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Home My WebLink AboutMiscellaneous - 795 JOHNSON STREET 4/30/2018i T Q J f0 C, V 0O D z cn 80 z o o ;u o im rt North Andover Board of Assessors Public Ac ess k, Parcel ID: 210/107.A-0068-0000.0 SKETCH Click on Sketch to Enlarge Community: North Andover PHOTO No Picture Available Location: 795L-8 JOHNSON STREET Owner Name: CUNNINGHAM, MAURICE F MARGARET C CUNNINGHAM Owner Address: 795 JOHNSON STREET City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 7 - 7 Land Area: 1.02 acres Use Code: 101- SNGL-FAM-RES Total Finished Area: 1643 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 370,100 353,600 Building Value: 170,900 164,000 Land Value: 199,200 189,600 Market Land Value: 199,200 Chapter Land Value: LATESTSALE Sale Price: 195,000 Sale Date: 12/18/1986 Arms Length Sale Code: Y -YES -VALID Grantor: ENGLISH JOHN K Cert Doc: Book: 02384 Page: 0352 Page 1 of 1 http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=468109 7/26/2005 Town of North Andover Office of the Health Department Community Development and Services Division 400 OSGOOD STREET North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/ RS Public Health Director 978.688.9540 - Phone 978.688.8476 - Fax CE�F7A�IE OF COW'LI�ANCE As of: November 21, 2005 This is to cert that the individuafsubsurface disposafsystem was Fully Repaired by john Soucy At 795 Johnson Street North Andover, V,4 01845 Yfas been instafCed in accordance with the provisions of TitCe v of the State Sanitary Code and with the North Andover (Board of Y[eafth regufations. 'The Issuance of this cert f cate shaff not 6e construed as a guarantee that the system wiff function satisfactorify. Tu6fic Yfealth Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER a NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT y '° 400 OSGOOD STREET * " NORTH ANDOVER, MASSACHUSETTS 01845 'ss40HU � 978.688.9540 - Phone Susan Y. Sawyer, REHS/RS 978.688.8476 - FAX Public Health Director E-MAIL: healthdept@townofnorthandover.com WEBSITE: hqp://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( ) constructed; (V) repaired; by. Name) located at 17425- 3-o A7'/1c e (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated and last Revised on , with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bed inspection date: 401.,F Engineer Re sentative (Signature) Final inspection date:!T f o And - PrAit ^ Engineer: ge (�1 And - Print 7"Of-+-A 011#4 And - Print Name -A 6girfeer Representat a (Signature) gee, 140*4.^ r awa.0.9 J;k And - Yrrint Name Date: //— a(-46— Date: 1,A,( 4 1-- TOWN OF NORTH ANDOVER cf ND to ' ti Office of COMMUNITY DEVELOPMENT AND SERVICES �� •'`�� -'`'• °°p HEALTH DEPARTMENT 400 OSGOOD STREET',. NORTH ANDOVER, MASSACHUSETTS 01845 ��Ss;;C U t� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX ADDRESS: 795 Johnson Street MAP: 107A LOT: 68 INSTALLER: John Soucy DESIGNER: New England Engineering PLAN DATE: 9/1/2005 Rev: BOH APPROVAL DATE ON PLAN: 9/15/2005 DATE OF BED BOTTOM INSPECTION: 10/18/2005 DATE OF FINAL CONSTRUCTION INSPECTION: 10/27/2005 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS Comments: SEPTIC TANK Comments: ❑Existing septic tank properly abandoned ®Internal plumbing all to one building sewer ❑Topography not appreciably altered ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ® 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ® Inlet tee installed, centered under access port ® Outlet tee (gas baffle or effluent filter) installed, centered under access port ® 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ® Hydraulic cement around inlet & outlet Page 1 of 5 TOWN OF NORTH ANDOVER ct NORTM 7 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 ��SS�cMus< Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ® 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ® Inlet tee installed, centered under access port ® Pump(s) installed on stable base ® Alarm float working ® Pump On/Off float working ® Drain hole in pressure line ® 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ® Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: D -BOX ® Installed on stable stone base ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ❑ Speed levelers provided (not required) Comments: Page 2 of 5 TOWN OF NORTH ANDOVER °f No pTH , ti Office of COMMUNITY DEVELOPMENT AND SERVICES F? •''^� -°`'• °°p HEALTH DEPARTMENT 400 OSGOOD STREET►,. ,r NORTH ANDOVER, MASSACHUSETTS 01845 �'�Ss"4CaU � Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX SOIL ABSORPTION SYSTEM I Bottom of SAS excavated down to soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan 3/4-1 %2" double washed stone installed 1/8-1/2" (peastone) double washed stone installed laterals installed and ends connected to header (and vented if impervious material above) Orifices @ 5 & 7 o'clock positions Gravelless disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan 40 Mil HDPE barrier installed Retaining wall (boulder / concrete / timber/ block) Final cover as per plan Comments: Trenches shifted a couple of feet on the North side due to mistake on tree location. Elevations same as design, asked installer to add (approx 15') barrier to North side, because placement of trenches may cause breakout concern. PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: Page 3 of 5 TOWN OF NORTH ANDOVER of NORTH 7 Office of COMMUNITY DEVELOPMENT AND SERVICES ';'•�° A HEALTH DEPARTMENT t 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'ss�cMU Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: ® Rated for exterior if placed outside Comments: Control box had alarm light on switch, instead of on top of box. Control panel located in basement Page 4 of 5 • TOWN OF NORTH ANDOVER pE NORTM 7 Office of COMMUNITY DEVELOPMENT AND SERVICES '`t��°� HEALTH DEPARTMENT m 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �+SS�CHU t� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX SYSTEM ELEVATIONS Benchmark: 100.00 Rod at Benchmark: 10.50 Height of Instrument: 110.50 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 88.03 Septic Tank IN 87.79 Septic Tank OUT 87.54 Pump Chamber IN 87.52 Pump Chamber OUT 87.27 Distribution Box IN 109.98 Distribution Box OUT 109.81 Manifold Lateral 1 HIGH 110.17 Lateral 1 LOW 110.17 Lateral HIGH 108.17 Lateral 2 LOW 108.17 Lateral HIGH Lateral LOW Lateral HIGH Lateral LOW Lateral HIGH Lateral LOW 92.40 92.08 91.83 91.78 91.42 109.91 109.73 110.20 110.08 108.06 107.96 Page 5 of 5 Page 1 of 1 DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Wednesday, October 26, 2005 11:15 AM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: 795 Johnson Final Inspection Final construction inspection for 795 Johnson scheduled for Thursday, October 26 at 8:30 a.m. Thanks, Lisa Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 11/21/2005 0 Commonwealth of Massachusetts Map -Block -Lot Board of Health 107.A- 006 8 - P.I. North Andover Permit No ANJIS F.I. BHP -2005-0291 FEE Disposal Works ConstructionPermit - -------- 0.00 Permission is hereby granted John Soucy --------- - --- --- to (Repair) an Individual Sewage Disposal System. .. ................. .. . at No 795 JOHNSON STREET as shown on the - - - - - --- -- ------------ --- application for Disposal Works Construction -- ----- - ---- ----- ---- -- - ----- Permit No. BHP -2005-029 Dated October 06, 2005 Issued on: Oct -06-2005 ...................................... ................. Ao4dof . ... ....................................... ................... ....................... . ..... 4 Date ......... ...............`..c' .......... .... ,,ORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING 40 Thiscertifies that ........ L I ............................ ....................................... has permission to perform .......... S. `L C ............ .............. wiring in the building of .... .................... at ............. Andover, Mass. ✓No" FeeL/ Lic. No///'.' ...................... z ELECTRICAL INSPECTOR Check# el- 3 'Z 0C i� �� 5 TU1rdN U iV �;DOVI HEAL 1 H DEr 11V�ENT Commonwealth of Massachusetts Department of Fire Services OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked tev. 11/991 (leave blank) 'PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with.the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL of To the Ins INFO ATION) Date: � .— � `'j �T— City or Town of: All 61 P;?'t P f Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant 1. A ,� ,,_„ Telephone No. Owner's Address t Is this permit in conjuon with a building permit? Yes ❑ No D (Check Appropriate Box) Building Purpose of71'11<1z� �c,_ F,4 --).:j. , kD1 Utility Authorization No. Existing ServiceIZI-V Amps /,;;o"'Volts Overhead E�_ Undgrd ❑ No. of Meters _ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /44J Com letion of the following table mav be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Sus (Paddle) Fans P ) No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures g g Swimming Pool Above ❑ In- ❑ rnd. d. o. o Units�mergcy ig g Battu Units No. of Receptacle Outlets No. of Oil Burners FIRE: ALARMS IX. of 'Zones No. of Switches No. of Gas Burners o. I ron d nitiatiniatin evices No. of Ranges No. of Air Cond.Tons No. of Alert' g Devices No. of Waste Dispose P Heat Pump Totals: J.N ber Tons KW No. of Se -Contained Detecti/Alertin Devices No. of Dishwashe Space/Ar Heatin KW g Loca. ❑ Municipal El Other Connection No. of Dryers/ Heating Appliances KW Security Systems: No. of Devices or E uivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors , Total HP Telecommunicationst No. of Devices or Equivalent OTHER: Attach additional detail iJ desired, or as required by the inspector of (vires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such covera is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: / 4f—l')(When required by municipal policy.) Work to Start: - ,21-;�`- Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. r LIC. NO. FIRM NAME: !I/ L - Licensee: �fT� %� {/ Signature � ) LIC. t—c N applicable ttei • exeippt" in the license number line.) Y� ', Bus. Tel. `- `Address t '� SCJ �% J Z %' ,r 4 ) y Alt. Tel. No. r OWNER'S INS JRANCE WAIVER: I am aware th2ft the Licensee does not have the liability insurance coverage normally OCT ,;(WirV4 law. By my signature below, I hereby waive this requirement. I am the (check one) Elowner Elowner's agent. 1 Wn nt PERMIT FEE: $ Signature Telephone No. INN OF N, 'i l i ANDOVER �FIEAL`l H DE.: ,AR ;,MLN T 141��' 2. Uw er Information 01 44_'` c CQ N% Name Add res (if different from above) QXA LID _r2f c�� La/ City/T10-A 1W f State Zip Code 3. Installer Information 77 �� Sc Name AQoress A4nwn City o Teledhb'he N Lt C41.4 Q� �f Name o Compa State �, .�{ // Zi Code (��l al'l ° �% 1-75— Telephone Number (Cell Phone # if possible please) 4. Designer Information Name Name of Company City/Town �- 4� � S� Zip Code Telephone Number (Best # to Reach) *****TURN OVER FOR PAGE "2" PLEASE***** Application for Disposal System Construction Permit • Page 1 of 2 Co-mo-nwealth of Massachusetts { pplication for Septic Disposal System W TODAY'S DATE - °Construction Permit - TOVN OF $ 250.00 -Full Repair $125.00 -Component NORTH ANDOVER, MA 01845 Fee (CIRCLE ONE Form 1A PLEASE) A. Facility Information Important: W Willi When filling Application is herebv made for a permit to: out forms on the ❑ Construct a new on-site sewage disposal system computer, use only the VRepair or re lace an existin on-site sews a dis osal s stem 9 9 P tab key top Y move your cursor - do ❑ Repair or replace an existing system component not use the return key. 1. Location of Facility i TO Address or Lot # /A/..F�� vim• ., YI�L1C LG City/Town State Zip Code 2. Uw er Information 01 44_'` c CQ N% Name Add res (if different from above) QXA LID _r2f c�� La/ City/T10-A 1W f State Zip Code 3. Installer Information 77 �� Sc Name AQoress A4nwn City o Teledhb'he N Lt C41.4 Q� �f Name o Compa State �, .�{ // Zi Code (��l al'l ° �% 1-75— Telephone Number (Cell Phone # if possible please) 4. Designer Information Name Name of Company City/Town �- 4� � S� Zip Code Telephone Number (Best # to Reach) *****TURN OVER FOR PAGE "2" PLEASE***** Application for Disposal System Construction Permit • Page 1 of 2 Commonwealth of Massachusetts Application for Septic Disposal Svstem °Construction Permit - TOWN OF °,M s•' NORTH ANDOVER, MA 01845 Form 1A PAGE 2OF2 A. Facility Information continued.... 5. Tvpe of Building: welling ❑Other: Type of Building 6. Design Flow: Calculated Daily Flow: B. Agreement !t—iR_?-nS" TODAY'S DATE $ 250.00 — Full Repair $125.00 - Component Fee (CIRCLE ONE PLEASE) ❑ Garbage Grinder (check if present) L11-10 Gallons per Day -7 -33 ' �- Gallons The undersigned agrees to ensure the construction and maintenance of the afore -described on- site sewage disposal system in accordance with the provisions of Title`5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to pla he system in operation until a Certificate of Compliance has been issued by this Board of H alth. Date 7Appl'ca * n Approved By: (Bold o alth Representative) /n•d N me Date Application Disapproved for the following reasons: For Office Use Only: 1. Fee Attached? Yes No_ 2. Project Manager Obligation Form Attached? Yes ✓ No 1 3. Pump System? If so, Attach copy of Electrical Permit Yes No 4. Foundation As -Built? (new construction only): Yes No S. Floor Plans? (new construction only): Yes No Application for Disposal System Construction Permit • Page 2 of 2 r r r_ INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at '_9�7 130 4.i 5U✓t .12(relative to the application of M- .. k,?"1- dated for plans by /V 4 4C, 6^S- and dated — /—O with revisions dated(_ I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necgssary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction. steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Unde tg d Licensed Se ' Installer Date:�-0S Di osal Works Const ction Permit # TOWN OF NORTH ANDOVER E NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ~ ' Y 400 OSGOOD STREE"T NORTH ANDOVER, MASSACHUSETTS 01845 cHuSe� Susan Y. Sawyer, REHS/ RS Public Health Director September 15, 2005 Maurice Cunningham 28068 Cavendish Court, Unit 2302 Bonita Springs, FL 34135 978.688.9540 — Phone 978.688.8476 — FAX RE: Subsurface Sewage Disposal System Plan for 795 Johnson Street, Map 107A, Lot 68 Dear Mr. Cunningham, The North Andover Board of Health has completed the review of the septic system design plans for the above referenced property, submitted on your behalf by New England Engineering Services dated September 1, 2005 and received by this office on September 2, 2005. The design has been approved for use in the construction of an upgrade onsite septic system. This approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. This approval is 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 plan does not call for installation of a septic tank effluent filter but one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use, if you choose to install one. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. Sincerel , usan Y. Sawyer, REHS/RS Public Health Director encl: List of licensed septic system installers cc: New England Engineering Services file Town of North Andover HEALTH DEPARTMENT 27 Charles Street North Andover, MA 01845 978.688.9540 healthdep0townofnorthandover. com SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: o? abor SITE LOCATION: ENGINEER NEW PLANS: YES ✓ $225.00/Plan_ Check #: (Includes 1 Ewr and one Re -Review Only) REVISED PLANS: YES S 75.00/Plan Check #: SITE EVALUATION FORMS INCLUDED:) NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone #: 91- 692- l M b A Fax #: % r1g - b t5' / DQE E-mail:ll QCS'e-n k'uz. edy?_ Ll HOMEOWNER NAME: OFFICE USE ONLY When the submission is complete Including check): I. ate stamp plans and letter . 2.Complete and attach Receipt 3. ✓ C,opy File; Forward to Consultant 4. �//Enter on Log Sheet and Database RE SEP - 2 2005 'COHEACTt-, UcFART;AEtVt'�R ik - NEW ENGLAND ENGINEERING SERVICES INC September 1, 2005 Mrs. Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 795 Johnson Street, North Andover, MA Septic System Design Submittal Dear Mrs. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. 2. (2) Copies of the Form 11 -Soil Evaluator Sheets. 3. (2) Copies of the Form 12 -Percolation Test Sheets. 4. (1) Copy of Septic Submittal Form. 5. Check for the Town approval fees. If you have any comments or questions please do not hesitate to contact this office. Sincerely, l Thomas Hector Project Engineer RECEIVED SEP - 2 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 A t • FORM .11-- SOIL EVALUATOR FORM Page 1 of 3 SEP - 2 2005 Date: QS TOWN OF NORTH ANDOVER Commonwealth ALTH DEPARTMENT c usetts •ir A°�-kh An4vtr . Massachusetts Published Soil Survey Available: No ❑ Yes ' Year Published $ j • d •. Publication Scale �.:.�� Sid Drainage Class Jl' 0,11• • • t--•••-••. Soil Map Unit � `-1��Soil Limitations,Lo4�t... Surficial Geologic Report Available; No 1] Yes .. e.�-..,....._....._.... ......._.._............--- --.- Year Published Publication Scale Geologic Material (Map Unit) Landform __._ ._..._,.------ ... - Flood Insurance Rate Map._..._._._._..___............�._...._ ._ ---- .:..-... .�.-..�._µy�.._._.___ r.._..._._.__y_..._....____._.._. -Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No ❑yes ❑ -- Within 100 year flood boundary No ❑yes ❑ Wetland Area: National Wetland Inventory Map (map unit) Wetlands ConscryancY - Pro gram Map (map unit) - 'Cur" --n' Water Resource Conditions (USGS): Month �tJ 02Q( -)S - Range :Above Normal . Norma! ❑Bela«i Normal ❑ Other References Reviewed: DEP APPROVED Font - 12/07/95 FOW'i 11 =SOIL EVALUATOR DORM Page 2 of 3 Location Address or Lot No. ] q,S�j ��n �� Of'�h N over. On-site ,Review beep Hole Number '.-ITTDate: f8 �oA� Time:.1 D.�� Weather Location (ide tify on site plant • Land Use ed�l ��.,n... � ,� slope..,,..�,,....M..,...�:..,.�..M.,.w._,.M� w.w....N,.�...�....M.., .�v...._ .. �....._....v...� o Surface nStones Vegetation �...�._ ., w . w M Landform �.r�l.�s .,.w,.....� _.�. _....M...w Position•on landscape (sketch on the back) Distances from: Open Water Body JAQO . feetDrainage way.-2 a? feet -_ Possible:We�Area, feet Property line.7 feet •D'rinking Water Well 2 ff1_6 feet :Other M. M.� �• DEEP OBSERVATION HOLE LOG_ Depth from, Sod Horizon Sol TextureSot! Colo: O'w.er Surface.11iid�esl (USDA) (Munsell Mottling (Struavre. Stones. Boulders. Consistency. !6 • Graveq . Vairies vAri es MMMUM Parent Material (geologic) C.CDn,DaG'� Tit I- . Depthtol3edrock Depth to Groundwater 'Standing water in the Kole: Weeping from Pit Face: t 11 Estanated Seasonal High Gibund Water- DEP aterDEP APPROVED FORM - 12/07/95 SOIL EVALUATOR TORI\2 ` Page 2 of 3 Location Address or Lot No. 5i 'I–k On-Site Review 8a^a� Deep Note Number .: �, Dpe-: rr Time:Y ,�°O Weather�+� Location (identify on site plans �?r�' wd Land Use �5¢Yl!�F��v......� �. Slope M ..��.. Surface Vegetation .6-I–Cs.SS — ...�- Position'on landscape (sketch on the back) Distances from: `...��•.:. ` "; " ti Open Water Body Jag!q'.' feet Drainage way..700_ feet Possible:wet' Area ,..7�P-.., feet Property Line .w.%z M� feet trinking Water Well�7OD feet -Other -- DEEP OBSERVATION HOLE LOGS Depth from, Sod t4ocizw Saa Texture Solt Colo, ! 0w.er Surface-(triches) (USDA) (tManseW Mottling (Suucwre. Stones. boulders, Consistency, y4 Grave4 a +� -3A .-A : 5 L: to ala -3a, 46 IYYY4 78 I CY � �f(hct a.5Y - Parent Material (eol i /p 9 09 cl ( ofMl3Q - Tl1! - De0rtol3edroc1L Depth to Groundwater: • `Standing Water in the Hole: Weeping from PitFace: Estimated SeasonGround Water- High GrouWater- 01� DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL. L"VALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination ,for Seasonal High Water Table Method Used: Depth observed standing in observation hole ..............:.... inches ❑ Depth weeping from side of observation hole ................... inches Depthjo soil mottles inches (Tpq rPS') ❑ Ground water adjustment ......... ......... feet Index Well Number .................. Reading Date .................. Index well level ................... Adjustment factor .................. Adjusted ground water level ........ ......................................... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in II areas observed throughout the area proposed for the soil absorption system? _ MS -If not, what is the depth of naturally occurring pervious material? -- Certification 1certify that on /Ucv. lig' (date) 1 have. passed the soil evaluator examinatic approved by the Department of Environmental Protection and that the above analy, was performed by me consistent with the required training, expertise and experien described in 310 CMR 15.017. Signature Date ` 0 S SOIL E`'ALUATOR FORM' Page 2 of 3 Location Address or Lot i1o. 1 S lei 7 qJr a f1h Old I ��Di' AiJover, On-site Review beep Hole Number T 0 05' p;�o _ - -.�.�: Date:._ .t':_:... Time:v:...�..:,�.:..:.. Weather Location (identify qn site plan) .: �Qllw./�✓.ed5�'..vS.f; ..:..vv.� .� ..... Land Use �.e� �..�........, Slope Surface Stones .. ^ _..:v...v� .:.M ,.. _. �..�.:::.......... Vegetation .......... . Landform r<<n ..,.:.: _.N �.......,...:..:. v.:...... ,.,,. .:.:,.: r Position*on landscape (sketch on the back) Distances from: Open Water Body 4�o�0a�. feet Drainage way -7M 9 Y- -7M feet Possible:We� Area,....,., feet Property Line . �:. , feet $risking Water Well>13° feet Otter M. Other (Structure, Stones, Boulders, Consistency, '16 Parent Material (geologic) _C.OWI-_DepihtoBedrock: Death to Groundwater: -Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High G(bund Water. DEP APPROVED FORM - 12/07/95 FOR'i 11 =SOIL F,`'ALUATOR rORM ,. Page 2 of 3 Location Address or Lot i4o. 0n -site ,Review :. _ Deep Hole Number -z- Date:_ Time:-..��.x'�� Weather Location (identif on site plan) Qat t- Ge-�f • Land Use � .._n. �o w�..._�. .�...v�..,.. ,.�. �.Su.: " Slope (/o) AS%Surface Sto �. . • .� .",..wM _. Vegetation Landform �rl� ►'►.�1� ... w M.......�_.�.. _.... M,... ;" ...� " . ". " �.w� "".� "_ M. w ... _.. v Position•on landscape (sketch on the back) Distances from: t Open Water Body L,IA QQ-. feet Drainage way. 70-()-.. feet PossibWWe� Area. ,79�.— feet Property line . $_M feet -Drinking Water Well > lSo feet DEEP OBSERVATION HOLE LOG* Depth from Sod Horizon $W Texture Scx( Go!o: c.,a 0.,WSurfax.ptidles) (USDA) - ( COL Mottling (Structure, Stones. Boulders, Consistency, 96 - GraveQ l 0 313 - -_ YR A• 9-q Parent Material (geologic) go J Depthto8edrock Depth to Groundwater• •'Standing Water in the Hole: Weeping from Pit Face: 11 Estimated Seasonal High Ground Water. 11.4 '• ' DEP APPROVED FORM - 12107/95 :FORM II -SOIL F,VALUATOR rOkhq Page 2 of 3 Location Address or Lot No. L,„s�e,�.� No!`f~hdv✓er On-site Review Deep Hole Number Date: 0-4,-Ibr ' UO Ti�x.,,,..,."� Weather Location (identify on site plan) Land Use .�'�t ...�".... ,�. �.... �,...�..""....",:.�...,"..... �..�....".....�.....".....wm.�.......".. ". Slope ( /otia) . /P.- Surface Stones Vegetation W—Pol Landform _"�rr��tR.�.�.....w.",�.".......... "... _...�......: •- - -- "".".".w.".".ww.,..�..�.._.".."...�..",.M... _""..�...... � ..� :."...... _.... . Position'on landscape (sketch on the back) Distances from: Open Water Body eta .. feet Drainage way..V766. feet ` Possible:We1� Area.,,,ZCn,,, feet Propeity Line feet rinking Water Well feet :Oilier ". DEEP OBSERVATION HOLE LOGS Depth from Soil Horizon Soa rextwe SQA Ge!o� -c-N Od.a Swface.(Icid�es) (USDA) (1tMmsetl MottBng (Strucane. Stones. Boulders. Consistencll. Gravel 313 toYR as, 3q — SIB . - C- -= ' S t I -Y5/6 ass tJe L - •MINIM Parent Material (geologic)YkDA (l4 DepttrtoBedrock- Depth to Groundwater- -Standing Water in the Hole: i Weeping from PitFace, Estimated Seasonal High Gjbund Water, 3}�� DEP APPROVED FORM - 12/07/95 4 BOARD OF HEALTH �� NORTH ANDOVER, MASS. 01845 RECEI ED 978-688-9540 JUL 2 5 2005 APPLICATION FOR SOIL TESTS 4N nHEA QEPf,k „q�NTr DATE: / 'Z S� MAP & PARCEL: IOrI C S LOCATION OF SOIL TESTS: �FlGHT ��°f�li OWNER-MSR1eE ISINit(Im(f"41 TEL. NO. -- ADDRESS O:ADDRESS: 9 9 ,5r 1110 ON&N 'f1W10- ENGINEER. Nrew kAAGz^A) ritr�r r��r,�iH [, TEL. No.: CERTIFIED SOIL EVALUATOR: A -WI.( E LOCO -)AA II-OM/t,r I:. Iii e#-<� Intended use of land: Residential Subdivision Single Family Ho Commercial Is This: Repair testing- Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No )K THE FOLLOWING MUST BE INCLUDED WrM THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $4425_00 per lot for new construction. This covers the minimum two deep holes and two percolation tests rewired for each disposal area. Fee of3S 60.00 per lot for =airs or upM. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Pull payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan (no smaller than lr-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted Please. Do This Line N.A. Conservation Commission Approv Date Received: Check Amount: Check Date: (s 'AWT kv, C'�A J�?4 h1.ed 'b fi L a)/ Nuc _ Re� 4 et JUL 2 6 2005 TOWN 112 -VER w c7 `-1 N S � 1�-� � i !2 e �' t Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. I" Commonwealth of Massachusetts City/Town of 1%4h A dox/L Percolation Test Form 12 Percolation test results must be submitted with the Sal 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 Maurice Cunningham Owner Name 28068 Cavendish Ct., Unit 2302 Street Address or Lot # Bonita Springs City/Town Contact Person (if different from Owner) B. Test Results FL 34135 State Zip Code (239)498-9633 Telephone Number t5forml2.doc• 06/03 Perc Test • Page 1 of 1 8/10/05 10:45 8/10/05 11:39 Date Time Date Time Observation Hole # PTI PT2 Depth of Perc 55"/14" 23"/15 Start Pre -Soak 10:45 11:39 End Pre -Soak Time at 12" Level Level Time at 9" Dropped Dropped Time at 6" 1/2 per inch 1/2 per inch Time (9"-6") in 1 hour in 1 hour Rate (Min./Inch) 1" in 27 Min 1" in 27 Min Test Passed: ❑ Test Passed: ❑ Test Failed: ® Test Failed: Benjamin C. Osgood Jr., P.E. Test Performed By: Randy Burley, Mill River Consulting Witnessed By: Comments: t5forml2.doc• 06/03 Perc Test • Page 1 of 1 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. ICS Iml Commonwealth of Massachusetts City/Town of No" endo va- Percolation Test Form 12 Percolation test results must be submitted with the Sal 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 Maurice Cunningham Owner Name 28068 Cavendish Ct., Unit 2302 Street Address or Lot # Bonita Springs Cityrrown Same Contact Person (if different from Owner) B. Test Results FL 34135 state Zip Code (239)498-9633 Telephone Number Date Time Test Passed: ❑ Test Failed: ❑ Benjamin C. Osgood Jr., P.E. Test Performed By: Randy Burley, Mill River Consulting Witnessed By: Comments: t5form12.doc• 06103 Perc Test • Page 1 of 1 8/25/05 9:50 Date Time Observation Hole # PT3 Depth of Perc 38"/15" Start Pre -Soak 9:52 End Pre -Soak 10:07 Time at 12" 10:07 Time at 9" 10:13 Time at 6" 10:24 Time (9"-6") 11 min Rate (Min./inch) 4 min per inch Test Passed: Test Failed: ❑ Date Time Test Passed: ❑ Test Failed: ❑ Benjamin C. Osgood Jr., P.E. Test Performed By: Randy Burley, Mill River Consulting Witnessed By: Comments: t5form12.doc• 06103 Perc Test • Page 1 of 1 Page 1 of 1 U �J DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Wednesday, July 27, 2005 12:52 PM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: soil tests 183 Forest Street is set for 8/2 at 8:30 497-Fost t is set for 8/10 at 8:30 795 Johnson Street set for 8/10 at 1:00 (or immediately following 497 Foster) Lis Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 7/27/2005 f1 C 4 SEWER 119 West Street SERVICE Methuen, MA 01844 (508) 683-5709 A jiff-iS 9 5 :10 f�Al ST. - fi��,lY�• ' -4 f 7& Farr, George Lot # 8, Johnson St. APPLICATION FOR SEWAGE DISPOSAL INSTALLATION r _ HEALTH DEPARTMENT - NORTH ANDOVER, MASS.a�.�y_�_„___ I hereby make application for a permit for a sewage disposal installation at Lot, #8& o nson �t. . 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 2%. I will install a con- crete septic tank of _ 1000 gal, 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 180 lineal () 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 e5-�� "L� , / r Sign 5p6re of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. �� _ 5 S gnature of Health Agent I have inspected the uncovered system indicated above and find everything done / as described. DATE 1 1 � 6T Signature o° nspecting Officer Percolation Test 6 min_ Sn; i . g„„„__ n, W Garbage Grinder BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. �/-, ,/ i,' 47/" t i re✓ ( �� . / ' .V ` �z7C 0006AL.c '.)C•TAu1G. o t _ 'ne-5 (00 D�s%'3�x. ':�G iP V-0 1. NAME DATE 2. ADDRESS ' :5-�! LOT NO. TEL. �: 3. NO. OF BEDROOMS --_7. DEN YES NO 4. GARBAGE GRINDER YES N0___Z— 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL .4�14 - 9. NOTE LOCATION AND DISTANCE OFW�<FROM SEWERAGE SYSTEM lb. SHOW LOCATION OF BR9_QKS, STREAMS, DIT-'-CAES, LEt3E-OUTCROP, ETC. 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL NAME OF APPLICANT George U. Farr LOCATION Eg� Starrett lot ,jnhn,ann St. Address of t no. BUILDING: Dwelling g_ Other SYSTEM: New X y Repair GENERAL DESCRIPTION OF LAND Ln wenaral is .High_ SUBSOIL: Clay GravelSand Y r PERCOLATION TEST 6 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK � gallon capacity. LEACH FIELD 1R()—lineal feet of drain pipe. William J. b iscoll, Engineer Board of Health TOWN OF NORTH ANDOVER - �- SYSTEM PUMPING RECORD DATE /0— / 7— �3' Ysi.bM UWNER& ADDRESS SYSTEM LOCATION (1,071712 79s 57` DATE OF PUMPING /0 —/ 7 QUANTITY PUMPED CESSPOOL NO YES SEPTIC TANK NO NATURE OF SERVICE: ROUTINE GlEMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN LACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY COMMENTS: CONTENTS TRANSFERRED TO YES