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HomeMy WebLinkAboutMiscellaneous - 731 JOHNSON STREET 4/30/2018\- Y I m J.IeC QUIn C�1'NZRX; BUY �.Zi gco�,r5�h�,t�eng .(�� '731 Toll?5o� Town of North Andover — Septic System - AS -BUILT CHECKLIST 1) All changes to the design plan have been reflected and noted on the as -built plan 2) `� As -built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans) / ✓ ✓ 3) Street Address, Assessor's Map and Lot Number 4) \V Lot Lines and Location of Dwellings served by the system 5) ✓ Locations, Elevations and Dimensions of As -built system components, includi reserve (if applicable) 6) ✓ Ties to all tank openings, d- ox, and leach area from dwelling or Permanent Structure Setback distances are shown on the as -built plan from system components to: a A Subsurface, interceptor & foundation drains A Catch basins Property lines Dwellings or other structures tl Private water supply or irrigation wells R' Watercourses or wetlands 8) Locations of Wells, Drains, Wetland Resource Areas within 150 feet of system 9) `t Location of water, gas, electric lines, cable, con pe anel (if applicable) 10) LLocation of Structures within 6 Inches of Finished Grade 11) � Original Stamp & Signature 12) AELocation and holder of any easements which could impact the system 13) ^� Impervious Areas; Driveways, etc 14)- ° North Arrow 15) , � Location & Elevation of Benchmark used 16) ),% STATEMENT ON PLAN (NA 5.3) a. "I certify the locations, elevations, ties, cover material; exposed component covers etc., shown on this as -built substantially agree with the approved plan and have determined that the break out elevations, if applicable, have been met." Signature of Designer Date b. "If a STUCTURAL WALL IS PRESENT (NA 4.9) a Letter or statement on the as -built indicating the wall -was, or was not, constructed in accordance with the intended des1 and any manufacturer's specifications." Signature of Designer Date As of: Tuesday, March 17, 2015 of NoRrh qti G SSA C HUSH PUBLIC HEALTH DEPARTMENT Town of North Andover Community and Economic Development Division r CERTIFICATE OF- COMPLIANCE As of: April 24, 2017 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Construction of an On -Site Sewage Disposal System By: James Kellett At: 731 Johnson Street Map 38 Lot 71. North Andover, MA 01845 The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Michele Grant Public Health Agent 120 Main St., North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web www.northandoverma.gov North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 731 Johnson Street MAP: 38 LOT: 71 INSTALLER: Jim Kellett DESIGNER: Peter Ogren, Hays Engineering PLAN DATE: 11/9/16, REV 12/16/16 BOH APPROVAL DATE ON PLAN: 12/27/16 INSPECTIONS TANK INSPECTION: 1/4/2017 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Vent and effluent filter are being added... IR SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ® Cleanouts per plan ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction ® Watertightness 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) ® 24" inch cover to within 6" of finish grade installed over one access port ® Hydraulic cement around inlet & outlet Comments: Effluent filter with manhole cover to grade added... IR 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: CONTROL PANEL ❑ 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 ❑ N/A Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: 40 Mil HDPE barrier will be added when boulder retaining wall is constructed... IR 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: Rough grade/seeded 2/6/2017 — needs final grade Brian LaGrasse. 4/24/2017 ok per Brian LaGrasse DOCUMENTS NEEDED ❑ Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer M As -Built Plan BM = HR = HI = SYSTEM ELEVATIONS SKETCH PLAN ROD AS -BLT INVERT ELEVATION 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 L9teral 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 Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- ® Waterline 10 10 101 ® Private drinking well 75 1001 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other) Foundation 10 (5) 20 (10) ® Drywells 20 25 1 Suction line 222(2) 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 Commonwealth of Massachusetts W City/Town of North Andover RECEIVED Certificate of Compliance Form 3 FEB M -rOW14 DEPARTMENT ANDOVER HEALTH DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. This is to Certify that the following work on an On -Site Sewage Disposal System Important: When filling out forms ® Construction of a new system on the computer, ❑ Repair or replacement of an existing system use only the tab ❑ Repair or replacement of an existing system component key to move your cursor - do not use the return Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): key. DSCP Number DSCP Date Facility Owner 731 Johnston Street Street address or Lot # Zip Code OF nti X- ys PETE J. OGREN CIVIL c� NO. 27145 AIstt T siorva� �� ry ner Information: J. Ogren P.E. nature Installer Information: Hayes Engineering, Inc Name of Company Feb. 2, 2017 Date Na�ture Name of Company Date Use of this system is conditioned on compliance with the provisions set forth below: This Certificate relates only to the construction of the septic system components as shown on the As -built plan for #731 Johnson Street North Andover, Ma The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. '-t I 2L4, �- Date Certificate of Compliance • Page 1 of 1 4 � �aC v- x w p � p Ira, *N �> a ari a '� P.I. F.I. Commonwealth of Massachusetts BOARD OF HEALTH North Andover Map -Block -Lot 038.00071 ----------------------- Permit No BHP -2017-0318 ----- ----------------- FEE DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted James- Kellett ----------------------------------------------------------------------- to (Upgrade) an Individual Sewage Disposal System. at No 731 JOHNSON STREET $350.00 --------------- ------------------ -------------- --- -- -- -- - ----------------------------------------------- ---------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No. BHP -2017-031 ed January 04, 2017 --------------- of -------------------------- -- - --------------- RLE COPY ------ Issued On: Jan -04-2017 BOARD OF HEALTH -- ------------------------------------------------------ .,, Application for Septile Disposal System , Construction hermit - TOWN OF NORTH ANDOVER, M, A 01$45 Important When filling out forms on the computer, use only the tab key to move your cursor do not use the return key,. f� �sunn 3 ' 2-oi 7 TODAY'S DATE nll iRepair $175.00 - Component A p ication is berebv made for a permit to: ❑ Construct a new on-site sewage ,d,is;posai .system" 'XRepair or replace an exastang an�site seuafage disposal system* �c��� ❑ 6 Rep,air or ,replace ;Pin existing system coMponent — What? �� A. Eaciitity Inform, at ori MIN U 4 LU1r '731 TaHNsanf 5T. TOWN OFNORP4AAir%^,,._ Address or Lot # NorrM City/Town, 2,.- LTi PIPE OF SEPTIC SYSTEW: ❑ PU:M;p )�tGravity (c'hoose one) ***If pomp Sy—stern, attach copy of electrical permit to application"* Conventional System (pipe and stone system) i ❑ infiltrato;r or Saodiffuser (Gravel -Less) (Attach a copy of,your certification to install this type of gystena.) > ❑ Press ure Distribaation S.A.S.. (No D -Box) r ❑ Pressure Dosed (D -Box present) ,SIA S. :Does the system mea ire an effiue;nt ,filter'? Xes No !f yes, does plan specify make and model of aiier?, (m.o further info. needed) :2Ar3 L A40=0ni s.tafler must speci fy brand of filter before .iDWC issuance) 'What is the Makep what is tine MIVia 2. A -r I D"Q,,h &""-L L C -- Name 01 'T>'IIV'&aK Rd. Address (if different from ,above) aj rLA F-ra a-' 1f4A City/(own State Zip Code Email ,address 3. Installer Information Name vo Address City/Town Telephone Number s tfiacc� U� h, 6 Dame of Company /yip¢ oi��y State Zip Code 9,9i- 95 7 - 7146 Telephone Number fCefl Phone # if possible please) 4. Ges neer Information / c� � n-c,�,'y'�-: C�an� Ko 'X 14A-1 t1 ,Name .Name of Company Gb 3 .5,d teto s-4 Address JAJ 44e4 � I City/rown A1,4 State Zip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit 'Page 1 of 2 ApWi�cation for ;Dt Dis aosai SystemJG 3, �6►-, TODAY'S .DATE Construction Permit — TOWN OF Full repair , NORTHOVER, MA 01$45 $175.00 - Component PAGE 2OF2 A. Facility Information cont nluad.... 5. T, a of Bwildin"'esidential Dwelling or ❑Commercial B. Agreement The undersigned agrees to ,ensure the construction and maintenance of .the afore -described on-site sewage disposal system in accordance with the provisions of Title a of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the'Town of North Andover. 1 understand that until a final Certificate sof Compliance ,has been issued by is Roard .of Health, the inVall�isystem is not approved. ;,% Date ( / v y= (Board of Health !Representative) 3 Zai lame Date Applicat/nDisapproved ,for the follovAng reasons: !For Office Use Only: Application for Disposal System Construction Permit • Page 2 of 2 1, Fee,Atxa.ched? Y _V No - No / 2. 2 i'rojectl araage igation oras �lttaclaeo'? 'es V No J. 1'vna�a sus, tern? ,Ifso, A°xac vfElecxric f. �CII33x Ies No Applicant received copy of "Electrical Inspection.Notes for tic Systerras" Yes No Handout? 4 Reviewed approvalletter,alipaperrvorkrece11 � Yes No S. Foundation As-Bvilt? (new construction only) (Sarre scale as approved pian) es Nos 6 Floor Plans? (new constructiononly).Yes No Application for Disposal System Construction Permit • Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: '?3d J (Address of septic system) For plans by � ex ��"Sm'h x � Relative to the application of V �*'r►Ko GCC.G e - (Installer's name) Dated. X+►-� -3 1 2-6,1 "7 (bays ate (Enguieer) .And dated i I ,j I zz) C rigina ate NCrith revisions dated /.L 7 �r a?dj � (Last revised dat ) 1 understani d the £eillowimg obligations for managerrment of this project; I. As the installer, I ani obligated todl)tain all pe its and Board of Health approved plans prior to performing any work oma a site.. i must have the approved plans and the permit on site when any work is l eimm Daae. 2, As the .installer, i must caU for any and all inspections. If homeowner, contra tor, project manager, or dray other person not associated with my company s(,-,hedtdes ,ran inspection and the system is not ready, then item, three shall be applicable. 1 As the installer, I am required to have .the maecessary work completed prior to the ,applicable inspections as indicated below,. I understand that regttes ing an inspect ion, without +comi2lerion of the items iia ac ordance with Title 5 and the ]Board of Health Regulations mnav result in a S50.00 fine being levied against ane .and/or my company. a. Bottom of Bed — Gener4 ly, thas Is the first (1;) inspection unless there is a retaining waif, which shotid he doe first. The installer must request ;the inspection but does not have to be present. h,. .Final Construction Inspection — Engineer inus.t first do their inspection for elevations, ties, etc. As -built of ved)al OK (or e-mail to:: healthdeptotownofnorthandover.com) from, the engineer must be sub pitted to :the Board of Health , after which installer calls for an inspection time. Instiller must be present for this inspection. With a pump systemn, ,all electrical work naust be ready and able to cause pump to work and alarm to function. Final Gracie — Installer must request inspection when ah grading is comaaPlete. Installer does not have to be on-site. 4. As the Instailler, I understand that only I may perform the work (outer than :wimple excavation) and.1 am required to ,complete the installation of the system identified iia ,the attached application for installation. ifurther understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of thesystem, and/or revocation orsuspension of m ly, license to operate in the Town of North An dover,significant finesto all persons involved .are also possible. le 5� As the installer, I understand that I must be on-site during the perfomrnance of the followima com3strtac tioma steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of .the sand and stone to be used. c. Final inspection by Board of Health staff or consultant. d. Installation of tank, D -Box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer_ I under tand that I am solely responsible for the installation of the •y ern as per the approved plans. No in •tructions by the homneowner,_gener:al contractor or any other persons shall absolve ne of this olAw "ora. Undersigned Licensed Septic Installer. `/�,, 3� -D/7 (Today's Date) (Name —Print) m rgne North Andover Health Department Community and Economic Development Division December 14, 2016 Peter Ogren, P.E. Hayes Engineering, Inc. 603 Salem Street Wakefield, MA 01880 Re: Subsurface Sewage Disposal System Plan for 731 Johnson Street (Map 38, Lot 71) Dear Mr. Ogren: The proposed wastewater system design plan for the above site dated November 9, 2016 and received on November 29, 2016 has been reviewed. Unfortunately, the plan cannot be approved until the following items are corrected. The specific section in Title 5: 310 CMR 15.000, or North Andover regulation that is not met by this design follows each item where applicable. 1. On sheet 1 of 2, the site plan view is difficult to distinguish between existing spot elevations and proposed finish grades. You may want to remove some of the existing spot elevations to make the plan easier to read. Please clearly indicate the proposed finish grades on the site plan view (3 10 CMR 15.220(4)(g)). 2. The invert elevation of the beginning and end of each leach trench should be indicated on the design plan to ensure the installer is aware of these elevations. 3. The breakout elevation for each trench does not appear to be met on the site plan view and cross section A -A (3 10 CMR 15.211(1)). 4. According to Board of Health records, the existing septic tank is a 1,000 gallon concrete septic tank that was installed in 1961. Please propose a new 1,500 gallon monolithic concrete septic tank. (310.223(1)(a)). 5. The brand and model of the septic tank, effluent filter and distribution box were not depicted on the design plan (NA 3.2). 6. Annual maintenance for the effluent filter should be specified on the design plan (3 10 CMR 15.227(7). 7. On sheet 2 of 2, in the cross section A -A, indicate the ESHWT elevation below the middle trench. Page 1 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 8. The specifications of the impervious barrier should be indicated on the design plan to ensure the installer uses the appropriate material. 9. Although not a reason for disapproval, on sheet 2 of 2, the leach trench detail is for a level trench system. You may want to depict the trenches as step trenches similar to the cross section A -A to prevent any confusion to the installer. Please feel free to contact the office or Mill River Consulting at 978-282-0014 with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincer ly, ian I LaGrasse, CEHT Director of Public Health cc: Freckle Internation LLC, Susan Gavin File Page 2 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 12/22/2016 Town of North Andover Mail - RE: 731 Johnson St. NOR ANDOVER AMassachusts Lisa Hadge <Ihadge@northandoverma.gov> RE: 731 Johnson St. 1 message Isaac Rowe <irowe@millriverconsulting.com> Thu, Dec 22, 2016 at 1:03 PM To: Lisa Hadge <Ihadge@northandoverma.gov>, Pam Lally<plally@millriverconsulting.com> Cc: Michele Grant <mgrant@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov>, Isaac Rowe <irowe@millriverconsulting.com> Brian/Lisa, I reviewed the revised plan and 1 would recommend approval based on the revisions. One item to be noted - the original plan indicated an existing 1500 gal septic tank to be reused but the revised plan now indicates a 1000 gal septic tank to be replaced. It appears they obtained more detailed information or indicated the incorrect size of the tank on the original plan. If we allowed them to reuse the old tank it would have been undersized. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager RIVIER CONSULTING d e�:Fr�,�s; �,i��tie�t►� fiat i �sstt �t'i'cCrjifiii5ltl 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.millriverconsulting.com From: Lisa Hadge [ma iIto: Ihadge@northandoverma.gov] Sent: Friday, December 16, 2016 10:47 AM hftp s://mai I.goog le.com/mai I/ca/u/0/? u i=2&ik=46857787d 0&view=pt&sea rch=i n box&th=15927 b 382e4ca 89 b&s i m I= 15927b382e4ca89b 1/3 12/9/2016 YY NORW COVER Massachuss Town of North Andover Mail - RE: 731 Johnson St. Lisa Hadge <Ihadge@northandoverma.gov> RE: 731 Johnson St. 1 message Isaac Rowe <irowe@millriverconsulting.com> Fri, Dec 9, 2016 at 11:04 AM To: Lisa Hadge <Ihadge@northandoverma.gov>, Pam Lally<plally@millriverconsulting.com> Cc: Michele Grant <mgrant@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov>, Isaac Rowe <irowe@millriverconsulting.com> Brian/Lisa, Attached is the disapproval letter for the initial plan review for the above referenced property. Mostly minor edits needed. #4 is trying to discourage the designer from re -using the existing septic tank. A new tank is a small cost compared to the rest of the system. Since they are replacing everything else it could potentially be a weak link for future owner. I believe this house is being flipped so they are likely trying to save costs. Let me know if you have any questions. Thanks, Isaac Rowe Project Manager �L'L RI R G0- NS ULT1 { [a:;t�li'L Lt��11C7[]kE4 �!i! if�i65Si $Ft'i't.ltri YTfi�:31� 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 www.millriverconsulting.com From: Lisa Hadge [ma iIto: Ihadge@northandoverma.gov] Sent: Tuesday, November 29, 2016 2:09 PM https://mail.goo.gle.com/mail/u/0/?ui=2&ik=46857787dO&view=pt&search=inbox&type=158e3cdb74be9bbb&th=158e453f0762afec&sim1=158e453f076... 1/2 No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade (- Abandon ( ) - ❑ Complete System ❑ Individual Components Location Map/Parcel L # 44 # Installer's Name Address Telephone # Type of Building: Z--7/AJ Dwelling — No. of Bedrooms Other — Type of Building _ Other fixtures Design Flow (min. rE Plan. Date kdv, rE7 k5 is Name n� ele ho e # � f9�/G�-'� e%� N �A le/� %- L O(' C)q6 O2 WV ess . ITelephone # Lot Size 474(9 7 7 / aGarbage Grinder ( ) No. of persons Showers �ld gpd Calculated Number of sheets Description of Soil(s) - _:?t:-4 s_CGJ6 Soil Evaluator Form No. %% Name of Soil Evaluator DESCRIPTION OF REPAIRS OR ALTERATIONS feet ), Cafeteria ( ) flow '�I gpdDesign flow provided gpd Revision Date Date of Evaluation ©C% a7 0%� The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Inspections Date FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 RECEIVED iiu`v C 9101 b TOWN OF NORTH ANDOVER HEALTH DEPARTMENT E 0 E -�' 0 O % "D ,, 1E. I., LLI Z< W C= 8 tl 0 i— g ui CV o Lz 0 VU- Lu oCd YS E 0 E -�' -z 0 O tj, 8 tl 0 -z 0 0 0 YS 41,❑ El 0 cl, IS lq a, o 0) > 0 C6 0 0 0 R — v kj\ fro! 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Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 978.688.9540 — Phone 978.688.8476 — FAX O`j healthdept@northandoverma.gov V www.northandovenna.gov APPLICATION FOR SOIL TESTS DATE: O61• /Z C -)0/(0 s0/(0 MAP & PARCEL: 39-7/ LOCATION OF SOIL TESTS: V-31 JQ-/-//l/SO1i/ '3%0t=t7- OWNER: 1l12mr-6 AM,, , ZZ d, Contact #: OCT 18 2016 APPLICANT: -506- 4/-1--V t Contact #: ` 7g �o� - % B 3 f OF NORTH ANDOVER f TN DEPARTMENT. ADDRESS: /q0/k) i'ryl ENGINEER: y c 5�C /AgContact #: 7 91 — CERTIFIED SOIL EVALUATOR: 60,PPOAJZ6cesoo Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5" x 11 " Plot plan & Location of Testing (please indicate test pit sites on the plan) ➢ Fee of $585.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $440.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval ate:� C( Signature of Conservation Agent: Date back to Health Department: (stamp in): 10/242016 Town of North Andover Mail - RE: CommDev-Ricoh NORI OVER Michele Grant <mgrant@northandoverma.gov> NassachusUs: RE: CommDev-Ricoh 1 message Pamela Lally <plally@milldverconsulting.com> Mon, Oct 24, 2016 at 9:13 AM To: Lisa Hadge <Ihadge@northandoverma.gov>, Dan Ottenheimer <dano@milldverconsulting.com>, Isaac Rowe <irowe@millriverconsulting.com> Cc: Michele Grant <mgrant@northandoverma.gov>, Brian LaGrasse <blagrasse@northandoverma.gov> We've scheduled soil testing for 731 Johnson St. for Thursday, 10/27 with Gordy Rogers. Isaac will arrive around 9:30am. Thanks, Pam Lally Administrative Assistant ■ WM.[,,LL RIVER + LTI; . CreativeCrealive Solutions for land Development 6 Sargent Street Gloucester, MA 01930-2719 978-282-0014, x805 www.millriverconsulting.com From: Lisa Hadge [mailto:Ihadge@northandoverma.gov] Sent: Tuesday, October 18, 2016 1:53 PM To: Dan Ottenheimer; Isaac Rowe; Pam Lally Cc: Michele Grant; Brian LaGrasse Subject: Fwd: CommDev-Ricoh Please contact Gordon Rogerson to set up soil testing. hftps:Hm ai l.googl e.com /m ai I/calul0/?ui=2&i k=d4458df3d9&view=pt&q=plal l y%40m i l l rivercons ulti ng.com &qs=true&search=query&th=157f6d2bOf855dff&si m l=1... 1/2 j I _ � a 1 i i � 1 � e j � .,e.., .�,— � � — _ .m ...._ ,,� .— — ,- .. _ .. m _.� .- _„ a� , -��,. _ _ �.�,� .., e . . ., ,. . , ... _, r . .. - - .. z _ r _. ..- - .�_! r4 Tj %13 J-9 7W 0 r4 %13 0 J1� 1 Zvz -ik r4/ to PO a s C I` ilA n IT -. x W n -I Oct.06.2016 10:54 AM gg 1.0/6/2016 To Whom it May Concern:: 1 am the new owner of 731 Johnson Street, North Andover. Per the letter of intention outlining the required terms as suggested by the 1 permit and begin work on site with a failed "Title V systerrr. 1n ordc usage of the failed system, my contractor and 1 will provide proof t off at street level which is scheduled for 1 pm today and we will al.s befibre beginning any work. I am diligently calling/pricing engineers to assist in soil testing and is my expectation to have an engineer and/or septic contractor hire the process. Thank you for your allowing me to continue work ander the terms Please don't hesitate to call me to discuss further. Respectfully, Sue Gavin 978-423-1831 tO FL��2,�, 2 Y # SERVICE'CA�'L J 3 ^ # �` � � , .. ,. � , as , "'� °� 4�r4 ' '4'K�{.i � , • :a�. �.., .. v:ES...3:�.,..,+�.rr.k..;r2.s•.s.,�....�w.wS9.._.a�^'iin +.r NAME Darren Sturtevant (DJS Contracting) for owner` 4 .. �, .::�. 4i' { i � 3a l v�p��' ;•y,�"�"' �k 4::.�5 t ' ��t^C',�� ,. #..'�'fiii� ��� n'.. ��; r.,^ �,w y ��A,r�: 4.:�� # a +_� i • tea „ J t' oJaS«`,�' d'cFtrr a� �„, a �r, ,i'� SERVICE APRWS X731 Johnson Street e_..ik_...:.. "+,.e.,.....F.T ...tYb'...t.,... — ...`..�....�,. !- r y CALLERS PHONE-'#1 ;t :�"w 1'978. 423 7210 ,y I � 4 �, .,� r } _�?. � a.. . irs ',:� 7 v yi•} a +Wf '� f `rr. s i i J-� g ::,i �. ^a5" �3� dsf r'. 1 r. �, {{, ``�J 4�'� �y's� .�. *, ��� }t;-' ; # `y�. ri � i it '� w J, wF r-t�� 4 A' Y+ Ji �.y�'�a A •ti �' "S r t. c`� a5 4 t ,j N r+r.�- � ,>* 4 � s � �, ^. 1 { � ri; tr t � •aa `, i � i `� c � �� � � • y k L � .. y}� is t p j.lw moi+ 1 � ; i.# Y� ✓� ,. y ti• , �"�t1u., �« a�:. �'d,n .* w ,q `k ,�# �l..:L.s.'�.�...i�.1�,�....''^,..a,..-f...«�i�'i;,aas.:$s...i..,:•.1:.,.,...�..M�t�,..,�:.ix3�'f�' rR j., 7q , Shut off water @ street until further notice. DESCRIPTION1 , ='. } Contractor working on property for a failed Title V. z , `Please bring paperwork back to the office for billing 1 J a fr�444 • �♦ �"`$ i h�. _ �t t��y�=... .-.-a.. �.ri�"L �^J=`—"5fjq,;r•� ,^ #_»•�-=nom,-�:>m=.-.c.- a '�� }:sr t��r J � �- a. % .k P � ti t -� I F •ek pa ': ° � f fr r"y' �J Y .5 � Ee �' t ..* _ t lx :..$' t, may, � [SERVICE,DATE '." ` Thursday October 06, 2016 J , � `c"is;{ � r• � ° '4. � " « .. � J' Jil� a � �+ � E ,, w s�r� � 4 > �„ ,. � � s .4, k fir. 4,'f• ,_. '_.., ,,. �� � ..,..e".,.�......G.........i .... ... ,, p 4 � ..t cy ^3 i �k .r SERUICETIME yz 1. �` f @E( t,i�3 �: _ � 7� i., $S ��., SY+'.�. JW,r a��y t,�f n��� i,., ��, l i� ,•i a�/ TAKEN BY j. iFi ' ^ �..r,. r..f.�. ..,,�-, rT.>. r. L...,.,s � t �� S� . �� th � £�»� {a ♦ r..-. J a,�i �� . tw i 3 5 ,` i t 4 ' } alt i, ..• � 'k ..4t r � # ; �. ` rtk f` a dti> °* ' n Sr ,'� ,, � 4 �'� _" rti v •� Z 4 � 4` ^� �a " 1 ro.J �„ f �� i i* S[I�t{i J •�� *i 1 T � �fT d , 7 ! •�- b � FFI{I{ NV i s g, tt trx i� # s i `ti 4 a Y ,�: .'4e ♦.bw .. 1.1.. }_. _ i .mei..... .Ma.aw.r.�,e.+,.��. w+M,s Pi_ I . -�t- Sherti ood"Home's, Inc. Lot 4, Johnson St., APPLICATION FOR SEWAGE DISPOSAL IMTALIATION HEALTH DEPARTNENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot 4, Johnson St. . I will install this system in ac- cordance with all the laws of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre- ceding the septic tank, where the grade shall not exceed 21o. I will install a con- crete septic tank of . 1,QpQ in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 2000 lineal (off) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches /100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree not to cover any portion of this installation until approved by the inspection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application. DATE _ _ 11/27/61 I hereby issue the above permit Andover, Massachusetts. DA TE ture of A th of the Town of North ignature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE 2,�� 7� t Signature of \Ibspecting Officer Percolation Test � /min. Soil: Clay Garbage Grinder No November 18, 1961 Miss Mary Sheridan R. N. Health Agent Board of Health North Andover, Mass. Dear Miss Sheridan: An examination was made as requested in order to determine the suitability of the soil for the subsurface disposal of sewage on the proposed Johnson Street, Lot #4, building site of Sherwood Homes, Inc. The land in general is high. The subsoil in the area was of clay content and a 6 -minute percolation test was conducted. It is recommended that a 11000 gallon concrete septic tank be installed together with 200 lineal feet of drain pipe. Very truly yours, Uvi111am 'scoll WJD:hd ax . BOARD OF HEALTH TOWN OF NORTH ANDOVER O MASS., zZ� Ai.,sapr,r-- * 2 C/ L� of toe t �t Y. NAME 9 /� . .�'1IM_ . . . . DATE r/ . s a. . 2. ADDRESS V�-!�' :9 . .�: � . .LUT N0. �'. . . . . . TEL. 3. N0, OF BEDROOMS . .3. . . DEN YES . . . . N0. �: . . . . 4. GARBAGE GRINDER YES . . i N0. ;. . . 5. SHOW DIPENSIONS OF HOUSE b. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7 SHOVE DIMiENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL q. NOTE LOCATION AIM DISTANCE OF WELL FROM SEWERAGE SYSTEM 10. SHOW LOCATION OF BROOKS, STREAMSp DITCHES., LEDGE OUTCROPt ETC. 11. SHOVE DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NCTE : LOCAL REGULATION'S SHOULD BE READ CAREFULLY, 4 6 O Form Approved. Budget Bureau No. 76-R376.2. VETERANS ADMINISTRATION REPORT OF INSPECTION, INDIVIDUAL WATER SUPPLY AND SEWAGE -DISPOSAL SYSTEM (THIS SECTION FOR VA USE ONLY) REGIONAL OFFICE PROPERTY ADDRESS SUBDIVISION NAME One Beacon Street Johnson Street Bosto n, Massachusetts tis p713 North Andover, Mass. BLOCK NO. LOT NO. NAME OF BUILDER Sherwood Homes, Inc. NAME OF LENDER ICASE Broadway Savings. Bank NO. 312887 Waverly, Y�averly Tad 454 Essex Street TYPE OF INSTALLATION L' j'� NEW 1:1 EXISTING No.- ,Andover,, Mass. Lawrence, Massachusetts TOTAL NUMBER BASEMENT ® YES ❑ CAN ATTIC OR OTHER AREA BE MADE INTO ADDITIONAL BEDROOMS? ❑ ® IF YES, HOW MANY? WATER SUPPLY AND SEWAGE DISPOSAL (Check) LIVING UNITS BEDROOMS BATHS PUBLIC COMMUNITY INDIVIDUAL , WATER SUPPLY BY 1 J1 NO YES NO SEWAGE DISPOSAL BY X PART I—FOR USE OF INSPECTING OFFICIAL (Fill in below information applicable to subject installation) INSTRUCTIONS: If new installation, inspect for compliance with approved exhibits and record any observed information not shown on, or which varies from, the approved exhibits. If existing installation, furnish as much of the information.as may be available. As applicable use inspector's sketch on reverse. INDIVIDUAL WATER SUPPLY SYSTEM Distance to nearest public water mein, feet. Size of main, inches. Individual wells ❑ are ❑ are not customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neighborhood ❑;are ❑ are not being developed with both individual water -supply and sewage -disposal systems. Lot size: feet wide, feet deep. Dwelling set back from front property line, feet. Individual water supply from: ❑ Drilled well. ❑ Driven well. [] Dug well. El Bored well. Distance of well from: Building foundation, feet; nearest lot line at front; ❑ side, ❑ rear,- feet; cast iron sewer, feet; the sewer, feet; septic tank, feet; disposal field, feet; seepage pit, feet; cesspool, feet; other sources of possible pollution, feet. Well construction:. Diameter, inches. Total depth, feet. Type of casing, Depth of casing, feet. Approximate depth of pumping level of water in well, feet. Approximate yield, gallons per minute. Sealed watertight to depth of feet. i Exterior space around casing sealed with: ❑ Cement grout. [] Puddled clay. ❑ Ordinary backfill. Well cover: F] Concrete. ❑Wood.Metal. Openings in well cover watertight: Yes. No. Pump: [] Shallow well. F] Deep well. Length of drop pipe, feet. Pump capacity, gallons per minute. Located in: F] Basement.Pump room off basement. ❑ Pump house above ground. ❑ Pump pit. Pump room properly drained: ❑ Yes. ❑ No. Pump mounting watertight:, ❑ Yes. [] No. Type of storage: ❑ Pressure. ❑ Gravity. Capacity, gallons. Has bacteriological examination of water been made? ❑ Yes. ❑ No." If answer is,"yes," give date '19 Quality of water ❑ is ❑ is not satisfactory for human consumption. Installation ❑ does Q does not comply with approved exhibits, if any. INDIVIDUAL SEWAGE -DISPOSAL SYSTEM PRIMARY TREATMENT consists of [Septic tank. n Cesspool. Septic tank: �r Distance from well, L 0_44eet. Material, Pre Cast Concrete2 Number of comportments Total liquid capacity, gallons. Capacity inlet compartment, 600 gallons. �q1pp000 Inside length, 701 Inside width, JW Liquid depth, 5611 fe Cesspool: Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, F] side, ❑ rear, feet. Inside diameter, • feet. Depth, feet. Liquid capacity, gallons. Lining material SECONDARY TREATMENT consists of X Distribution box and DQ Tile disposal field. Seepage pits. Other Tile disposal field: Distance from: Well, feet; foundation, 20 feet; nearest lot line at [Xf%-[] side, [] rear, feet. Total length of tile lines,© feet. Number of lines,_. Distance between lines, 10 Total effective absorption area in bottom of trenches, 00 square feet. Trench width, 22 inches. Length of each line, 67 Depth, top of tile to finish grade, 12 inches. Type of filter material: []'.Gravel. IX Broken stone. ❑ Cinders. Other Depth of filter material beneath tile, 12 inches. Depth of filter material over tile, 4 inches. Seepage pits: Number of pits, Outside diameter, feet. Depth, feet. Lining material Distance from: Well, feet; foundation, feet; nearest lot line at ❑ front, side, ❑ rear, feet. If existing installation, give all the following additional information available: Distance to nearest: Public sewer, feet. Community system, feet. Approximate direction of surface drainage of lot, Approximate slope, feet per 100 feet. Soil is: ❑ Loam. ❑ Sandy loam. [] Clay. ❑ Sandy clay. ❑ Coarse sand or gravel. [] Hardpan. ❑ Rock. Other Number of bathrooms, . Is there a basement? ❑ Yes. ❑ No. Basement drains to Fixtures in basement: ❑ Laundry troy. [] Toilet. [] Bathtub. ❑ Shower. ❑ None. ❑ Floor drain. ❑ Sump pump. Laundry waste disposal: Diredto ❑ Seepage pit.. Other Through sump pit to: Ej Septic tank. Seepage pits. Is footing drain provided? E] Yes. ❑ No. Drains to: ❑ Surface. [] Dry well. E] Sump in basement. Other Downspouts or areaway drain to: E] Surface discharge. ❑ Dry well. Other Depth of house sewer below finish grade at foundation, feet. 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I __ _ HIEf m i µ [ _..t,.,.. _ _ tW (•ap/s jaqjo uo paynsep dllnl you s6ulpuy 4uauiyad duo mopq 4N4s Xq MOgS) HJ13XS S: ODUSNl (panw;uoJ) I18Vd .� iti1M� ' q�/.!p F 4 k:e .•r SSM � �' �, 4p 1 �4�1 � fyg «"}I`,rayfila rl�������fq��}iq�.�� 3t,�M��'` t♦pa a .,•..% � ' .m".rY.!''..fia���"``y'',(►`.SR' !t�'�ily(f"4t1i., 'moi 1+ � 4rt''ti�; •a����'�hY,.'y�:;:a; • 1,71 W': RECEIVED �� ��' � �� � � • DEC 0 6 2005 TOWN NOR) Qvi J Y 9 TE 1"j P tJ m p 1U OF NORTH ANDOVER N ��I�I N� A.LTH DEPARTMENT j Ysr M p QR nnDR�sS 731 i vi w.r e'er r; •.. Y ��� i I T f )vpuc I'uid h, N�► rvxu ®f' S�RY1(.`L�r xC�l1'rtNc t nirn�rl;r~� , �U �'IC1N YvLL (v Coy I x f�YY Oma .,,�.. B�.a3 INr- RG '3.. ✓rWWaC) Y� 34t,1p� r„.ri PLUtJD�D L�C��V'(Y9Y�K ,.O11f�R•EXPLAIN • •. p. ••4 . ♦ • • wllae• .w ♦ .. • • w• .•. . www 4 {i North Andover Health Department (ommunity and Economic Development Division December 27, 2016 Freckle International, LLC 9 Putnam Road Grafton, MA 01519 Re: Subsurface Sewage Disposal System Plan for 731 Johnson Street (Map 38, Lot 71) Dear Freckle International, LLC: The proposed wastewater system design plan for the above site dated November 9, 2016 with a final revision date of December, 16, 2016 and received on December 16, 2016 has been approved. The design has been approved for use in the construction of a new on-site septic system for an Existing 4 -bedroom (maximum of 9 total rooms) home utilizing a gravity leach field system. This design plan approval is valid until December 27, 2019. During this time, a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance be endorsed by the installer, designer and the Town of North Andover. This approval is also subject to the following conditions: 1. 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. The installer of the septic system shall provide a swale along the northern property line to prevent runoff onto the adjacent property. Page 1 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542 A% �1 A. t=: 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a wastewater treatment and dispersal system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincer , rian J. LaGrasse, CEHT Director of Public Health CC: File Hays Engineering, Inc. Peter Ogren, P.E. 603 Salem Street Wakefield, MA 01880 Page 2 of 2 North Andover Health Department, Town Hall, 120 Main Street, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688. 9542