HomeMy WebLinkAboutMiscellaneous - 9 TURTLE LANE 4/30/2018I
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Commonwealth of Massachusetts
Map -Block -Lot
106.B0104
BOARD OF HEALTH
-----------------------
Permit No
North Andover
- BHP -2017-11 - 08 - -
--------------- ----
FEE
$350.00
-----------------------
DISPOSAL WORKS CONSTRUCTION PERMIT
Permission is hereby granted James Kellett
----------------------------------------------------------------------------------------------------------------
to (Construct) an Individual Sewage Disposal System.
at No 9 TURTLE LANE
---------------------------------------------------------------------------------------------------------- ---------------- ------ -----
as shown on the application for Disposal Works Construction Permit No. BHP -2017- d Pdov 2017
Issued On: Nov -28-2017
--------------------
-------------------------------------------
BOARD OF HEALTH
�1
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
ILS
,eaan
Application for Septic Disposal System
Construction Permit —TOWN OF
NORTH ANDOVER, MA 01845
Application is hereby made for a permit to:
❑ Construct a new on-site sewage disposal system*
Repair or replace an existing on-site sewage disposal system*
❑ Repair or replace an existing system component — What? _
A. Facility Information
9 '�urL�� (ANe.
Address or Lot #
o2.-tf ky d a o e.2-.
City/Town
NOV, ?il 2-0I`7
TODAY'S DATE
$350.00 - Full Repair
$175.00 - Component
2.- *TYPE OF SEPTIC SYSTEM*:
➢ Pump ❑ Gravity (choose one)
***If pum s stem, attach copy of electrical permit to application***
➢ 2Conventional System (pipe and stone system)
➢ ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system.)
➢ ❑ Pressure Distribution S.A.S. (No D -Box)
-->-- Pressure- Dosed,_(D-Box-Present)-S-.A:S-.S.----_—_--
➢
IL
the system require an effluent filter? Yes No
If yes, does plan specify make and model of filter? YES = (no further info. needed)
NO = (installer must specify brand of filter before DWC issuance)
Wlb2t is the Make? What is the Model.
2. Owner Information
Name
01 Tu y L A 6- U41t-L-
Address (if different from above)
M, A&dave,n- "A Ul�yS
City/Town State Zip Code
97&'- 5 -02 -
Email address Telephone Number
3. Installer Information
Name Name of Company
400 SA" sq
Address
City own State Zip Code
Telephone Number (Cell Phone # ifpossible please)
4. Designer Information r
C/C C� Aaot —B", C.
Name Name of Company
15-7 i34,v >= J=- 5-77
Address
JAS N11 03 0 7
City/Town State Zip Code
77k- 1135-- 1.32 `-/
Telephone Number (Best # to Reach)
Application for Disposal System Construction Permit • Page 1 of 2
Application for Septic Disposal System %flay - 2_1 I Z;&)71
Construction Permit — TOWN OF TODAY'S DATE
NORTH ANDOVER MA 01845 $ -Full Repair
, $1775.5.00 00 -Component
PAGE 2OF2
A. Facility Information continued....
5. Type ofBuilding: 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 5 of the
Environmental Code, 11 a e Local Subsurface Disposal Regula ions for the Town of
orth Andover. 1 underst t until a final Certificate of Complia a has been issued by
t "s Board of Healt/r', the stalle tem is not approved.
V Date
�A o By: (,Ward of Health Representative)
Date
n Disapproved for the following reasons:
For Office Use Only:
1. Fee Attached? Yes/ No
2. Project Manager Obligation Form Attached. Yes v No
3. Pump System? Ifso, Attach copy ofElectrical Permit Yes No
AppAcant-received copy of
"Electrical Inspection Notes for Septic Systems" Yes No
Handout?
4. Reviewed approvalletter, all paperwork received. Yes v No
missing,—
5. Foundation As -Built? (new construction only): Yes No
(Same scale as approved plan)
G. Floot Plans? (new construction only): Yes No
Application for Disposal System Construction Permit • Page 2 of 2
81 4
Town of North Andover
%;'• �' HEALTH DEPARTMENT
,SSACNU`+tt
CHECK #:3,2,o(. DATE:
LOCATION: _ 9 /uri �e zzn
r --
H/O NAME: L�Ji���/� "l'y`�.2,
CONTRACTOR NAME:Oa-me,,-7 AelleH
Type
of Permit or License: (Check box)
❑
Animal
$
❑
Body Art Establishment
$
❑
Body Art Practitioner
$
❑
Dumpster
$
❑
Food Service - Type.
$
❑
Funeral Directors
$
❑
Massage Establishment
$
❑
Massage Practice
$
❑
Offal (Septic) Hauler
$
❑
Recreational Camp
$
❑
Sun tanning
$
❑
Swimming Pool
$
❑
Tobacco
$
❑
Trash/Solid Waste Hauler
$
❑
Well Construction
$
SEPTIC Sustems:
❑ Septic - Soil Testing $
�❑j Septic - Design Approval $
L� Septic Disposal Works Construction (DWC) 0 `
,❑` Septic Disposal Works Installers (DWI) $
❑ Title 5 Inspector $
❑ Title 5 Report $
❑ Other. (Indicate) $
HMft&Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
TOWN OF NORTH ANDOVER `� �•
Community & Economic Development
HEALTH DEPARTMENT
120 Mainn Street
RECEIVED NORTH ANDOVER, MASSACHUSETTS 01845
AUG 16 2017978.688.9540 — Phone
i< 978.688.9542 — FAX
TOWN OF NORTH ANDD healthdept@northandoverma.gov
HEALTH DEPARTMENT www.northandovenna.gov
APPLICATION FOR SOIL TESTS
DATE: 8-14-17 MAP & PARCEL: Map 106B -104
LOCATION OF SOIL TESTS: 9 Turtle Lane
OWNER: William Durfee Contact #: 978-502-4920
APPLICANT: same Contact #:
ADDRESS: 9 Turtle Lane, North Andover, MA 01845
ENGINEER: Ben Osgood, Jr. Contact #: 978-435-1324
CERTIFIED SOIL EVALUATOR: Ben Osgood, Jr.
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This: Repair Testing: Yes Undeveloped Lot Testing: Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
No X
➢ Proof of land ownership (Tax bill, or letter from owner permitting test)
➢ 8.5"x.11"Plot plan & Location of Testiue (please hidicate test nit sites on the plait)
➢ Fee of $585.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of4$ 40.00 per lot for repairs or upgrades.
GENERAL INFORMATION
➢ Only Certified Soil Evaluators may perform deep hole inspections.
Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system disposal area.
➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH
representative.
Full payment will be required for all additional tests within two weeks of testing.
➢ Within 45 days of testing, a scaled plan (no smaller than 1"-100') shall be submitted to the Board of Health
showing the location of all tests (including aborted tests).
➢ Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date: 1h 4 / Z b f 4
Signature of Conservation
Date back to Health Department!(statnp in):
✓`o�osu..( will r'e�'uist`C Co�s�,�va`F-tr1-�1-�Q`�.e�t�-�ek� ��tl��.
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T....... ..i AI.. ..A.L. A—.1—.- SAA
1 WVVII VI IVVi ILII P'U I%AVv�.I. 1-1l1
9 Turtle Lane, North Andover
d
f
.8-0080)
Property Information
Property 106.6-01040000.0
ID
Location 9 TURTLE LANE
Owner DURFEE, WILLIAM M
V\
106.13-0057 C
TCs
106.8-0104
106.8-0058
/ 106.
A�
MAP FOR REFERENCE ONLY
NOT A LEGAL DOCUMENT
Town of North Andover, MA makes no claims and
no warranties, expressed or implied, concerning
the validity or accuracy of the GIS data presented
on this map.
I
1106.B-0103
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Commonwealth of Massachusetts
City/Town of North Andover
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.
Important: When
filling out forms A. Site Information
on the computer,
use only the tab William Durfee
key to move your Owner Name
cursor - do not 9 Turtle Lane
key.
Street Address or Lot #
North Andover Ma 01845
City/Town State Zip Code
Contact Person (if different from Owner) Telephone Number
B. Test Results
^ / ^ A- ^. All
Board of Health Witness
Comments:
t5form12.doc• 08/15 Perc Test • Page 1 of 1
Date Time
Date Time
Observation Hole #
TP 1
Depth of Perc
24"/20"
Start Pre -Soak
9.49
End Pre -Soak
10:05
Time at 12"
10:05
Time at 9"
10:14
Time at 6"
10:26
Time (9"-6")
12min
Rate (Min./Inch)
4 mpi
Test Passed: ®
Test Passed: ❑
Test Failed: ❑
Test Failed: ❑
Benjamin C. Osgood, Jr.
Test Performed By:
Isaac Rowe, North Andover Board of Health representative
Board of Health Witness
Comments:
t5form12.doc• 08/15 Perc Test • Page 1 of 1
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10/19/2017 Pump to D -Box Pump Calcs v1
9 Turtle Lane, north Andover, MA
Calc'd by:
BCO Chk'd by:
Total Dynamic Head = Static Head + Friction
Head
Static Head: (D -Box Inlet) - (Pump Off Elev.)
= 97.25 - 90.50
= 6.75
Friction Head = (Total Equivalent Pipe Length)
PC Notes:
x (Friction Head/100' of pipe)
(131.1)
1 90* Elbows each @ 5.2
=
5.2
Pump Off Elev. 90.50
0 45o Elbows each @ 2.8
=
0
n
D -Box Inlet Elev. 97.25
1 Check Valve each @ 17.2
=
17.2
s
Force Main Length 20,
1 Gate Valve each @ 1.4
=
1.4
i
Equivalent Pipe Length
=
23.8
d
Select Pipe Diameter 12 `!
+Actual Pipe Length
=
6
e
Equivalent Pipe Length Inside Pump
=
29.8
Select Pipe Material Plastic W
1 90° Elbows each @ 5.2
=
5.2
O
2 450 Elbows each @ 2.8
=
5.6
u
0 Check Valve each @ 17.2
=
0
t
0 Gate Valve each @ 1.4
=
0
s
Equivalent Pipe Length
=
10.8
i
+ Actual Pipe Length
=
20.0
d
Equivalent Pipe Length Outside Pump
=
30.8
e
Total Equivalent Pipe Length
=
60.6
Total Equivalent Pipe Length
60.6 Friction Head 0.5333
x Friction Head per 100' of Pipe
0.88 Static Head 6.75
Total Dynamic Head 7.28
@.
20
.GPM
Total Equivalent Pipe Length
60.6 Friction Head 1.8907
x Friction Head per 100' of Pipe
3.12 Static Head 6.75
Total Dynamic Head 8.64
@.
40
. GPM
Total Equivalent Pipe Length
60.6 Friction Head 3.939
x Friction Head per 100' of Pipe
6.5 Static Head 6.75
Total Dynamic Head 10.69
@
60
, GPM
Total Equivalent Pipe Length
60.6 Friction Head 6.7266
x Friction Head per 100' of Pipe
11.1 Static Head 6.75
Total Dynamic Head 13.48
@
80 ,
GPM
Total Equivalent Pipe Length
60.6 Friction Head 10.181
x Friction Head per 100' of Pipe
16.8 Static Head 6.75
Total Dynamic Head 16.93
@
100
GPM
10/19/2017 Pump to D -Box Pump Calcs v1
9 Turtle Lane, north Andover, MA
Calc'd by: BCO Chk'd by:
Septic Tank: M 1500
Cover over tank (ft.). 0.8'.
Ground water Elev. 92.62
Tank Inlet Elev. 94.30
Weight of Tank and Soil 11035 5417 16452
Weight of Water 11140
Buoyancy OK
Pump Chamber: 1000 H
Cover over tank (ft.), -0.8
Ground water Elev. 92.62
Pump Inlet Elev. 94.00
Weight of Tank
11035
Length
Width
Cover
10.8
5.7
0_8
Weight of Soil
5417
Groundwater Elev.
92.62
Bottom of Tank Elev.
89.72
Length
Width
Water
10.8
5.7
2.9
Weight of Water
11140
Weight of Tank and Soil 11035 5417 16452
Weight of Water 11140
Buoyancy OK
Pump Chamber: 1000 H
Cover over tank (ft.), -0.8
Ground water Elev. 92.62
Pump Inlet Elev. 94.00
Weight of Tank and Soil 9785 3661 13446
Weight of Water 8307
Buoyancy OK
10/19/2017 Buoyancy Pump Calcs v1
Weight of Tank
9785
Length
Width
Cover
8.0
5.2
0_8
Weight of Soil
3661
Groundwater Elev.
92.62
Bottom of Tank Elev.
89.42
Length
Width
Water
8.0
5.2
3.2
Weight of Water
8307
Weight of Tank and Soil 9785 3661 13446
Weight of Water 8307
Buoyancy OK
10/19/2017 Buoyancy Pump Calcs v1
Job Address ,9 Turtle Lane, north Andover, MA
Calc'd by: BCO
ESHGW @ tank 92.62
ESHGW @ pump 92.62
Se_ lect Tank
Tank Inlet
94.30
___
M jsoo
Tank Outlet
94.05
- -
3 inch walls; (132.3)
Select Pump Chamber
Pump Inlet
94.00
1000 H
Pump Outlet
93.75
D Box Inlet
97.25'
ESHGW @ tank 92.62
ESHGW @ pump 92.62
Gf NORT `,�
79b5
0
s R r
Town of North Andover
,S
::,' HEALTH DEPARTMENT
SACHUSE
CHECK #: 785 DATE:
LOCATION: Tv/' 114P_
H/O NAME:
CONTRACTOR NAME: 05 oocC
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
$
SESystemsSeptic
xx
- Soil Testing
$ yyd❑
Septic - Design Approval
$
❑
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑
Title 5 Report
$
❑ Other: (Indicate) $
Hea `gent Initials
White - Applicant Yellow - Health Pink - Treasurer
November 22, 2017
William Durfree
9 Turtle Lane
North Andover, MA 01845
North Andover Health Department
(ommunity and Economic Development Division
Re: Subsurface Sewage Disposal System Plan for 9 Turtle Lane (Map 1068, Lot 104)
Dear Mr. Durfree:
The proposed wastewater system design plan for the above site dated October 16, 2017 with a
final revision date of November 6, 2017 and received on November 6, 2017 has been approved.
The design plan has been approved for use in the construction of a new on-site septic system for
a Four (4) bedroom home with a maximum of Nine (9) total rooms utilizing a pump chamber and
leaching field system. This design plan approval is valid until November 22, 2020.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover. In the event an imminent health problem, such as sewage backup into the dwelling is
occurring, the North Andover Board of Health may reduce the time period for which this plan is
valid.
This approval is also subject to the following conditions:
1. If site conditions are found in the field to be different from those indicated on the design
plan and/or soil evaluation, the originally issued Disposal System Construction Permit is
void, installation shall stop, and the applicant shall reapply for a new Disposal Systems
Construction Permit (3 10 CMR 15.020(1))
2. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system installer or other representative to ensure that all other state and municipal
requirements are met. These may include review by the Conservation Commission,
Page 1 of 2
North Andover Health Department
120 Main Street
North Andover, MA 01845
Phone: 978.688.9540 Fax: 978.688.9542
9 Turtle Lane
November 22, 2017
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.
Sincerely,
rian. LaGrasse, CEHT
Director of Public Health
Encl. Installers list
cc: Benjamin C. Osgood, Jr., PE, 157 Bluff Street, Salem, NH 03079
Page 2 of 2
North Andover Health Department
120 Main Street
North Andover, MA 01845
Phone: 978.688.9540 Fax: 978.688.9542
C�Qar\n
Commonwealth of Massachusetts D
City/Town of North Andover
Form 9A - Application for Local Upgrade Approval
;M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming
septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR
15.404(1), is not feasible.
Important: When
filling out forms
on the computer,
use only the tab
key to move your
cursor - do not
use the return
key.
tab
System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full
compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410
through 15.415.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of
a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved
capacity of an on-site system constructed in accordaniebe 1978 Code or 310 CMR 15.000.
RECEIVED
A. Facility Information NOV 0 6 2017
1. Facility Name and Address
Name
9 Turtle Lane
Street Address
North Andover
City/Town
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
2. Owner Name and Address (if different from above):
William Durfee
Name
North Andover
City/Town
01845
Zip Code
3. Type of Facility (check all that apply):
® Residential ❑ Institutional
4. Describe Facility:
4 bedroom home
5. Type of Existing System:
❑ Privy ❑ Cesspool(s)
NOV lF 2017
TOWN NEAOLTH DEPARTMENT ANDOVERF NORTH
MA 01845
State Zip Code
9 Turtle Lane
Street Address
MA
State
Telephone Number
❑ Commercial
❑ School
® Conventional ❑ Other (describe below):
6. Type of soil absorption system (trenches, chambers, leach field, pits, etc):
leach field
t5forrn9a • rev. 7/06 Application for Local Upgrade Approval* Page 1 of 4
5 '
Commonwealth of Massachusetts
City/Town of North Andover
Form 9A - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
A. Facility Information (continued)
7. Design Flow per 310 CMR 15.203:
Design flow of existing system:
Design flow of proposed upgraded system
Design flow of facility:
B. Proposed Upgrade of System
440
gpd
440
gpd
440
gpd
1. Proposed upgrade is (check one):
® Voluntary ❑ Required by order, letter, etc. (attach copy)
❑ Required following inspection pursuant to 310 CMR 15.301:
date of inspection
2. Describe the proposed upgrade to the system:
Install new 1500 gallon tank, 1000 gallon pump chamber and pipe in stone leach system
3. Local Upgrade Approval is requested for (check all that apply):
❑ Reduction in setback(s) — describe reductions:
❑ Reduction in SAS area of up to 25%: SAS size, sq. ft. % reduction
® Reduction in separation between the SAS and high groundwater:
Separation reduction 1
ft.
Percolation rate 4 MPI
min./inch
Depth to groundwater 3
ft.
t5form9a • rev. 7/06 Application for Local Upgrade Approval* Page 2 of 4
Commonwealth of Massachusetts
City/Town of North Andover
a
Form 9A - Application for Local Upgrade Approval
;M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
B. Proposed Upgrade of System (continued)
❑ Relocation of water supply well (explain):
❑ Reduction of 12 -inch separation between inlet and outlet tees and high groundwater
❑ Use of only one deep hole in proposed disposal area
❑ Use of a sieve analysis as a substitute for a perc test
❑ Other requirements of 310 CMR 15.000 that cannot be met— describe and specify sections of the
Code:
If the proposed upgrade involves a reduction in the required separation between the bottom of the soil
absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the
high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluatormust be a
member or agent of the local approving authority.
High groundwater evaluation determined by:
Isaac Rowe
Evaluator's Name (type or print)
C. Explanation
Signature
9/22/17
Date of evaluation
Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be
completed)
1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible:
no area on the lot available
2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible:
cost is prohibitive
t5form9a • rev. 7/06 Application for Local Upgrade Approval* Page 3 of 4
Commonwealth of Massachusetts
City/Town of North Andover
a
Form 9A — Application for Local Upgrade Approval
uM DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
C. Explanation (continued)
3. A shared system is not feasible:
no adjacent property available for a shared system
4. Connection to a public sewer is not feasible:
sewer is too far
5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the
appropriate boxes):
® Application for Disposal System Construction Permit
® Complete plans and specifications
® Site evaluation forms
❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines.
Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2).
❑ Other (List):
D. Certification
"I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my
knowledge and belief, are true, accurate, and complete. I am aware that there may be significant
consequences for submitting false information, including, but not limited to, penalties or fine and/or
imprisonment for deliberate violations."
acility wner's Signature
Benjamin C Osgood, Jr., Agent for owner
Print Name
Benjamin c. Osgood, Jr
Name of Preparer
157 Bluff Street
Preparer's address
NH 03079
State/ZIP Code
iIRAI VA
Date
11/6/17
Date
Salem
City/ Town
978-435-1324
Telephone
t5form9a • rev. 7/06 Application for Local Upgrade Approval* Page 4 of 4
Benjamin c. Osgood, Jr. P E.
157 Bluff Street
Salem, NH 03079
Tel: 978-435-1324
November 6, 2017
Brian LaGrasse, Health Director
North Andover Board of Health
120 Main Street
North Andover, MA 01845
Re: 9 Turtle Lane, North Andover
Dear Brian:
Enclosed are three sets of revised septic system design plans for the above referenced property
These plans incorporate the items required to address the previously submitted plans and they
include a pipe in stone leach field versus the previously designed infiltrator system.
These plans also require that a Local Upgrade Approval for the reduction in offset to the water
table from 4' to 3'. A Form 9A Local Upgrade Approval Request form is attached.
With this letter we request that the Health Department approve the local upgrade approval and
the proposed plans. If you have any questions please do not hesitate to contact this engineer.
Sincerely,
Benjamin C. Osgood, Jr., PE
RECEIVED
NOV 0 6 2017
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
RECEIVED
NOV ' 2017
wo
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
4L
FCLE C�?d
North Andover Health Department
Community and Economic Development Division
November 2, 2017
Benjamin Osgood, Jr., P.E.
157 Bluff Street
Salem, NH 03079
Re: 9 Turtle Lane (Map 106B, Lot 104)
Dear Mr. Osgood:
The proposed wastewater system design plan for the above site dated October 16, 2017 and
received on October 19, 2017 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.
1. On sheet 1 of 2, a north arrow was missing from the site plan (3 10 CMR 15.220(4)(g)).
2. An effluent filter is required prior to or within the pump chamber (3 10 CMR 15.23 1 (10)).
3. On sheet 2 of 2, the pump chamber detail and model numbers need to indicate a
monolithic the tank. The pump notes indicate a monolithic tank but the model number
indicates a 2 -piece tank.
4. Since the Infiltrator Chamber system is proposed as an alternative soil absorption system
the "Standard Conditions for Alternative Soil Absorption Systems with General Use
Certification and/or Approved for Remedial Use" will apply. Please provide the
following as required by the approval conditions
Section II(7):
e) The record drawings, approved by the LAA, must clearly indicate an area for
the best feasible replacement system that could be installed in the event that the
proposed Alternative Soil Absorption System fails or it is determined that it is not
capable of providing equivalent environmental protection;
North Andover Health Department, Town Hall, 120 Main Street,
North Andover, MA 01845 Phone: 978.688.9540
Page 1 of 2
Fax: 978.688. 9542
Section II(18):
c) a certification, signed by the Owner of record for the property to be served by
the Technology, stating that the property Owner:
1. has been provided a copy of the Title 5 IIA technology Approval,
the Owner's Manual, and the Operation and Maintenance Manual,
and the Owner ajzrees to comply with all terms and conditions;
iii if the design does not provide for the use of garbage grinders, the
restriction is understood and accepted; and
iv whether or not covered by a warranty, the System Owner
understands the requirement to repair, replace, modify or take any
other action as required by the Department or the LAA, if the
Department or the LAA determines the System to be failing to
protect public health and safety and the environment, as defined in
310 CMR 15.303.
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.
FX
ely,
J. aGrasse, CEHT
Director of Public Health
cc: William Durfee
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
nECEIVED
SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS
NOV 2 8 2017
As the North Andover licensed installer for the construction for the septic system for the prop Tot OF NORTH ANDOVER
rU Ic— L AN HLTH DEPARTMENT
(Address of septic system) For plans by J� L/
/� (Engineer)
Relative to the application of V A mea
(Installer's name) And datedIc'�', !6 ! ZV -7
nglna ate
Dated ND u 2-1, 2-DI1
( o ay s date With revisions dated Y o U , & t Zo
(Last revised date
Lfi
I understand the following obligations for management of this project: fi�Q
l Gfj GC>/'%
1. As the installer, I am obligated to obtain all permits and Board of Health approved plans riot 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 manager, 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 necessary work completed prior to the applicable inspections as
indicated below. I understand that requesting an inspection, without completion of the items in accordance
with Title 5 and the Board of Health Regulations may result in a $50.00 fine beim levied against me and/or
my company
a. Bottom of Bed — Generally, this is the first (1'� inspection unless there is a retaining wall, which
should be done first. The installer must request the inspection but does not have to be present.
b. Final Construction Inspection — Engineer must first do their inspection for elevations, ties, etc.
As -built of verbal OK (or e-mail to: healthdept@northandoverma.gov) from the engineer must be
submitted to the Board of Health, after which installer calls for an inspection time. Installer must be
present for this inspection. With a 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. Installer does not
have to be on-site.
4. As the installer, I understand that only I may perform the work (other than simple excavation) and I am required
to complete the installation of the system identified in the attached application for installation. I further
understand that work done_bp 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 ofHealth 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 anv other persons shall absolve
me of this obligation.
Undersigned Licensed Septic Installer:
A1 e e
(Name — Print)
Hou , L-7, 2,0-7 (Today's Date) 11 `l //7
�7—Signed)
It
TOWN OF NORTH ANDOVER
Community & Economic Development
HEALTH DEPARTMENT
120 Main Street
NORTH ANDOVER, MASSACHUSETTS 01845
SEPTIC PLAN SUBMITTAL
FORM
Date of Submission: 10-20-17
Site Location: 9 Turtle Lane
Engineer: Benjamin C. Osgood, Jr.
978.688.9540 - Phone
978.688.9542- FAX
E-MAIL: healthdept@northandoverma.gov
WEBSITE: hn://www.nortliandoverma.,izov
RECEIVED
OCT 10 2017
TOiOF NORTH
ER
DEPARTMENT
HEA
New Plans? Yes X $275/Plan Check # 795 (includes 1St submission and one re-
review only)
Revised Plans?Yes $125/Plan Check #
Site Evaluation Forms Included? Yes X
Local Upgrade Form Included? Yes.
Telephone #: 978-435-1324
E-mail:-Bosgoodpe@gmaii.com
Homeowner
Name: Bill Durfee
OFFICE USE ONLY
No
No N/A
Fax #: N/A
When the submission is complete (including check):
➢ ✓ Date stamp plans and letter
' ➢Complete and attach Receipt
➢ ��Copy File; Forward to Consultant
➢ _��Enter on Log Sheet and Database
TOWN OF NOR TH ANDOVER
RFPORT OF PERC TEST
ADERESS OF SYSTEM �Llr �� G DATE /0 Z 7 C
NAME OF PROFESSIONAL ENGINEER CR SANITARIAN CONDUCTING TESTS 4:;�,,,r ��()
NAME OF LOTOWNER i'j ADL&�ESS j�J�?lrs
SHOW APPROXI1,1ATE LOCATION OF PITS ON SKETCH ON REAR OF THIS SHEET
Total
Soil Log: To sp oil Subsoil `T Depths & Tis Water Level Pit Depth
NORTH ANDOVER BOARD OF HEALTH
/7 G Time to Time to
Pe T sts Depth Saturation Time Drop 1211 - 911 DroD 9" - 61,
Other Considerations:
j Recommendations:
4
Signature
Jao..Ice 3: 3 7
4
113
IL
TO: NORTH ANDOVER, MASS a /7 19 7.7
BOARD OF HEALTH
FROM:
DESIGN ENGINEER
Re: Soil Absorption Sewage
System Inspection
This is to certify that I have inspected the construction of the said disposal system at
LL 1r 7` 1-t iC rLZ--- Z4 /VE North Andover, Mass.
SITE LOCATION
The grades and construction are as specified in my plans and specifications dated
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ANDOVER
rH ANDOVER
HOUSEHOLD
HAZARDOUS
HASTE PAINT
r.nT,r.p.rTmnt
Free Estimates
r
41 WEST FOREST STREET
"Ac&"4� Sc.m seozo&e
OWNED AND OPERATED BY THE KING FAMILY
Serving Homes — Factories — Restaurants — Institutions
'SEPTIC CERTIFICATION
Tel. 452-7750
LOWELL, MASS. 01851
DATE: _-7IiNb� /O
PROPERTY ADDRESS:
On the above date, I inspected the -septic system.at the.above
referenced property.
Based on my inspection, I certify that the,system, at this time:
is in proper working order.
is NOT in proper working order. VA�TC;X RUR/N';&�C )91fe-K FpoJ**'�' i
SIGNATURL: /
Francis,R. King Jr.
ACTION -KIND ENTERPRISES, INC. d/b/a ACTION -KING SEWER CO.
14 Livingston Street
Y� Lowell, Ma. 01852
(Cy USS
Vacc',
-rS��t',dS 5
tkl�� Gt ✓fit `r Y v ✓ rte �/: 10
61er_
Sewers — Drains Opened
Serving Homes — factories — Restaurant — Institutions