HomeMy WebLinkAboutMiscellaneous - 865 JOHNSON STREET 4/30/2018 (6)R
TOWN OF NORTH ANDOVER
Community & Economic Development
HEALTH DEPARTMENT
120 Main Street
NORTH ANDOVER, MASSACHUSETTS 01845
978.688.9540 — Phone
978.688.9542— FAX
E-MAIL: healthdept@northandoverma.�ov
WEBSITE: http://www.northandoverma.gov
SEPTIC PLAN SUBMITTAL
FORM
Date of Submission: a2,G> / 7
Site Location: J �r�in 50/} S Za -/9
Engineer: A)
New Plans? Yes $275/Plan Check # (includes Ist submission and one re-
review only)
Revised Plans?Yes1__$125/Plan Check # 7613
Site Evaluation Forms Included? Yes No
Local Upgrade Form Included? Yes No
Telephone #: 56 .> Q
E-mail:
Homeowner
ea,1-01,
Name:
e,5
OFFICE USE ONLY
When th ission is complete (including check):
➢ % . Date stamp plans and letter
➢ Complete and attach Receipt
➢ Copy File; Forward to Consultant
➢ Enter on Log Sheet and Database
7946
Town of North Andover
HEALTH DEPARTMENT
C14
CHECK #:78/3 DATE:? -/Z AZO��
LOCATION: ?6 5 M/? ) sp t) J o-� A
H/O NAME:CQ,
CONTRACTOR NAME: 1711 "ii/Y29-C,,t
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
$
LU ` 1 J�V
Other (Indicate) 1 $
Initials
White - Applicant Yellow - Health Pink - Treasurer
I
Bill Dufresne
Merrimack Engineering Services, Inc.
•66 Park Street • 907 Ocean Blvd.
-Andover, MA .01810 • Hampton, NH 03842
•(978) 475-3555 Ext. 20 • Cell: (978) 502-6206
Fax: (978) 475-1448
Email: brdufresne@comcast.net
LETTER OF TRANSMITTAL
RECEIVED
JUL i L `t017
ToDOM
HMV �ARn
TO: NA Board of Health
DATE: 7-12-17
DATE
RE: 865 Johnson Street
DESCRIPTION
2
Revised 6-6-
17
WE ARE SENDING YOU: (x) PRINTS ( ) PLANS ( ) SPECIFICATIONS ( )COPY OF LETTER
COPIES
DATE
NO.
DESCRIPTION
2
Revised 6-6-
17
Lots 1A, 1B, 2A & 2B Subsurface Sewage Disposal System Plans
THESE ARE TRANSMITTED as checked below
(x ) FOR APPROVAL ( ) FOR YOUR USE ( ) AS REQUESTED
( ) FOR REVIEW AND COMMENT ( ) APPROVED AS SUBMITTED ( ) RESUBMITTED
The plans were modified ONLY to reflect the different lot numbers which were assigned to the (4) proposed lots during the
Planning Board ANR process. Lots were previously numbered 1-4, now are numbered IA, 1B, 2A & 2B.
North Andover Health Department
Community and Economic Development Division
September 29, 2016
Vladimir Nemchenok
Merrimack Engineering Services
66 Park Street
Andover, MA 01810
Re: 865 Johnson Street — Lot 3 (Map 107A, Lot 28)
Dear Mr. Nemchenok:
The proposed wastewater system design plan for the above site dated September 10, 2016 and
received on September 16, 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, a benchmark was not depicted within 50-75' of the proposed facility
(3 10 CMR 220(4)(q).
2. The location and elevation of the foundation drain was not depicted on the design plan
(NA 3.2).
3. The survey statement by the designer was not depicted on the design plan (NA 3.2).
4. Specify all system components shall be marked magnetic marking tape (3 10 CMR
15.221(12)).
5. On sheet 2 of 2, test pit 4B only has 45" of soil depth (C horizon) below the estimated
soil depth removal (3 10 CMR 15.240(1)).
6. On sheet 2 of 2, the bottom of the trench in the scaled profile is sloping.
7. Indicate whether or not the new property lines have been approved by the Planning
Board. If so, please submit a copy of the subdivision plan for reference.
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
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.
Sincerely,
f " y
Brian J. LaGrasse, CEHT
Director of Public Health
cc: Carol Resca
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
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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
978.688.8476— FAX
E-MAII,: healthdept@northandoverni&gov
WEBSTTE: hgp://www.northandoveffna.gov
SEPTIC PLAN SUBMITTAL
FORM
RECEIVED
Date of Submission: SEP 16 201 R
Site Location:
WWN OF NORTH ANDOVER
JJEALTH DEPA jRTMI ENT
Engineer: �� .L�%J � '. V k I ll' )�d
New Plans? Yes /Q;
n Check#(includes 1" submission and one re-
review only);.��
Revised Plans?Yes $125/Plan Check #
Site Evaluation Forms Included? Yes V-11� No
Local Upgrade Form Included? kW Yes No
Telephone Fax #: 0Vn
Homeowner
Name: GAS CL,
OFFICE USE ONLY
When the sub sion is complete (including check):
➢ Date stamp plans and letter
➢ --�' Complete and attach Receipt
Copy File; Forward to Consultant
Enter on Log Sheet and Database
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Important:
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only the tab key
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use the return
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VQ
Commonwealth of Massachusetts
City/Town of
Percolation Test
Form 12
Percolation test results must be submitted with the Soil Suitability Assessment for On-site'Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
A. Site Information
-'"WL, KC -SGA
Owner Name
City/Town
41?-,
Contact Person (if different from Owner)
B. Test Results
Observation Hole #
Depth of Perc
Start Pre -Soak
End Pre -Soak
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rate (Min./Inch)
Witnessed By:
Comments:
D 0415
Zip Code
Date Time
r- 3A
5+f� .
Ila l�
t �d
Test Passed:
Test Failed: ❑
NumDer
W, I
Date Time
7
l V57
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I'v _91
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Test Passed:4
Test Failed: ❑
t5form12.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.
_Q
Commonwealth of Massachusetts
City/Town of
Percolation Test
Form 12
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
A. Site Information
B.
SGA
Owner Name
City/Town '
41�-
Contact Person (if different from Owner)
Test Results
Observation Hole #
Depth of Perc
Start Pre -Soak
End Pre -Soak
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rate (Min./Inch)
Test Performed By.
TGS, C -
Witnessed By:
Comments:
1 d� t4
Date Time
P� $A
61-eib-11
Dat Time
F_
p
!e
Test Passed:
Test Failed: ❑
Is 4'
1M
40
Test Passed:
d
Test Failed:
❑
t5form12.doc• 06/03 Perc Test •Page 1 of 1
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 978.688.9540 — Phone
Public Health Director 978.688.8476 —FAX
www.townofnorthandover.om ECEI-VE®
APPLICATION FOR SOIL TESTS_
`y AUG a b 2014
DATE: --` �l i MAP & PARCEL: �A Tn,ip, OF NORTH ANDOVER
I 11���TH DEPARTPvflE�fT
LOCATION OF SOIL TESTS:
OWNER: (i .r; E �qd �`C Contact
APPLICANT: Veto, Contact #:
ADDRESS:
i
ENGINEER:" alUg,404C � � �{'� Contact #: � � —75 � i 7� k
CERTIFIED SOIL EVALUATOR: Lt— l/ aEdx16
Intended Use of Land• Residential Subdivisio Single Family Home Commercial
Is This: Repair Testi n • v eveloped Lot Testing:�Upgrade for Addition: 2 j l
In the Lake Cochichewick Watershed? Yes
I
am. - lol3A
P
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 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
Signature of Conservation Agent:.
Date back to Health Department: (stamp in): 6 Y
rot., d '.
t~ 'f -
4.1S � (�
�O-L- S>1
North Andover MIMAP May 12, 2014
0981=0079. 107.A-0067. 038.0-0060
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Rail Line
IntIntInterstates,tateHorizontal Datum: MA Stateplane Coordinate System, Datum NAD83,
-- SR Meters Data Sources: The data for this map was produced by Merrimack
Roads t, NORTN Valley Planning Commission (MVPC) using data provided by the Town of
3? O tt e o r s q�0 Environmental Affa s/Ma sGIS.The provided orrmatio depic ed oon this map is
GrEasements gt OL
North Andover. Additional data
0 MVPC Boundary O 9 for planning purposes only. It may not be adequate for legal boundary
definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER
[' Municipal Boundary MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING
Trails t M THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY
OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT
❑ Parcels o 9��• i ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
.. Hydrographic Features ?t '0o��rEo-��•`"�y THIS INFORMATION
Streams 9SSACHUSEt
Wetlands
Exempt Lands 1" = 233 ft �`
Mil
t
Blackburn, Lisa
From: Isaac Rowe <irowe@mill riverconsulting.com>
Sent: Friday, September 19, 2014 8:03 AM
To: Blackburn, Lisa; Sawyer, Susan
Cc: 'Pam Lally'; 'Isaac Rowe'
Subject: RE: 865 Johnson St.
Attachments: 865 Johnson Street - Soil testing results 9-18-14.PDF
Susan,
Attached are the soil testing results for the above referenced property. We did a total of (5) lots. Generally good soil
except some pockets of excessive rock. There is relatively a high groundwater table throughout the site so all systems
will be raised above grade.
I allowed (2) deep holes and (2) perc tests per system area because they were across the proposed system location.
Trenches will be proposed. If leach beds are proposed instead then we should probably require additional test pits
before or during construction. The soil was consistent and I am not worried about lack of soil depth in the areas we
tested.
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(aD-millriverconsultina.com
www.miliriverconsulting.com
From: Blackburn, Lisa[mailto:LBlackburn(atownofnorthandover com]
Sent: Wednesday, August 27, 2014 3:26 PM
To: Dan Ottenheimer; Isaac Rowe; Pam Lally
Cc: Sawyer, Susan
Subject: 865 Johnson St.
Good Afternoon,
Please contact Bill Dufresne to set up soil testing for 865 Johnson St. Thank you.
Lisa Blackburn
Health Department
Town of North Andover
1600 Osgood Street, Suite 2035
North Andover, MA 01845
Phone 978-688-9540
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