detailed information on application procedures
and deadlines.
INQUIRIES: If you have questions on how your preliminary tax was determined, you should contact the Board of Assessors. If you have questions on payments, you should
contact the Collector's Office.
7/1 /14re/prelim/generic
' Of NORTH ,� 7000
aidi
OOL
O 9
Town of North Andover
`;'•�,.... ;, HEALTH DEPARTMENT
c/1u5�4
CHECK #: DATE:
LOCATION: l�
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 Sustems:
❑ Septic - Soil Testing
$
❑ Septic - Design Approval
$
❑ Septic Disposal Works Construction (DWC)
$
❑ Septic Disposal Works Installers (DWI)
$
❑ Title 5 Inspector
$
❑ Title 5 Report
$
Other. (Indicate) A $
P�
Health Agent1 nitials
White - Applicant Yellow - Health Pink - Treasurer
TOWN OF NORTH ANDOVER
NORTH ANDOVER, MASSACHUSETTS 01845
Permit Number 190,
Date Issued
Expiration Date, `
Jackie's Law — Permit Application
Pursuant to G.L. e. 82A §1 and 520 CMR 7.00 et seq.(as amended)
THIS PERMIT MUST BE FULLY COMPLETED PRIOR TO CONSIDERATION
Name of Applicant
Phone Cell
Street Address
/% e-6;
CZ)f Iowa
0 a -111-e V
MA
I ZIP
1 vitor (if dlfferez� from applicant)
rAAeddress
Phone Cell
R-0 /, /Q e
�P-6 97- a 7 7 3
Cityrfown
1311A
ZIP
XOW /, ("
. �
dlp� 7
Name of Ownir(s) ofP
Street Address
Phone CCU
C 92
4 V 1 r
2 A
-L
City Town
MA
ZIP
. . .... .....
Permit Fee Received N12A
Other Contact
Description, location and purpose of proposed tmeb:
Please describe the exact location of the proposed trench and its purpose (include sk description of what is (or is intended) to
be laid in proposed trench (eg; pipes/cable lines etc..) Please use reverse side if additional space is needed.
74
--'IED
014
2014
Insurance Certificate To)NN VV -MEN I
HEALTH DEPART
I
Name and Contact Information of Insurer.-
.
. ..... . .... .....
Policy Expiration Date:
Dig Safe #: � / L � � y
Name of Competent Person (as defined by 520 CMR 7.02).
le
Massachusetts Hoisting License ,# /A/.F- -T97 6777
License Grade: /,:f h
Expiration Date -
BY SIGNING THIS FORM, THE APPLICANT, OWNER, AND EXCAVATOR ALL ACKNOWLEDGE
AND CERTIFY THAT THEY ARE FAMILIAR WITH, OR, BEFORE COMMENCEMENT OF THE
WORK, WILL BECOME FAMILIAR WITH, ALL LAWS AND REGULATIONS APPLICABLE TO
WORK PROPOSED, INCLUDING OSHA REGULATIONS, G.L. c. 82A, 520 CMR. 7.00 et seq., AND ANY
APPLICABLE MUNICIPAL ORDINANCES, BY-LAWS AND REGULATIONS AND THEY COVENANT
AND AGREE THAT ALL WORK DONE UNDER THE PERMIT ISSUED FOR SUCH WORK WILL
COMPLY THEREWITH IN ALL RESPECTS AND WITH THE CONDITIONS SET FORTH BELOW.
THE UNDERSIGNED OWNER AUTHORIZES THE APPLICANT TO APPLY FOR THE PERMIT AND
THE EXCAVATOR TO UNDERTAKE SUCH WORK ON THE PROPERTY OF THE OWNER, AND
ALSO, FOR THE DURATION OF CONSTRUCTION, AUTHORIZES PERSONS DULY APPOINTED BY
THE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR AND INSPECT THE WORK
FOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND
REGULATIONS GOVERING SUCH WORK.
THE UNDERSIGNED APPLICANT, OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY
TO REIMBURSE THE MUNICIPALITY FOR ANY AND ALL COSTS AND EXPENSES INCURRED BY
THE MUNICIPALITY IN CONNECTION WITH THIS PERMIT AND THE WORK CONDUCTED
THEREUNDER, INCLUDING BUT NOT LIMITED TO ENFORCING THE REQUIREMENTS OF STATE
LAW AND CONDITIONS OF THIS PERMIT, INSPECTIONS MADE TO ASSURE COMPLIANCE
THEREWITH, AND MEASURES TAKEN BY THE MUNICIPALITY TO PROTECT THE PUBLIC
WHERE THE APPLICANT OWNER OR EXCAVATOR HAS FAMED TO COMPLY THEREWITH
INCLUDING POLICE DETAILS AND OTHER REMEDIAL MEASURES DEEMED NECESSARY BY
THE MUNICIPALITY.
THE UNDERSIGNED APPLICANT, OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY
TO DEPEND, INDEW, FY, AND HOLD HARMLESS THE MUNICIPALITY AND ALL OF ITS AGENTS
AND EMPLOYEES FROM ANY AND ALL LIABILITY, CAUSES OR ACTION, COSTS, AND EXPENSES
RESULTING FROM OR ARISING OUT OF ANY INJURY, DEATH, LOSS, OR DAMAGE TO ANY
PERSON OR PROPERTY DURING THE WORK CONDUCTED UNDER THIS PERMIT.
ANT SIGNATURE
DATE
11 �' X'
EXCAVATOR SIGNATURE (IF DIFFERENT)
DATE
_...1.._..._.....
2 a .1 g . e
t7/3
(IFI)IFFERENT)
-
CONDITIONS ANIS REQUIREMENTS PURSUANT TO G.L.C.82A AND 520 CMR 7.00 et seq.
(as amended)
By signing the application, the applicant understands and agrees to comply with the following:
iv.
V.
vi.
No trench may be excavated unless the requirements of sections 40 through 40D of chapter 82, and any
accompanying regulations, have been met and this permit is invalid unless and until said requirements
have been complied with by the excavator applying for the permit including, but not limited to, the
establisbutent of a valid excavation number with the underground plant damage prevention system as
said system is defined in section 760 of chapter 164 (1310 SAFE),
?Tenches may pose a significant health and safety hazard. Pursuant to Section I of Chapter 82 of the
General Lays. an excavator shall not leave any open trench unattended without first making every
reasonable effort to eliminate any recognized safety hazard that may exist as a, result of leaving said
open trench unattended. Excavators should consult regulations promulgated by the Department. of
Public Safety in order to familiarize themselves with the recognized safety hazards associated with
excavations and open trenches and the procedures required or reconmended by said department in
order to make every reasonable effort to eliminate said safety hazards which may include covering,
barricading or otherwise protecting open trenches from accidental entry.
Persons engaging in any in any trenching operation shall familiarize themselves with the federal safety
standards promulgated. by the Occupational Safety and Health Administration on excavations: 29 CFR
1926.650 et.seq,, entitled Subpart P "Excavations".
Excavators engaging in any trenching operation who utilize hoisting or other mechanical equipment
subject to chapter 146 shall only employ individuals licensed to operate said equipment by the
Department of Public Safety pursuant to said chapter and this permit must be presented to said licensed
operator before any excavation is commenced;
By applying for, accepting and signing this permit, the applicant hereby attests to the following: (1) that
they have read and understands the regulations promulgated by the Department of Public Safety with
regard to construction related excavations and trench safety; (2) that he has read and understands the
federal safety standards promulgated by the Occupational Safety and Health Administration on
excavations: 29 C 1926.650 et.seq., entitled Subpart P "Excavations" as well as any other
excavation requirements established by this municipality; and (3) that he is aware of and has, with
regard to the proposed trench excavation on private property or proposed excavation of a city or town
public way that forms the basis of the permit application, complied with the requirements of sections 40-
40D of chapter 82A.
This permit shall be posted in plain view on the site of the trench.
For additional information please visit the Department of Public Safety's website at wmrw.mass.aoy*—s.
3 1 P a g e
Sawyer, Susan
From: Sawyer, Susan
Sent: Monday, July 28, 2014 2:11 PM
To: 'Jack Sullivan'
Subject: RE: 674 Turnpike
Let me know what you are thinking. I should at minimum have him/you go to the board for continued use of a system in
failure. But the board will want to be convinced.
Susan
Hope you enjoyed your time off.
-----Original Message -----
From: Sawyer, Susan
Sent: Wednesday, July 23, 2014 9:21 AM
To: 'Jack Sullivan'
Subject: RE: 674 Turnpike
We will Talk more when you get back. Thank you
-----Original Message -----
From: Jack Sullivan fmailto:iacksu11532comcast.net]
Sent: Tuesday, July 22, 2014 6:00 PM
To: Sawyer, Susan
Subject: Re: 674 Turnpike
I have been working on the best way for him to proceed. The town does not allow individual sewer force mains
anymore ... that was the design I was going to go with ... but I may have to see if I can get a septic to work knowing my site
area is limited by wetlands to the rear.
I am on vacation this week -but will get back to a solution when I return
Sullivan Engineering Group, LLC
Jack Sullivan
22 Mount Vernon Road
Boxford, MA 01921
978-352-7871 phone + fax
----- Original Message -----
From: Susan Sawyer <ssawyer@townofnorthandover.com>
To: Jack Sullivan (iacksu1153@comcast.net) <iacksu1153@comcast.net>
Sent: Tue, 22 Jul 2014 21:54:13 -0000 (UTC)
Subject: 674 Turnpike
Hi Jack,
Did this go anywhere?
Thanks
Susan
Susan Sawyer
1
Public Health Director
Town of North Andover
1600 Osgood Street
Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mailto:ssawyer@townofnorthandover.com
Web www.TownofNorthAndover.com<http:Hwww.townofnorthandover.com/>
[cid:image001.ipg@01CFA5D5.F292D580]
Sullivan Engineering Group, LLC
Civil Engineers & Land Development Consultants
ENGINEERING COST ESTIMATE
December 4, 2013
Mohammad Yamin
Project: Design of Septic Upgrade Plan
674 Turnpike Street, North Andover
Mohammad,
Since the nearest available municipal sewer connection is approximately 450 feet from the existing structure at
674 Turnpike Street, it appears designing an onsite septic system is your most cost effective means to handle
the sanitary sewage.
The following is a breakdown of engineering and survey services required for the preparation of a septic
upgrade plan for the above referenced property.
Task: Cost:
1)
Municipal and Registry Research for property information,
$150.00
Topographical data, and utility information
2)
Conduct soil testing w/ Health Agent (1 day)
$600.00
3)
Engage botanist to flag wetlands
$600.00
4)
Conduct partial topographical field survey of property
$900.00
5)
Prepare Sewage Disposal upgrade plans
$1,300.00
6)
Prepare Wetland paperwork for Conservation submission
$500.00
Total Cost Estimate:
$4,050.00
Items not included in estimate (responsibility of client):
1) Excavation services for soil testing ($400-$600)
2) Town application and permit fees ($450)
3) Wetland fees to Town and State ($400-$700)
4) Newspaper Ad and certified mailings to abutters ($300-$500)
Payment Schedule:
Invoices will be generated following completion of each task.
I look forward to working with you on this project. If the terms of this estimate are acceptable please sign and
date below and return to my attention. A retainer fee of $1,000.00 is required to secure this contract with the
check payable to,; `Sullivan Engineering Group, LLC'.
Date` � I
22 Ment Vernon Road — Boxford, Massachusetts 01921 — (978) 352 -7871 -Phone — 978 352-7871 - Fax
I
of NORTl�
o m
A C H
North Andover Health Departm
(ommunity Development Division
Delivery of letter to Property owner of 6,
DELIVERED BY:
RECEIVED I
DATE:?l�'�3 3.�7 PM
North Andover Health Department
Community Development Division
Delivery of letter to Property owner of 674 Turnpike St.
DELIVERED BY:
RECEIVED BY:
DATE:
OF NORTy qti '
S�� OOG
SSACHU`'�
North Andover Health Department
(ommunity Development Division
Delivery of letter to Property owner of 674 Turnpike St.
DELIVERED BY: /
RECEIVED BY: C/-/-,",
DATE: j?I�'�3 3:07 PM
North Andover Health Department
Community Development Division
Delivery of letter to Property owner of 674 Turnpike St.
DELIVERED BY:
RECEIVED BY:
DATE:
Postage
$
CerdBed Fee
3<�
e
Return ReceiptFee
(Endorsement Required)
_
�, I
Postmark
Here
Restdoted Delivery Fee
(Endorsement Required)
p•
Total Postage & Fees
Q
`�
__ S.l..........
or PO Box No.
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Certified Mail Provides:
m A mailing receipt (96JeAea) aooa eunr'ooee uuoJ Sd
® A unique Identifier for your mallplece
® A record of delivery kept by the Postal Service for two years
Important Reminders:
m Certified Mail may ONLY be combined with First -Class Maile or Priority Maile.
® Certified Mail is not available for any class of international mall.
n NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
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o For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPSe postmark on your Certified Mail receipt is
required.
n For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
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m if a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
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IMPORTANT: Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on mail
addressed to APOs and FPOs.
x~
NORTH ANDOVER HEALTH DEFT eopost
l�
1600 Osgood Street, Suite 2035 noioost 3 -
North Andover, MA 01845 112
�
7005 1,820 0004 2835 2436 ZIPA1845 � �,.
041L1A? 393
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# p 1H01H 3H1013 Ol3ANd0 dO1�1V�ki3J1011S-30d
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
A. Signature
❑ Agent
X ❑ Addressee
B. Received by ( Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
(6 AL-, JU S/-aVU(Cs Coy
G"9Cwl VI l.�JL / Sice Type
/ Certified Mail
f �>
anuavr 1� l.f Registered
4 1) ❑ Insured Mail
❑ Express Mail
❑ Return Receipt for Merchandise
❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7005, 1820 0004 2835 2436
(Transfer from service label)
i� PS Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540 1
Q\4
North Andover Health Department
(ommunity Development Division
10/02/2013
BAC Tax Services Corp.
c/o 39 Cotuit Street, LLC
No. Andover, MA 01845
To Whom It May Concern:
Please be advised that it has been two years since the septic system located at 674 Turnpike
Street has failed the Title 5 inspection (inspected on 8/31/2010). This exceeds the states
requirements for completion of upgrades. Please see the attached document for specific
information.
Thank you for your anticipated cooperation regarding this issue.
iY..e Kaer,
Public Health Dir,
Encl. Title 5 Letter of Non-compliance
310 CMR: DEP (15.305: Deadlines for completion of upgrades)
Title 5 inspection form (page 1)
Page 1 of 1
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Commonwealth of Massachusetts
City/Town of North Andover
W° Title 5 Letter of Non -Compliance
Form 7
M
DEP has provided this form for use by local Boards of Health if they choose to do so.
CERTIFIED MAIL
Dear . BAC TAX SERVICES CORP
C/O 39 COTUIT STREET, LLC 733 Turnpike St. #217
It has come to the attention of The North Andover Health Department
Approving Authority
That the on-site sewage disposal system owned/operated by you and located at
674 Turnpike Street
Address
North Andover
City/Town
MA
State
01845
Zip Code
Is not being properly maintained in accordance with 310 CMR 15.300 (and/or any Local Inspection
and Maintenance Plan or Local Requirements):
Specify Local Requirements
The following items have been found to be in non-compliance with Title 5 — the State Environmental
Code.
System failed the Title 5 inspection conducted on 8/31/2010 by James Wright. Time has for upgrade
(see attached). Please contact the Health Department within 48 hours of receipt of this letter to
discuss the non compliance. Failure to respond in 48 hours will result in the matter being brought
before the next Board of Health meeting on October 24. 2013.
I hereby certify that the following action(s) be taken within 5 days from receipt of letter
number of days
And that you inform this office when those actions have been completed.
Please be advised that failure to perform the specified actions may result in further enforcement
actions.
Approving Authority Signature
Susan Sawyer, Health Director
Approving Authority Name
10/02/13
Date
t5form7.doc• 06/03 Letter of Non -Compliance • Page 1 of 1
310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION
15.305: Deadlines for Completion of Upgrades
(1) If a system is failing to protect public health, safety, welfare or the environment as set forth
in 310 CMR 15.303(1) or 15.304(1), the owner or operator shall upgrade the system within two
years of discovery unless:
(a) a shorter period of time is set by the local Approving Authority or the Department based
upon the existence of an imminent health hazard; or
(b) the continued use of the system is permitted by the local Approving Authority in
accordance with the provisions of an enforceable schedule for upgrade. Bases for continued
use include, but are not limited to, proposals to connect to a sanitary sewer or shared system.
A fiscal commitment to the sewering plan or shared system plan, together with an approved
facility plan where appropriate, proposing connection or replacement of the failing system
within five years, and an enforceable commitment by the owner to perform interim measures
(for example, regular pumping) shall accompany any such local approval. Such approval
shall expire in five years or upon the failure of the applicant for such approval to meet
interim deadlines set forth in the enforceable schedule for upgrade and the plan. The
Department may by specific written approval authorize the local Approving Authority to
allow a longer period of time, where the municipality has provided the Department a
proposed implementation schedule for design and construction and has made a demonstrated
financial commitment to the construction schedule. The Department may revoke any such
approval if the approved schedule is not met.
(2) if a system serving a facility with a design flow of 10,000 gpd or greater but less than 15,000
gpd is a significant threat to public.health, safety, welfare or the environment as set forth in 310
CMR 15.304(2), the owner or operator shall upgrade the system within five years of discovery
in accordance with the provisions of an enforceable schedule unless:
(a) a shorter period of time is set by the Department based upon the existence of an
imminent health hazard;
(b) the continued use of the system is permitted by the Department because it is necessary
to allow implementation of an environmentally superior solution. An enforceable
commitment by the owner to perform interim measures (e.g., regular pumping, addition of
fill) shall accompany any such approval by the Department. Such approval shall expire in
severs years or upon the failure of the applicant for such approval to meet interim deadlines
set forth in the enforceable schedule for upgrade.
(3) The owner or operator shall take appropriate measures throughout the period between
discovery of the condition requiring upgrade and completion of the upgrade to ensure that there
is no backup or direct discharge of sewage or effluent to buildings, to the surface of the ground,
or to surface waters. The local Approving Authority or the Department may order the owner or
operator to take any measure necessary to ensure the protection of public health, safety, welfare
and the environment during such period.
(4) Except as provided in 310 CMR 15.004(3), all systems shall be abandoned in accordance
with 310 CMR 15.354 and the buildings served by the systems shall be connected to a sewer
when a sewer becomes available, unless:
(a) the system is an alternative system approved for such use pursuant to 310 CMR 15.280
through 15.287;
(b) the Department has made the determination in approving either the remedial use of an
alternative system pursuant to 310 CMR 15.284 or in certifying an alternative system for
general use pursuant to 310 CMR 15.288 that any person using such system need not connect
the facility to a sanitary sewer if such connection is feasible; or
(c) the owner of an existing system has obtained a variance from this requirement pursuant
to 310 CMR 15.410 through 15.415.
All systems shall be abandoned in accordance with 310 CMR 15.354 and the buildings
served by the systems shall be connected to a sewer when directed to do so by the Board of
Health pursuant to M.G.L. c. 83, § 11, by the Department pursuant to 310 CMR 15.000, or by
court order.
15.340: Approval of System Inspectors
(1) System Inspectors who perform inspections pursuant to 310 CMR 15.301 shall be approved
by the Department and shall be limited to:
9/22/06 (Effective 4/21/06) - corrected
310 CMR - 557
Owner
information is
required for every
page.
Important: When
filling out forms
on the computer,
use only the tab
key to move your
cursor - do not
use the return
key.
Commonwealth of Massachusetts
"G fl
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessment
674 Turnpike Street
Property Address
Fannie Mae
lelG j
OMEN
56,E 2 � z Q10
TOWN �f NQRTH ANDOVER
Owner's Name
N. Andover MA 01845 8/31/2010
Cityrrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered i am
way. Please see completeness checklist at the end of the form. /
t
A. General Information
Inspector:
James Wright
Name of Inspector
Aspen Environmental Services LLC
Company Name
270 Lawrence St
Company Address
Methuen
Citylrown
-978-681-5023
Telephone Number
B. Certification
MA
State
2035
License Number
01844
Zip Code
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 ails
Further Evaluation by the Local Approving Authority
8/31/2010
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.
U
t5ins - 09108 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 1 of 17
Blackburn, Lisa
From:
Jack Sullivan <jacksu1153@comcast.net>
Sent:
Thursday, November 21, 2013 9:45 AM
To:
Sawyer, Susan
Cc:
Blackburn, Lisa
Subject:
Re: 674 turnpike
Susan,
I gave him an estimate over a year ago ... he told me he would get back to me and I never heard
anything... until yesterday (now it makes sense!). He has not engaged my services. I am going to
look over my estimate to update and send it off to him again.
Thanks.
Jack Sullivan
From: "Susan Sawyer" <ssawver(cD-townofnorthand over. com>
To: "Jack Sullivan" <jacksull53acomcast. net>
Cc: "Lisa Blackburn"<LBlackburna-townofnorthand over. com>
Sent: Thursday, November 21, 2013 9:14:43 AM
Subject: 674 turnpike
Jack,
We had the owner of this property served a letter yesterday, because it has been 3 years since his Title V failed and we
had yet to hear from them.
Hence they are in violation. The owner called and said that you are working on this project.
If so, could you give me an update and projected time line?
Thank you
Susan
Susan Sawyer
Public Health Director
Town of North Andover
1600 Osgood Street
Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mailto:ssawver@townofnorthandover.com
Web www.TownofNorthAndover.com
NO�iry
Ot m
a
gsRCHUS4
Blackburn, Lisa
From: Sawyer, Susan
Sent: Thursday, November 21, 2013 2:11 PM
To: 'moyamin@yahoo.com'
Cc: Blackburn, Lisa
Subject: 674 Turnpike Street - Title V violation
Mr. Yamin,
Thank you for responding to the Health Department's letter, which was hand delivered to you yesterday. This email is a
follow up to our conversation this morning. Please submit to this office a written description of the actions you have
taken to date to remedy failed Title V subsurface disposal system. This could include; contracts, bids, proposals,
narrative etc.
The deadline for this request is December 6th. If the submission is not found acceptable or you choose to ignore this
request, the issue will be placed on the December 191h agenda of the Board of Health, at which time penalties may be
discussed per Title V enforcement guidelines.
Thank you for your anticipated cooperation in this important matter of Public Health.
Susan Sawyer
Susan Sawyer
Public Health Director
Town of North Andover
1600 Osgood Street
Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mailto:ssawver@townofnorthandover.com
Web www.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: http://www.sec.state.ma.us/pre/preidx.htm.
Please consider the environment before printing this email.
North Andover Health Department
(ommunity Development Division
10/23/2013
39 Cotuit St. LLC
733 Turnpike St., #217
No. Andover, MA 01845
To Whom It May Concern:
Please be advised that it has been three years since the septic system located at 674 Turnpike
Street has failed the Title 5 inspection (inspected on 8/31/2010). This exceeds the states
requirements for completion of upgrades. Please see the attached document for specific
information.
Thank you for your anticipated cooperation regarding this issue.
a•t f
/"S anY. Sa er, QTS/RS
r1'
s P blic Health Di ctor
Encl. Title 5 Letter of Non-compliance
310 CMR: DEP (15.305: Deadlines for completion of upgrades)
Title 5 inspection form (page 1)
Page 1 of 1
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Commonwealth of Massachusetts
N W City/Town of North Andover
w° Title 5 Letter of Non -Compliance
Form 7
M 5ey`0 ,
DEP has provided this form for use by local Boards of Health if they choose to do so.
CERTIFIED MAIL
Dear 39 Cotuit Street LLC, 733 Turnpike St. #217
It has come to the attention of North Andover Health Department
Approving Authority
That the on-site sewage disposal system owned/operated by you and located at
674 Turnpike Street
Address
North Andover
MA
01845
City/Town State Zip Code
Is not being properly maintained in accordance with 310 CMR 15.300 (and/or any Local Inspection
and Maintenance Plan or Local Requirements):
Is not being properly maintained in accordance with 310 CMR 15.300 (and/or any Local Inspection
and maintenance Plan or Local Requirements)
Specify Local Requirements
The following items have been found to be in non-compliance with Title 5 — the State Environmental
Code.
System failed the Title 5 inspection conducted on 8/31/2010 by James Wright. Time has expired for
upgrade (see attached). Please contact the Health Department within 5 days of receipt of this letter to
discuss the non compliance. Failure to respond in 5 days will result in the matter being brought before.
the next Board of Health meeting on November 21, 2013.
I hereby certify that the following action(s) be taken within 5 days from receipt of letter
number of days
And that you inform this office when those actions have been completed.
Please be a vised that fail re to perform the specified actions may result in further enforcement
actions. . l � ,
Approvinuttiority Sig ur
Susan awyer, < ealth, irector
Approving Authority Name
October 23, 2013
Date
t5form7.doc• 06/03 Letter of Non -Compliance - Page 1 of 1
310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION
15.305: Deadlines for Completion of Upgrades
(1) If a system is failing to protect public health, safety, welfare or the environment asset forth
in 310 CMR 15.303(1) or 15.304(1), the owner or operator shall upgrade the system within two
years of discovery unless:
(a) a shorter period of time is set by the local Approving Authority or the Department based
upon the existence of an imminent health hazard; or
(b) the continued use of the system is permitted by the local Approving Authority in
accordance with the provisions of an enforceable schedule for upgrade. Bases for continued
use include, but are not limited to, proposals to connect to a sanitary sewer or shared system.
A fiscal commitment to the sewering plan or shared system plan, together with an approved
facility plan where appropriate, proposing connection or replacement of the failing system
within five years, and an enforceable commitment by the owner to perform interim measures
(for example, regular pumping) shall accompany any such local approval. Such approval
shall expire in five years or upon the failure of the applicant for such approval to meet
interim deadlines set forth in the enforceable schedule for upgrade and the plan. The
Department may by specific written approval authorize the local Approving Authority to
allow a longer period of time, where the municipality has provided the Department a
proposed implementation schedule for design and construction and has made a demonstrated
financial commitment to the construction schedule. The Department may revoke any such
approval if the approved schedule is not met.
(2) If a system serving a facility with a design flow of 10,000 gpd or greater but less than 15,000
gpd is a significant threat to public health, safety, welfare or the environment as set forth in 310
CMR 15.304(2), the owner or operatar shall upgrade the system within five years of discovery
in accordance with the provisions of an enforceable schedule unless:
(a) a shorter period of time is set by the Department based upon the existence of an
imminent health hazard;
(b) the continued use of the system is permitted by the Department because it is necessary
to allow implementation of an environmentally superior solution. An enforceable
commitment by the owner to perform interim measures (e.g., regular pumping, addition of
fill) shall accompany any such approval by the Department. Such approval shall expire in
seven years or upon the failure of the applicant for such approval to meet interim deadlines
set forth in the enforceable schedule for upgrade.
(3) The owner or operator shah take appropriate measures throughout the period between
discovery of the condition requiring upgrade and completion of the upgrade to ensure that there
is no backup or direct discharge of sewage or effluent to buildings, to the surface of the ground,
or to surface waters. The local Approving Authority or the Department may order the owner or
operator to take any measure necessary to ensure the protection of public health, safety, welfare
and the environment during such period.
(4) Except as provided in 310 CMR 15.004(3), all systems shall be abandoned in accordance
with 310 CMR 15.354 and the buildings served by the systems shall be connected to a sewer
when a sewer becomes available, unless:
(a) the system is an alternative system approved for such use pursuant to 310 CMR 15.280
through 15.287;
(b) the Department has made the determination in approving either the remedial use of an
alternative system pursuant to 310 CMR 15.284 or in certifying an alternative system for
general use pursuant to 310 CMR 15.288 that any person using such system need not connect
the facility to a sanitary sewer if such connection is feasible; or
(c) the owner of an existing system has obtained a variance from this requirement pursuant
to 310 CMR 15.410 through 15.415.
All systems shall be abandoned in accordance with 310 CMR 15.354 and the buildings
served by the systems shall be connected to a sewer when directed to do so by the Board of
Health pursuant to M.G.L. c. 83, § 11, by the Department pursuant to 310 CMR 15.000, or by
court order.
15.340: Approval of System Inspectors
(1) System Inspectors who perform inspections pursuant to 310 CMR 15.301 shall be approved
by the Department and shall be limited to:
9/22/06 (Effective 4/21/06) - corrected
310 CMR - 557
commonwealth of Massachi isetfs
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Asses
674 Turnpike Street
Property Address
TOWN OF NO. TH ANDOVER
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:
Conditional/ ails
❑ Passes ❑ y Passes
Further Evaluation by the Local Approving Authority
Ri1v9ni n
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. t�u
� i
�6
Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 1 of 17
t5ins - 09108
Fannie Mae
Owner
information is
Owner's Name
MA
01845
I
8/31/2010 1 - u
required for every
N. Andover
State
Zip Code
Date of Inspection
page
Cityrrown
Inspection results must be submitted on this form.
i
Inspection forms may not be altered n an
Please see completeness checklist at the end
of the form..
,
way.
a
Important: When
A. General Information
filling out forms
on the computer,
use only the tab
1. Inspector:
key to move your
cursor - do not
James Wright
use the return
Name of Inspector
key.
Asoen Environmental Services LLC
Company Name
270 Lawrence St
Company Address
Methuen
M
MA
01844
City/Town
State
Zip Code
-978-681-5023
2035
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:
Conditional/ ails
❑ Passes ❑ y Passes
Further Evaluation by the Local Approving Authority
Ri1v9ni n
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. t�u
� i
�6
Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 1 of 17
t5ins - 09108
1. e 4895
t
• Town of North Andover
HEALTH DEPARTMENT
SACHUSt
CHECK #: C%G/ T • % /O
LOCATION:
H/O NAME:
CONTRACTOR NAME: �4i�o
Type
of Permit or Licensr- (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 Sustems:
❑ Septic - Soil Testing $
❑ Septic - Design Approval $
❑ Septic Disposal Works Construction (DWC) $
❑ Septic Disposal Works Installers (DWI) $
❑ Ti tl nspector $
t�
C� Title 5 Report $
❑ Other: (Indicate) $
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
Owner
information is
required for every
page.
Important: When
filling out forts
on the computer,
use only the tab
key to move your
cursor - do not
use the return
key.
VQ
I
d f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessment,
674 Turnpike Street
Property Address
Fannie Mae
�G
D
1090
TOWN OF NORTH ANDOVER
owners Name
N. Andover MA 01845 8/31/2010
City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered i Za
way. Please see completeness checklist at the end of the form.
A. General Information
Inspector:
James Wriaht
Name of Inspector
Aspen Environmental Services LLC
Company Name
270 Lawrence St
Company Address
Methuen
Cityrrown
978-681-5023
Telephone Number
B. Certification
MA
State
2035
License Number
01844
Zip Code
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 ails
Further Evaluation by the Local Approving Authority
8/31/2010
n ector's Signatu 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.
o
t5ins • 09/08 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 1 of 17
r r
s
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
r
B. Certification (cont.)
8/31/2010
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 f�ilure-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.
Check the box for "yes", "no" or "not determined" (Y, N, JVD) for the following statements. If "not
determined," please explain.
The septic tank is metal and over 20 years or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltratiop4f exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is re ced with a complying septic tank as approved by the Board of
Health.
" A metal septic tank w0 ass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicati that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Pape 2 of 17
674 Turnpike Street
Property Address
Fannie Mae
Owner
Owner's Name
information
fired is every
re wired for eve
N. Andover MA 01845
page.
Citylrown State Zip Code
B. Certification (cont.)
8/31/2010
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 f�ilure-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.
Check the box for "yes", "no" or "not determined" (Y, N, JVD) for the following statements. If "not
determined," please explain.
The septic tank is metal and over 20 years or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltratiop4f exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is re ced with a complying septic tank as approved by the Board of
Health.
" A metal septic tank w0 ass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicati that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Pape 2 of 17
, T
. 1 ,
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
wired for every N. Andover MA 01845 8/31/2010
page. Cityfrown State ZID Code nntta of Incnnr}inn
B. Certification (cont.)
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
❑ Y ❑ N [I ND (Explain below):
❑ Y ❑ N.-" ] ND (Explain below):
❑ distribution box is leveled or replaced ❑ >-"'D N ❑ ND (Explain below):
❑ The system required p ping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass ins ion if (with approval of the Board of Health):
❑ broken We(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obsyuction is removed ❑ Y ❑ N ❑ ND (Explain below):
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 isnot functioning in a manner which will protect public health,
safety and the environmg
❑ Cesspool or ivy is within 50 feet of a surface water
❑ Cessp I or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins • 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 3 of 17
Owner
information is
required for every
page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
uwners Name
N. Andover MA 01845 8/31/2010
City/Town State Zip Code Date of Inspection
B. Certification (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 wa!t�Pgupply.
❑ The system has a septic tank and SAS and thes within a Zone 1 -of a public water
supply. SW,
❑ The system has a septic tank and/eSAS
a SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS anis 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 wel ater analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent an a presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided at 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
U, ❑ 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 Y2 day flow
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information isquiredfor every
very N. Andover
MA 01845 8/31/2010
page. Cityfrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ V Required pumping more than 4 times in the last year NOT due to clogged or
/ obstructed pipe(s). Number of times pumped:
L�' ❑ ny 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.
Cl Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ Lam' 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 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.]
❑ The system is a cesspool serving a facility with a design flow of 2000gpd-
10 pd.
❑ Thea system
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" no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the em 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.
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
required fo is every
N. Andover
required for eve MA 01845 8/31/2010
page. Cityrrown 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
❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ Ifs Were any of the system components pumped out in the previous two weeks?
❑ E� Has the system received normal flows in the previous two weekP eriod?
E]Have large volumes of water been introduced to the system recently or as part of
this inspection?
❑ ❑ �Y% 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?
�,/
�[E] Was the site inspected for signs of break out?
l� 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(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): Number of bedrooms (actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms):
t5ins • 09/08 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 6 of 17
• Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is N. Andover
required for every
page. Cityrrown
D. System Information
Description:
Number of current residents:
Does residence have a garbage grinder?
MA 01845
State Zip Code
8/31/2010
Date of Inspection
Is laundry on a separate sewage system? [if yes separate inspection required)
Laundry system inspected?
Seasonal use?
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump?
Last date of occupancy:
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203):
Basis of design flow (seats/pens sq.ft., etc.):
Grease trap present?
Industrial waste h ing tank present?
Non -sanitary aste discharged to the Title 5 system?
Water meter readings, if available:
Gallons per day (gpd)
❑ Yes
Sump
De<o
❑ Yes
P__ o
Kr Yes
0 No
❑ Yes
9-09'o--
tor
❑
P -les
❑ No
y._�il�,dl•�rrY
Date
❑
Yes
❑
No
❑
Yes
❑
No
❑
Yes
❑
No
t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 7 of 17
Owner
information is
required for every
page.
n
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
owners Name
N. Andover
Citylrown
D: System Information (cont.) ,
Last date of occupancy/use:
Other (describe below):
MA 01845
State Zip Code
Date
General Information
Pumping Records:
Source of information:
Was system pumped as part of the inspection?
If yes, volume pumped:
How was quantity pumped determined?
Reason for pumping:
Type of System:
gallons
�/ eptic tank, istribution box, oil�absorp�fionstem
❑ Single cesspool
8/31/2010
Date of Inspection
❑ Yes P-lqo--
❑ 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) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
800'�—" Other (describe):
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System •Page 8 of 17
Owner
information is
required for every
page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
owners Name —
N. Andover MA 01845 8/31/2010
Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
Were sewage odors detected when arriving at the site?
Building Sewer (locate on site plan): .
Depth below grade:
Material of construction:
cast iron ❑ 40 PVC ❑ other (explain):
❑ Yes ❑ No
/
feet
Distance from private water supply well or suction line: feet
Comments (on condition oYff joints, venting, evidence of leakage, etc.):
FL''O �'�'r` l'l
Septic Tank (locate on site plan):
Depth below grade:
Material of construction:
oncrete ❑ metal ❑ fiberglass
If tank is metal, list age:
i
feet
❑ polyethylene ❑ other (explain)
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
Sludge depth:
t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System •Page 9 of 17
• Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Foran - Not for Voluntary Assessments
y< 674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every N. Andover
page. Citylrown
D. System Information (cont.)
Septic Tank (cont.)
MA 01845 8/31/2010
State Zip Code Date of Inspection
Distance from top of sludge to bottom of outlet tee or baffle
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
How were dimensions determined?
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
U
%C
Grease Trap (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass
Dimensions:
Scum thickness
Distance fromXop of scum to top of outlet tee or baffle
Distance frim bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
feet
❑ polyethylene ❑ other (explain):
Date
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17
• Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner owner's Name
information is
required for every N. Andover MA 01845 8/31/2010
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet utlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evide of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on sit�ilan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass
Dimensions:
Capacity:
Design Flow:
Alarm present:
Alarm level:
Date of last
Comments (
gallons
❑ polyethylene ❑ other (explain):
gallons per day
❑ Yes ❑ No
Alarm in working order: ❑ Yes ❑ No
Date
of alarm and float switches, etc.):
Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner owner's Name
information is
required for every N. Andover
page. Cityrrown
D. System Information (cont.)
MA 01845
State Zip Code
8/31/2010
Date of Inspection
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert Zl6>- /-I�f ' _
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.):
Pump Chamber (locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
Comments (note condition of pum chamber, condition of pumps and appurtenances, etc.):_ -z
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 12 of 17
Commonwealth of Massachusetts
UTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner s Name
information is
required for every N. Andover MA 01845 8/31/2010
page. City/Town State ZiD Code natty of IncnarPinn
D. System Information (cont.)
Type:
❑
leaching pits
❑
leaching chambers
❑
leaching galleries
❑
leaching trenches
❑
leaching fields
❑
overflow cesspool
❑
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.):
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
Materials of
Indication of groundwater inflow
t5ins - 09108
❑ Yes ❑ No
Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is N. Andover
required for every MA 01845 8/31/2010
page. Cltylrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site
Materials of construc
Dimensions
Depth of sol' s
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 14 of 17
t.
MW M
40
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every N. Andover MA 01845 8/31/2010
page. City/rown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
7ha
ublic water supply enters the building. Check one of the boxes below:
nd-s
ketch in the area below
❑ drawing attached separately
t5ins • 09/08 rdle 5 Official Inspection Form: Subsurface Sewage Disposal System •Page 15 of 17
Owner
information is
required for every
page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner's Name
N. Andover
Cityrrown
D. System Information (cont.)
Site Exam:
Check Slope
Surface water
Check cellar
Shallow wells
Estimated depth to high ground water:
MA 01845 8/31/2010
State Zip Code Date of Inspection
�r
feet �-GCjGl2 1vL'� L
Please indicate all methods used to determine the high ground water elevation:
Fol
U
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:
7-67
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
r 674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every N. Andover
page. City/Town
MA 01845
State Zip Code
8131/2010
Date of Inspection
E. Report Completeness Checklist
Inspection Summary: A, B, C, D, or E checked
Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
191/system Information — Estimated depth to high groundwater
Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17
-02/22/2007 1G:31 19186899573
mczur�e�
6l7$-Hr7-
Class 101
Ske Total 1.48
FY 2011
UB Mailinn Index
Name/Address
CAROL LARKIN
40 SUMMER ROAD
BERLIN. MA
01503
'summery Renard Card Generated on 9120!4010 3'08:41 PM W Lila Evans
Town of North Andover
Tax Map # 210-098.D-0021-0000.0
Parcel Id 15982
674 TURNPIKE STREET
CAROL LARKIN
40 SUMMER ROAD
BERLIN, MA
01503
igle Family
:res Property Type
US Account Maini.
Account No Cycle
Bldg Id. 13474.0.674 TURNPIKE STREET
1090223 01 Cycle 01
UB Services Malnt.
A=unt No. 1090223
Service Code
MISCFEE ADMIN FEE
WTR WATER
UB Meter Maintenance
Account No. 1090223
Type Loan Number Active/tnact. From
Payor
Occupant Name Active/Inactive
1,26t Billing Date 8/6/2010
Active
Rate Charge MultIplierlUsers
01635/8 7.82 1/
01 ALL METER.SIZE 259.15 Ji
serial No
32772733
Status
a Active
Location
00
Brand
Type
Type
Date
Reading
Code
b Badger
Water
7/2112010
534
a Actual
Consumption
Posted Date
4/21/2010
481
a Actual
53
8/18/2010
1/21/2010
345
a Actual
138.
5/12/2010
10/21/2009
282
a Actual
63
2/12/2010
7/23/2009
263
a Actual
19
11111/2009
4/22/2009
248
a Actual
15
8/1212009
1/22/2009
232
a Actual
16
5/13/2009
10/23/2008
217
a Actual
15
2/10/2009
7/21/2008
201
a Actual
16
11/1212008
4/22/2008
179
a Actual
22
8/15/2008
1/25/2008
162
a Actual
17
511M008
10!2212007
144
a Actual
18
2/19/2008
7/19/2007
126
aActual
18
11/16/2007
4123/2007
111
a Actual
15
8/15/2007
1/26/2007
94
a Actual
17
5/2112007
1025/2006
79
a Actual
15
2/20/2007
7/27/2006
48
a Actual
31
11/16/2006
5/2/2006
28
a Actual
20
8/18/2006
1/30/2006
0
n New Meter
28
5/15/2006
1/302006
759
r Replacement
0
2/13/2006
10272005
734
a Actual
25
2/13/2006
7/26/2005
713
a Actual
21
11&2005
412112005
689
a Actual
24
8/10/2005
2/1/2005
672
M Manual estimate
17
$113/2005
10/25/2004
647
a Actual
25
2115/2005
7/29/2004
622
a Actual
25
11/15/2004
19
8125/2004
Size
0.63 0.63
PAGE 01/01
Papa 1
1 Residential
Until
YTD Cons
355
Variance
-61%
121%
224%
29°%
8°h
-3%
-30%
27%
2a/a
0%
10%
-12°%
21%
-53%
48%
-24°%
-1 DDe%
-100°%
17°%
-10%
16%
-15%
-11%
20°%
15°%
W
Town of North Andover
Building Inspector
Mr. Robert Nicetta
120 Main Street
North Andover, Mass. 01845
Dear Mr. Nicetta,
I am an abutter of 674 Turnpike Street, in North Andover, Mass. The owners of this
property are Carol and Patrick Larkin.
Patrick Larkin recently opened a Commercial Real Estate business at 674 Turnpike
Street. He rents the upstairs as a residential apartment and operates his Commercial Real
Estate business there also. He does not live there and its my understanding of the current
zoning that this is illegal to have both apartments and business in the same building.
When he purchased the property approximately four years ago the septic system under
Title V failed the test and he has done nothing to correct the problem or hook up to sewer
lines.
I would appreciate it if you could look into the situation.
I have to remain( anonymouskt this time.
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DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Tuesday, June 28, 2011 10:39 AM
To: 'JHughes663@aol.com'
Subject: FW: I.R. - 674 Turnpike Street - Health Departr
Attachments: 20110628095211811
Importance: High
A digit off..
From: DelleChiaie, Pamela
Sent: Tuesday, June 28, 201110:38 AM
To: '3Hughes6630@aol.com'
Subject: I.R. - 674 Turnpike Street - Health Department File
Importance: High
To: John Hughes - Real Estate Agent
978.808.3312
Mr. Hughes,
Attached is the Assessor's information sheet on this property, as well as the Title S Report from last year.
Please call the office with any further questions.
&W Regaada,
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 01845
2 Office - 978-688-9540
Fax - 978-688-8476
El Email - pddellechiaie@townofnorthandover.com l
'16 Website http://www.townofnorthandover.com/Pages/index
"We can never see the path of our life if we are too busy focusing o
If you are happy with the customer service you have rect
know ...feel free to complete the general Comment Form
http://www.townofnorthandover.com/Pages/NAndove
1
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Tuesday, June 28, 2011 10:39 AM
To: 'JHughes663@aol.com'
Subject: FW: I.R. - 674 Turnpike Street - Health Department File
Attachments: 20110628095211811
Importance: High
A digit off.... -
From: DelleChiaie, Pamela
Sent: Tuesday, June 28, 201110:38 AM
To: 'JHughes6630@aol.com'
Subject: I.R. - 674 Turnpike Street - Health Department File
Importance: High
To: John Hughes - Real Estate Agent
978.808.3312
Mr. Hughes,
Attached is the Assessor's information sheet on this property, as well as the Title S Report from last year.
Please call the office with any further questions.
fiat RA90?4,
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 01845
2 Office - 978-688-9540
1 Fax -978-688-8476
El Email - pdellechiaieotownofnorthandover.com
`1� 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
If you are happy with the customer service you have received from town departments, please let us
know ...feel free to complete the general Comment Form (link below):
http://www.townofnorthandover.com/Pages/NAndoverMA WebDocs/contact
I
North Andover Board of Assessors Public Access
NORtl,
CHUG t�
Click Seal To Return
Search for Parcels
Search for Sales
Summary
Residence
Detached Structure
Condo
Commercial
r
Farce! 11) :21wugs.v-uu2l-uuuu.0 rY:2wi
SKETCH
Click on Sketch to Enlarge
Page 1 of 1
0�
- roperty Record Card
Community: North Andover
PHOTO
Click on Photo to Enlarge
Location: 674 TURNPIKE STREET
Owner Name: BATTISTA, CAROL ANN
C/O FNMA
Owner Address: P.O.BOX 650043
City: DALLAS State: TX Zip: 75265-0043
Neighborhood: 5 - 5 Land Area: 1.48 acres
Use Code: 101-SNGL-FAM-RES Total Finished Area: 1992 s ft
ASSESSMENTS
CURRENT YEAR
PREVIOUS YEAR
Total Value:
284,400
293,800
Building Value:
142,600
151,000
Land Value:
141,800
141,800
Market Land Value:
141,800
Chapter Land Value:
htti)://csc-ma.us/PROPAPP/disDlay.do?linkId=1706495&town=NandoverPubAce 6/2R/2611
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Commonwealth of Massachusetts "07
Ub
Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments674 Turn ike Street no
TOWN 0!" N
Property Address
H
Fannie Mae
Owner owner's Name
Information is
required for every N. Andover MA_ 01845 8/31/2010 J7,Jt
page. Cityfrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered i gaqw-
way. Please see completeness checklist at the end of the form.
r
Important: When
filling out forms A. General Information
on the computer,
use only the tab 1. Inspector:
key to move your
cursor - do not James Wright
use the return Name of inspector
key.
Aspen Environmental Services LLC
a Company Name
270 Lawrence St
Company Address
Methuen MA 01844
Cityrrown State Zip Code
978-681-5023 2035
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:
0 Passes ❑ Conditionally Passesails
Further Evaluation by the Local Approving Authority
8/31/2010
n ectoes Signatu 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.
ln�
Mina • 09}08 Tide 5 otfidel fns
pscUon Farm: SubsuAace Sewage Disposal System •Page 1 of 17
Owner
Information is
required for every
page.
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner's Name
N. Andover MA
City/rown State
B. Certification (cont.)
01845 8/31/2010
Zip Code 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. Anyfieilure—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.
Check the box for "yes", "no" or "not determined" (Y, N,,,ND) for the following statements. If "not
determined," please explain. /
The septic tank is metal and over 20 years d'ror the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltratio exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is re ed with a complying septic tank as approved by the Board of
Health.
* A metal septic tank w ass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicatiri§ that the tank is less than 20 years old Is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins • 09108 Title 5 OMdal Inspeodon Forth. Subsurfeoe Sewage Dlsp0381 System • Pepe 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/31/2010
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
El 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
❑ Y ❑ N ❑ ND (Explain below):
❑ Y ❑�t 1�'� ND (Explain below):
❑ distribution box is leveled or replaced ❑ ,Y/"❑ N ❑ ND (Explain below):
❑ The system required p ping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspdction if (with approval of the Board of Health):
❑ broken 96e(s) are replaced
❑ obsAction is removed
❑ Y ❑ N ❑ ND (Explain below):
❑ Y ❑ N ❑ ND (Explain below):
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 systems not functioning in a manner which will protect public health,
safety and the environm tt
❑ Cesspool or ivy is within 50 feet of a surface water
❑ Cesspo6ll or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
Wins . 09108 Tille 6 official lnspedlon Form: Subsurface Sewage Disposal System - Page 3 of 17
Owner
Information is
required for every
page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner's Name
N. Andover MA 01845 8/31/2010
Cityfrown State Zip Code Dates of 1flQRaMo%n
0. t-oeritiricazion (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 wate -supply.
❑ The system has a septic tank and SAS and the S>S is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS an �t�e SAS is within 50 feet of a private water
supply well.
El The system has a septic tank and SAS and a 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 we! ater analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent anphe presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided at 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
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 Y day flow
t5ins • OM Tige 5 Oftal lnspoWon Forth. Subswfew Smago Disposal System • Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is N Andover
required for every MA 01845 8/31/2010
page. Citylrown State Zip Code Date of inspection
B. Certification (cont.)
Yes No
❑ Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
L�" ❑ ny 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.
❑ P 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 but9 reater 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.]
❑ ET,/� The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000
❑ 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" no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the em 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
11 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.
t5ins • 09108 TWO 5 offidal Inspection Form: Subsurface Sewage Disposal System • Page 5 or 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
eIs
requir fo
ed for every
N. Andover MA 01845 8/31/2010
requir
page. cityrrown 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
❑ 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?
ElHave 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)
0/ 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
E-1 2010�
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)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): Number of bedrooms (actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms):
Mme' 09= Title 5 official Inspection Form: Subswfaw Swr ne Disposal System • Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/31/2010
page. Cityfrown State Zip Code Date of inspection
D. System Information
Description:
Number of current residents:
Does residence have a garbage grinder?
Is laundry on a separate sewage system? [if yes separate inspection required]
Laundry system inspected?
Seasonal use?
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump?
Last date of occupancy:
Commerclaltindustrial Flow Conditlons:
Type of Establishment:
Design flow (based on 310 CMR 15.203):
Basis of design flow
Grease trap present?
Industrial waste
ft., etc.):
tank present?
discharged to the Title 5 system?
Water meter readings, if available:
Gallons per day (gpd)
❑ Yes Z/<o
❑ Yes P,<o'
Yes [] No
❑ YesVo
s�.�_ ,�Tr�d
es ❑ No
Date
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
151ns • 09= Titre S Official Inspection Form: Subsurface Sewage Disposal sposal System •Page 7 of 17
Owner
information Is
required for every
page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner's Name
N. Andover MA
Cityfrown State
D. System Information (cont.)
Last date of occupancy/use:
Other (describe below):
01845 8/31/2010
Zip Code Date of Inspection
General Information
Pumping Records:
Source of information:
Was system pumped as part of the inspection?
If yes, volume pumped:
How was quantity pumped determined?
Reason for pumping:
Type of System:
gallons
vate
❑ Yes P--Kor
a/' �tank,istribution box, oil absorp�system
[] Single cesspool
11 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) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
0001-0* Other (describe):
rsrns • 0=8
Title 6 Olfidal Inspection Form: SubsuAace Sewage Disposal System •page 8 01 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Forth - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/31/2010
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
Were sewage odors detected when arriving at the site?
Building Sewer (locate on site plan):
Depth below grade:
Material of construction:
ast iron ❑ 40 PVC ❑ other (explain):
Distance from private water supply well or suction line:
El Yes ❑ No
vg /
feet
feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Septic Tank (locate on site plan):
Depth below grade:
Material of construction:
oncrete ❑ metal ❑ fiberglass
If tank is metal, list age:
feet
❑ polyethylene ❑ other (explain)
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate)
Dimensions:
Sludge depth:
❑ Yes ❑ No
Was • 09= We 5 Official Inspection Form: Subsurfeoe Sswage Disposal System • Pegs 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
k
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/31/2010
page. cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
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
How were dimensions determined?
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:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass
Dimensions:
Scum thickness
Distance from fop of scum to top of outlet tee or baffle
Distance f�m bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
feet
❑ polyethylene ❑ other (explain):
Date
Wns • 09!08 Title 5 Official Inspectlon Form: Subsurface Sewage Disposal System • Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/3112010
page. Cityrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet utlet tee irbaffle condition, structural integrity,
liquid levels as related to outlet invert, evide of leakage, etc.):
ZZ
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on sit -Ian):
Depth below grade:
Material of construction:
concrete ❑ metal ❑ fiberglZEIene ❑ other (explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes (I No
Date of last pumpi date
Comments (c dition of alarm and float switches, etc.):
* Attach copy of current pumping contract (required). Is copy attached? [❑ Yes ❑ No
t5ins - 09108 7169 5 OfrMiat Inspection Form: Subsurface Sewage Disposal System • Page i t of 17
Commonwealth of Massachusetts
mova Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
r• 674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/31/2010
page. CitytTown State Zip Code Date of Inspection
D. System Information (cont.)
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.):
Pump Chamber (locate on site pian):
Pumps in working order:
Alarms in working order:
Comments (note condition of pum-0/61
❑ Yes ❑ No
❑ Yes ❑ No
, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ms • 09= Title 5 Offidel Ins
padion Form: Subsurface Sewage Disposal System •Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is N. Andover MA 01845 8/31/2010
required for every
page. cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits
❑ leaching chambers
❑
leaching galleries
❑
leaching trenches
❑
leaching fields
❑
overflow cesspool
❑
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.):
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 cesso
Materials of
Indication of groundwater inflow
❑ Yes ❑ No
Wns • 09= Tide 6 Of dal Inspedion Form: SubsudaM Sewage Disposal System • Page 13 01 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
° 674 Turnpike Street
Property Address
Fannie Mae
Owner Owners Name
information Is N. Andover
required for every MA 01845 8/31/2010
page. CiWown State Zip Code Date of Inspection
u. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site
etc.):
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
t5ins • 09!09 Title 6 OBidel inspection Form: subsurface Sewage Dlspose1 Syslem • Page U of 17
Commonwealth of Massachusetts
Title 5 -official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae .
Owner owner's Name
Inform@tion is
required for every N. Andover MA 01845
page. Citylrown 8/31/2010
State Zip Code Date of Inspection
D. System Information (cont)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
:7hand-sketch
ublic water supply enters the building. Check one of the boxes below:
in the area below
❑ drawing attached separately
161ns • 09108
7 7
7,2
Tr9s 5 offidal inspection Form: Subsurface Sewage 01sposal System • Page IS or 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
Information is
required for every N. Andover MA 01845 8/31/2010
page. City/Town State Zip Code Date of Inspection
D. system Information (cont.)
Site Exam:
Check Slope
Surface water
Check cellar
Shallow wells
Estimated depth to high ground water:
//
feet �%-Gacr2 � rvt
Please indicate all methods used to determine the high ground water elevation:
❑1
❑0
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)
El Accessed USGS database - explain:
You must describe how you established the high ground water elevation:
Grf2n l �•
Before filing this inspection Report, please see Report Completeness Checklist on next page.
rslns - 09=
TNB 5 Official Inspection Form: Subsurface Sewage Disposal System • Page to 01 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
674 Turnpike Street
Property Address —
Fannie Mae
Owner Owners Name
Information is N. Andover
required for every MA 01845 8/31/2010
page. City/rown State Zip Code Date of Inspection
E. Report Completeness Checklist
Inspection Summary: A, B, C, D, or E checked
Inspection Summary D (System Failure Criteria Applicable to All Systems) y ) com I
p eted
Yls"ystem Information — Estimated depth to high groundwater
Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
tains - 09108
Titin 5 OfrKiel Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17
•02/22/2007 13:31 19786889573 PAGE 01/01
` • Summary Reoord Cnrd Dene/aled on 812MO10PM W Live Evans
Town of North Andover Page
ll I L Tac Map # 210-098.D-0021-0000.0
Parcel Id 15982
674 TURNPIKE STREET
CAROL LARKIN
41 SUMMER ROAD
BERLIN, MA
01503
Class 1101 Ingle Family —
Slxa Total 1.48 Acres 'Property Type � 1 Reslden0i
FY 201 t
UB Mallina Index l '""'
Name/Addrese i Type Loan Number
CAROL LARKIN Payor Active/Inact. From Unit
40 SUMMER ROAD
BERLIN. MA
01503
US Account Malnt
Account No Cycle Occupant
Bids Id. 13474.0.674 TURNPIKE STREET
Name
Active/Inactive
1090223
01 Cycle 01
Last Billing Date 8/6/2010
Activg
111 9erviCes MaInt.
mount No, 1090223
Service Code
Rate
MISCFEE ADMIN FEE
0.63 518
Charge
Multlplledusers
WTR WATER
01 ALL METER 512E
7.82
1/
UB Meter Maintenance
Account No.1090223
Sedel No Status
32772733 a Active
Legation
00
Brand
Type Slxe
Date
7/21/2010
Reading
Code
b Bad 9 at
Consumption
w Water 0.63 0.63
Posted Date
4/21/2010
534
481
a Actual
a Actual
53
8/16/2010
1/21/2010
345
a Actual
138
6/12/2010
10/21/2009
282
a Actual
83
2112/2010
7/23/2009
263
a Actual
19
11/11/2009
4/2212009
248
a Actual
15
8/12/2009
1122/2009
232
a Actual
16
6/13/2009
10/23/2008
217
a Actual
16
2110/2009
7/21/2008
201
a Actual
16
11/12/2008
4/22/2008
179
aActual
22
8116/2008
1/25/2008
1$2
a Actual
17
8/19/2008
10/22/2007
144
a Actual
16
2/19/2008
7/19/2007
126
a Actual
18
11/16/2007
4/23/2007
'1126/2007
111
a Actual
15
17
8/45/2007
94
a Actual
6/21/2007
10/2612006
79
8 Actual
15
2/20/2007
7127/2008
48
a Actual
31
11/16/2006
6/212008
28
S Actual
20
8/18/2006
1/30/2006
0
n New Meter
28
671612006
1/30/2006
10/27/2005
759
734
r Replacement0
a Actual
25
2/13/2006
2/13/2006
7/26/2006
713
a Actual
21
11/9/2005
4/21/2005
689
a Actual
24
8/1612005
2/112005
1012512004
672
647
m Manual estimate
17
25
6113/2005
2/18/2005
7/29/2004
622
a Actual
a Actual
25
11/1512004
19
8/25/2004
Town of North Andover
Building Inspector
Mr. Robert Nicetta
120 Main Street
North Andover, Mass. 01845
Dear Mr. Nicetta,
I am an abutter of,674 Turnpike Street, in North Andover, Mass. The owners of this
property are Carol and Patrick Larkin.
Patrick Larkin recently opened a Commercial Real Estate business at 674 Turnpike
Street. He rents the upstairs as a residential apartment and operates his Commercial Real
Estate business there also. I Ie does not live there and its my understanding of the current
zoning that this is illegal to have both apartments and business in the same building.
When he purchased the property approximately four years ago the septic system under
Title V failed the test and lie has done nothing to correct the problem or hook up to sewer
lines.
I would appreciate it if you could look into the situation.
'I have to remain
.'anonymousht this time.'
--tim
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