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HomeMy WebLinkAboutMiscellaneous - 99 GRAY STREET 4/30/2018 (2)i,, 4 �2 0�� I �I Lot & Street 9? 6,ei9y 3r Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid: YES NO Permit# �9 Plan Approval: Date: 1,q 17 Approved by: Designer: (. C6P_565� Plan Date: ��(/. �?Q jGjc� Conditions: Water Supply: Town Well Well Permit: :::::Driller: Well Tests: Chemical Date prove( Bacteria I DateAp over Bacteria II Date Aporo c Plumbing Sign -Off: Comments: Form "U" Approval Date Issued Conditions: Wiring Sign Approval to Issue: YES NO By: Final Approval: All Permits Paid? CESD Well Construction Approval? YES Septic System Construction Approval? QYEs Certification? YE Other YES Any Variance Needed? YES FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: NO NO NO NO NO SEPTIC SYSTEM INSTALLATION Ir I Is the installer licensed? NO Type of Construction: NEWp� New Construction: Certified Plot Plan Review YES NO Floor Plan Review YES NO Conditions of Approval from Form U YES NO Issuance of DWC permit: SNO DWC Permit Paid? NO DWC Permit #_JO- Installer: SIO y ,U S5ouc l' Begin Inspection: LCD NO Excavation Inspection: Needed: Passed: !% By: Construction Inspection: Needed: t Plan Satisfactory: YES: Approval of Backfill: Date: 911di By: 7 � Final Grading Approval: Date: I �af-hqzBy:­ Final Construction Approval: Date: By-.— Certificate y:Certificate of Compliance: Approval: Date: �� d ml"- IF l"- m �m �< n t�nNZ Q3� �a 0 IC ?3 rn Xa �o is O` ti ................ v0X 40- r� �r r 328.3% S 8 Q 1 1^ H CIA C� V 9 �f/ zo- cn ,U v tIj tri I N s� 'nil ro N H r h vz mI _I rd � o� H O G7 m 1.4ra z vz O ow H ds mI _I rd � 1-3 H O G7 m 1.4ra 1-3 O O m 1.4ra hOd O H ds i 0 ro �, z x � � N tsi H 1-3 O H hOd O H ds i Commonwealth of Massachusetts City/Town of NORTH ANDOVER, MASSACHUSETTS System -Pumping Record Form 4 DEP has provided this form for use by local Boards of Heal h. Tlie°S'F&i /AlQping Record must be submitted to the local Board of Health or other approvin authority. A. Facility Information TOWN OF NORTH ANDOVER Important: HEALTH DEPARTMENT When filling out 1. System Location: forms on the computer, use I y > only the tab key Address _ to move your JN 'Jag) tJ cursor - do not City/Town State (/ Zi Code `7 use the return p key. 2. System Owner: �r R S e v,, t e r ej e Name r'I Address (if different from location) City/Town State Zip Code 9 7 C/ Z 3 1-fc�`) Telephone Number I B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): 7 --- 6,1 t -a-t/0 Date 1 12. Quantity Pumped Cesspool(s) eptic Tank Gallons © i) ❑ Tight Tank 4. Effluent Tee Filter present? PYes ❑ No If yes, was it cleaned? x Yes ❑ No 5. Condition of System: 6. System Pumped By: K055 Name Vehicle License Number (r7J�1 J Company 7. Location where contents were dispodisposed:T, 05 I Signature of HNUler http://Www.mass.gov/dep/water/approvals/t5forms.htm#inspect Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 077?010282 System Owner *1 i ke 99 (,,r. -,y SLr+oett ;;c�Ttr2 ft7'1Ci.'+VE'C� •^w1� ,+.�; -; Type: Em Cesspool: No Date of Pumping: System Pumped By: Contents Transferred to: Commonwealth of Massachusetts Massachusetts System Pumping Record Routine Yes Wind River Environmental, LLC System Location .r I'M Form 4 -- System Pumping Record AUG - 7 2007 HEALTH DEPARTMENT Contents Disposed at: u Ipswich Water reatment Plant IW.�-h-rMA 0- 1, 9f-4 8 - bate: Date: Condition of System/Other Comments Pumper Dep Approved Form -12/07/95 Septic Tank: No = YesE�d� Quantity Pumped: Gallons Permit #: i tea/ / � • a TO: NORTH ANDOVER, MASS 19 7-5— BOARD 3BOARD 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 Z,:3 r /— ' A X North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated a ct_ G a 19—z5.- 4 initarian A-5 PLAq, 1 1 4M. Ib 125f"� l t'J i, T • U,) • PLAQ LOT E OR-AY 4�rl 5.,O'rC '.:� _ : t ► I r---.-.- .�, .--- _ .' - - - - ,� 1211 ���,.Toi��J►�. Cdvct3 f: 4"PEkFowaTUD Di!AKvE US R ul � -r ♦ -r� �r tib"'�AsNEGWSNE1.�'ibraE3i'.t�-tllt (• , NB���►tPT1��► ftREN rl iy 2/ ' ABSORPTION BED END SECTION 1 w Y q i, V 94.ca y {— t` EALLCIN �ffi lit t a' .�,� SERTIL tc+ l Zatv.l. t ., 93.0 DISPOSAL'SYSTEM PROFILE FY• 1 5 } ABSORPTION BED PLAN (; OBS. HOLE i PERC HOLE r !J PERC ' R A E G PERC TEST TEST DATE _ -49: _ .. 'r Smeoc —I A kwvee, Joy+ J. �aAU NICLUiEK/ �OA v No PEADiNc=J ) MAss TEL X64-4953 SCALE f=50' ASU " 7, 1474 �-t3etck ,MQe� 6e,4 Y ST& EES-- X-c4rr ,AJ 0 PEC TEST- 0 EST0 OM. NOLs v��K '�� I11 �i 111 '••i \��!i� ���..� v \\♦ 111 /r^�.� \ � 0 0 J 0 0 •O pU W O O•.. uvoo o ° 0'joa o d a°� •J JJ pd ° •2i i 2 5' ---�- -- — 201 BED ABSOR PTION -7-- END SECTION _ IZ" M1n.Topsoll Cover V Wa shed PeaS-fone 1/8'=318" 4"Perf0r4+ed Orangeberg 16 Washed Crushed S+one3/4"-I'/tM 4'1 Abu rptlon Area ��oq�zsE <Awl> Q 970 0 a— _ _ _ _Proposed Flnlsh Q=ade -a - — — 6 00 COvt r t- 1000 Va11011 m SepfIGTdnk �Z'o w DISPOSAL SYSTEM PROFILE �? Y' lo041 'to°1 u�:o o: 1a3� ' WAS TAP -j E cs9.o ABSORPTION BED PLAN stir _ , FPUCr(OM MorEs : C06J ; nZucr 3Ed As S140W l . �i v i5N G �Adf tiG MUST' SLOPE SOLln OP-Au64BLX6 ce- E200, Bok AfjjAY Feom e-,cb • QIP OBS. HOLE PERC. HOLE UITH SMkC'0 OF LI -AV t wATEP- rA kt PERC RATE 7 M,ki.'1 ij. PERC TEST �/�TU�A'f�� ISM r 1-► g To 6 ' 22 "Al j. TEST.DATE C4-ZL-74"J LED i 4 T mh �Dq_ coc�icnewic _�/ Applicant Town of North Andover, Massachusetts BOARD OF HEALTH Form No. 1 APPLICATION FOR SITE TESTING/INSPECTION Site Location Engineer Test/Inspection Date and Time CHWIMAN, BOARD OF HEALTH Fee Test No. S.S. Permit No.-D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts NORT1y BOARD OF HEALTH Form No. 1 T 19 ' APPLICATION FOR SITE TESTING/INSPECTION \RATE DE PPP .'�5 Applicant NAME ADDRESS TELEPHONE Site Location Engineer r NAME ADDRESS TELEPHONE Test/Inspection Date and Time Fee CHAIRMAN, BOARD OF HEALTH Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE This is to certify that the individual subsurface disposal system constructed ( ) or repaired ( x) by North Andover Licensed Installer John Soucy at 99 Gray Street, North Andover, MA 01845 has been installed in accordance with the provisions of Title V of the State Sanitary Code and'with the North Andover Board of Health regulations as described in the Design Approval Site System Permit Number 989 dated 10/31/97. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES WILLIAM J. SCOTT Director Gordon Rogerson Hayes Engineering, Inc. 603 Salem Street Wakefield, MA 01880 RE: 99 Gray Street Dear Mr. Rogerson: 30 School Street North Andover, Massachusetts 01845 November 17, 1997 �NORTM\ 0 oto ".,�< This is to inform you that the proposed plans for the site referenced above have been disapproved for the reasons below. If new plans satisfactorily addressing all these issues are submitted to the Health Department by November 28, 1997, then approval for the plans should be given by December 5, 1997. %1�ofile is not to scale. (N.A. 8.02c) 4%Perc elevations are missing. (N.A. 8.02n) : Trenches are to be used whenever possible; please justify choice of field. (310 CMR 15.240(6)) �., ssessor's map and parcel number missing. (N.A. 8.02a) 5;.'No scale indicated for site plan. (310 CMR 15.220(4). Pipe ends of leach area to be joined. (N.A. 15.01) L7,: -'First 2 feet of pipe from D -box to be laid level. (310 CMR 15.232(c). Please be aware that all revision submittals must be accompanied with a $25.00 fee. If,you have any questions, please do not hesitate to call the Board of Health. Sincerely, Sandra Starr, R.S. Health Administrator Cc: B. Scott, Dir. _CD&S B. Benincasa File CONSERVATION - (978) 688 9530 - HEALTH - (978) 688-9540 - PLANNING - (978) 688-9535 *BUILDING OFFICE -'(978) 688-9545 - *ZONING BOARD OF APPEALS - (978) 688-9511 - *146 MAIN STREET HAYES ENGINEERING, INC. 603 SALEM STREET WAKEFIELD, MA 01880 ,� �•� (617) 246-2800 ,�~I FAX (617) 246-7596 No. ["ORM 11 - SO11, 1:.\':k1,1 :k'1'0R 1,701t�1 Z3 I'agc 1 of 3 Date: JOB FILE _Aad ots Commonwealth of Massachusetts W r 41nG/er__ , Massachusetts Soil Suitability Assessment ffor On-site Sewage Disposal Perfonmed By:'-6aaP!Jo y_ 240 66 0 - Date :.. Witnessed By:Cl Location Adds/ or Owwr-s,Namc. n La I Addrcs:, ud /Jo/'1 �t en n c4 -S New Construction ❑ Repair knuce Review Published Soil Survey Available: No ❑ Yes lAl Year Published ....._ . _ _ I'_. _... Publication Scale.. :i5�_f�__._.:__ _ Soil Map Unit Drainage Class_-...:::------ ., ...._.. Soil Limitations Surficial Geologic Report Available: No ❑ Yes ❑ Coo+sc-laan►�D✓cr,S'and �,r' �gr!��t �K..,Q. -7n `oX ' --A o TYPiG Dist► 6 re Year Published Publication -Scale Geologic Material (Map Unit)------- , Landform.----- -----._.-.__...-�-------._...._.--•------------------.._.._.............._.--....._:.. ___________ _ _ _ Flood Insurance Rate 5 Map:. �S� O � OG/� ,Q �Un e. Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No V Yes ❑ Within 100 year flood boundary No Ai Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ............ ... ... . . __. _ ._.. _ _ _ _. Wetlands Conservancy Program Map (map Current Water Resource Conditions (USGS): Month Range :Above Normal ' ❑ Normal Ehelctv Normal n Other References Reviewed: DEP APPROVED F01R-%1 - 12/07/95 r! location Address or Lot No.� FORM 11 -SOIL E'N'AL[ ATQR Ii'0IZ, I., age 2 OF 3 On-site Review Deep Hole NumberT-/...... Date:_!.' `3 � Time:. �._. Weather../_ __. a Location (identify on We plan) ......... _........... . Land Use ... ` 0. _- 4"T o N .. . _........... •---- Slope (/o).........._. Surface Stones- Vegetation. tones Vegetation..lf'a,".) Landform ........�....... . Position on landscape (sketch on the back) Distances from:, Open Water Body .. !V /E ...feet Drainage way.../..feet Possible Wet Area...��-... feet Property Line. _ ....feet Drinking Water WellfvItt _feet Other . . .............._ DEEP OBSERVATION HOLE LOG' Depth from _ Surface (Inches) Soil Horizon,:. Soil Texture (USDA) Soil Color (Munsell) -.--..Soil .. Mottling Other (Structure, Stones, Boulders, Consistency. % Gravel) 41r, i3 � C,i � j 2• s �.sy� 18 ►G5� - MtNIMUaa Ur z HULES REUUIREU�VERY PROPOSED DISPOSALAREA Parent Material (geologic) DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: N'1�.1Cr Estirriated Seasonal High Ground Water: 52" iiDEP APPROVED FORM - 12/07:9: • "+1 "0 CNli1NhLH1NU, INU. 603 8ALEM 81REfET JOB FILEf'� 61AKE4�� 01 88o 4 � FORM 11 - SOIL EVALUATOR 00 nIUFi 00� I FAX(617)246-7596 rage 3 of 3 ^� DEP MPROVED Font. 12/07/95 Location Address or Lot No. (/;fI � , �D • %�/ICYo✓ Determination for Seasonal .high Water Table Observation Hole Number: T Method Used: —1 ❑ Depth observed standing in observation hole...._... inches ❑ Depth weeping from side of observation hole ...... inches ❑ Depth to soil mottles .5-� inches ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ............ R Adjustment factor ................... Adjusted ground water level .............. ... ......... ............ .... ..... Depth' of Naturally Occurring Pervious Material r Does at least four feet of naturally occurring pervious material exist in afl areas observed throughout the area proposed for the soil absorption system? -e. If not, what is the depth of naturally occurring pervious material? Certification I certify that on Nov. 1994 (date) I havepassed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature 11i Date -23 Y7 DESCRIPTION OF HORIZONS TExrwlle --wo p+ewl —D wry carr• alnd •aorw erns —rasa --,va• ens fimIM7d --,. wry IJne sora --rfe Jawq'comw sand --ills J"W 8#nd —J8 l~fine •end --Jfs sandy lose ---#J AIMfmw Iowa --f9J wry ffoo sandy lam —rfal CawiSTENCE: Art 80!11 A&M919t1 --wo allentiy *tic" -ase stldty -re wry MAO -,wrs wwpl"ur @Maly e1106tly plastic - iw• plastic --�w wry plastic --*VP P—Hy s"y Jaw. _VSJ ST19UMNE.• --0l Very friable --0rfr frisals lows —J @Maly reit fffr Blrr. extreMJy fin. -'1e/1 Far or row pvV#l!y lows --1J •ttwctmWess —o tory fin# —rf piety -pJ stojam ny -- M&tJ ek -I fine -f ANOMtic -w slit —+f AVOWYls -,? Mslae -,a ooluner --Cpr silt low. —all st—W -.t co"s -,c Ducky --At cloy lows ---CJ very cows# -re Awier aloes l --ok elity cloy lows --Wei subwWior bloat'y --W ewgsy cloy love --,rcl VVMJ- --A" stony cloy Jam —ore! 811wif pvin -ap slity cloy ---sic Msiiri -e oley---C fMet sof J.' MOTTLING.• Joass --0l Very friable --0rfr frisals -aft fire -,efi reit fffr -,arfl extreMJy fin. -'1e/1 MOTTLING.• ADursrnt .' 6fr*• Qmtraat. arr soft' fell -f &-Jw fins -J faint -f 1000# --di eaawn -C A -MV Mdfav -? dletfact --d soft --dr Mny -A AV-foav PfWment --0 alontiy naw —wn naw -,al► wry oars -,dvn #XtrweNy nw•W —ssA \1 HAYES ENGINEERING, INC. 603 Salem Street Wakefield, MA 01880 (617) 246-2800 Fax (617) 246-7596 Location Address or Lot No. / FORM 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS ,!40B RILE ' 4 (U 00-S/V /11�0Ve�, Massachusetts i Percolation Test* Date:._.._..... ............. Time:......................_....... Observation Hole # �I Depth of Perc/�i0 �► D Start Pre-soak End Pre-soak Time'at 12" 11:13 Time at 9" //; 3 a Time at 6" Time (9"-6") Rate Min./Inch Q rn * Minimum of 1 percolation test must be performed in both the primary area AND reserves area. Site Passed IJ Site Failed ❑ Performed By: Witnessed By: Comments: DEP APPROVED FORM - 12/07/95 5 "AYES ENGINEERING, INC. 603 SALEM STREET WAKEFIELD, MA 01880 (617) 246-2800 , FAX (617) 246,-7596 No. v FORM I1 - SO11, 1"-A1.1':1•1'UR FOlt�l I'agc 1 of 3 Date: JOB FILE `t`o{4 606 Commonwealth of Massachusetts o. , Massachusetts Soil Suitability Assessment -for On-site Sewage Disposal Performed By: '>_._..... . .- �.......------------------. Date:..V•�t`�3� Witnessed By: .c.S a -.?1............. .............. - --- _ _ - - t.=6611 Aftat of Owrcr s Namc. Address. and ew Construction ❑ Repair ❑ a )��dow,41, Office Review Published Soil Survey Available: No ❑ Yes Year Published ..._._._�1_.. Publ�catton Scale...._.Soil Map U it ..�_.._�... Soil Limitations Sucial Geologic Report Available: No El Yes ❑ Case%Q,„j. orws�nol ora ... Year Published - Publication- Scale /x'`'�•accr7"�Icymci Geologic Material (Map Unit) ................_....._...._._.._._..._.__.:____._._._ Flood InsuranceRate Map:. ... 4 ... -Q �v _..-� / �&3 Above 500 year flood boundary No ❑ Yes 14, Within 500 year flood boundary No Yes ❑ Within 100 year flood boundary No 4 Yes ❑ Wetland Area: , National Wetland Inventory Map (map unit) ................... _ ...__ Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month Range :Above Normal ❑ Normal ❑ Belc , Normal El Other References Reviewed: DEP APPRO\'FU FOP -\i - 12/07/95 FORM 11 - SOIL I-,N'.ALQATQR F0It11 1)age 2 Of 3 Location Address or Lot No. tI -r On-site Review Deep Hole Number.... Date:l—��--�7 Time:../G.. ria.-. Weather.1411 t C�G.�L- Location (ident-fy on ite plan) Land Use ...�.Q...... _._...... _ ---- ----- Slope (/o)..-- ----� Surface Stones.......... ..............._ ...._ ._.. Vegetation._... . -GL.. _.... . Position on landscape (sketch on the back) Distances from: Open Water Body ... ....feet Drainage way ..... feet Possible Wet Area..1(!_ .. feet Property Line. _ _....feet Drinking Water Well. klkkf .feet Other . _ _ _...--......_ DEEP OBSERVATION HOLE LOG' Depth from , Surface (Inches) Soil Horizon ;.. Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, % Gravel) 5y y rh'I '3yt-� G 2.� 1 13 -••••-•-- —'I.. , cvvu, r� cvcn� rnvr�xu uiJrVJNLArttA Parent Material (geologic) DepthtoBedrock: Depth to Groundwater: Standing Water in the Hole: uj&tU Weeping from Pit face: Estimated Seasonal High Ground Water: kiDEP APPRONTr) PofLM . 121/07:9c »I ` "h ENGINEERING, INC. 603SALEM 81REa JOB FILE w17j AICEFIEw, MA olsa0 FORM 11 - SOIL EVALUATO1t FOp (6 2462800 n►� FAX (617) 246.7596 Pagc 3 Of 3 DEP APPROVEp FORM . 12Jt17/95 Location Address or Lot No. Y , Determination ,for Seasonal High Yater Table Observation Hole Number: Method Used: ❑ Depth observed standing in observation hole ......... inches ❑ Depth weeping from side of observation hole ........ inches ❑ Depth to soil mottles .S inches ❑ 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 a)1 areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on Noy. 1994 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Dateii, DESCRIPTION OF HORIZONS Mxru9E.• rwal —o pvrojif •caner looA ---oeJ STRUCTURE.' wry carr• Cele —rem Jowl —J AYvaV SJu• Farr or TJpi• CV~ •ov►o --,cos P WJlr Jam —o! stewtmWess -o fry film -rf Platy -�oJ NAIW --• stony lom ---stJ We* -I fine -f cooluww fine S&V —fi silt ---.J AVdWVto -,e .maJUN -. wry flm eaW —r/e •JJt loam --ell StrAWV -a care. --c Alockr -d* Jour caerie sane —Jcae cloy J0" ___CJ rerr cowrie -VC wwlr OJockl -MDk JoAey •one —Js •Jit clo love ---sic! auD tlocky --yak Jowr fine mane —ifs money clef Jove ---#Ci p4ml �wlr � *OWy Jove —eJ stony Clay Jam ---•tel Arnoer prim -+0 fim owner loam —fel AJJty cloy —alc mrmemri -A wry fine ewoey Jmw —vfoJ cloy ---C MOTTLING.• CGWSISMAICE.' AaaWincw• SJri• Abntr&At: Awt "Ji., Mist soli: Lhy Coil: fill -f X-Im rine -J faint --f nerwuc*r -reo Jooie ,AI Jaa•m -d! commn -c f? -MV WOW ? elstinct -� •Jlphur •tfa*r -roe very f^Wle --wfr soft --ah many -a AV.fmv carll - J Prw•Jnen[ -�v •tlnt'r --re frJAAJm --Afr ompOtir neve -a" wry seta*r --w• fly,. -,•fJ it" -a, Aaplaeuc --N» rerr firr rery erre --ern slipnur pieetic --we •xtre..Jr fin. --Amro ffXtMWJr twre -den pl••tle --w wry olsetic --mvp I EtuS7��cl� I;e,0N4 X45 SINr /�C�rs �ia�cn 6yd; BAC8+46AI�a L� DATE: Y — 3 LOCATION: ENGINEER: BOH WITNE PERCOLATION TEST # BOTTOM DEPTH OF PERC TEST: 4 7 TIME OF SOAK: (At least 15 minutes long) TIME AT 12" % f TIME AT 9" TIME AT 6" I OVERNIGHT SOAK TIME STARTED NEXT DAY SOAK: (At least 15 minutes) TIME AT 12" TIME AT 9" TIME AT 6" FV �Ir/ f/s- F2 f y 41A M W 2 C O Z 2 Q E w O O LL J WZr Vf e•-- ~ Q 2 Q F- 0 J Q N W � 2 LL O Z — -a o o U g m o LU ro Z a s Z O L _ c d L W F- O41) Q 'o N Z ago U- c O u a� o Q O � O c o z m 3 U c O J O 3 C p 'A ro N ro b° E W 4� L N N (ham 0.40 *** O {A O kn m o o<< i ,ir' S U J p to E 00 ro a a, 3 a� V" �MOt *yrt � Q to C. V1 November 9, 1998 North Andover Board of Health North Andover, Ma Dear Sandy, Per our conversation last week, John Soucy has indicated that at the time he pulled the permit to work on my leaching field that you changed the requirements of my driveway drain that was routed around the leaching field on my approved plans. When I spoke to you, you indicated that you had not spoken to John Soucy and had not changed my plans. Ii spoke to Susan Ford today and she indicated that John Soucy said I agreed to change the routing of the drainage pipe. That is Not true. John is telling me that you are requiring me to make a change and telling you that I have agreed to make this change. Neither statement is true. I, have an approved plan. John has a contract to install my leaching field and drainage pipe according to that plan. I want the installation to agree with the approved plan. I have a legal right to have the installation satisfy the plan. I do not want road salt and chemicals dumping in the middle of my yard by the border. I do not want the pipe extended 20 feet requiring a pipe running through my garden and therefore preventing the garden from being plowed. An extension would also risk breaking roots of my Canadian hemlock row and dump water close to my neighbor's, property.. There was a reason the drain was designed to be where it is on the plans This process is very frustrating, I have been waiting 2 months for John Soucy to finish my job. He started in August. If you have any questions, give me a call (617 350-1205). Thank you for any help you can give to resolve this conflict. Sincerely, Bonnie Be 'incasa 99 Gray Street cc: John Soucy Town of North Andover, Massachusetts Form No. 2 oft,AooT:�h BOARD OF HEALTHnarome Q.y o p DESIGN APPROVAL FOR HUS SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant ��N��& v, 0&,U1,0GA5,4 Test No. Site Location q q 6 R P y 5T Reference Plans and Specs ENGINEER DESI Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. AIR ,BOARD HEALTW Fee 166' - Site System Permit No. M APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DAT'E:, 1,1d CURRENT INSTALLER'S LICENSE# LOCATION: qQ G e -W- Y Z) %, LICENSED INSTA ER: o kn u c SIGNATURE: p TELEPH E# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As -Built? Yes No I Floor Plans? Yes No Approval Date: ZX/4 / I Town of North Andover t NORTIy , OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 30 School Street North Andover, Massachusetts 01845 `°•�.,°µ••"'` c` WILLIAM J.1 SCOTT So - Director January 5, 1998 Gordan Rogerson Hayes Engineering 803 Salem St. Wakefield, MA 01880 Re: 99 Gray Street Dear Mr. Rogerson: This is to inform you that the proposed plans for the site referenced above have been approved. I If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S. Health Administrator S S/cjp cc: Bonnie J. Benincasa William Scott, Director, MCD File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 SEPTIC PLAN SUBMITTALS LOCATION: _(�r� I" ,dR_of" Y'J°) 0,400 NEW PLANS: YES REVISED PLANS: DATE: Z--� DESIGN ENGINEER: When the submission is all in place, route to the Health Secretary $60.00/Plan $25.00/Plan i WILLIAM J. SCOTT Director Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 30 School Street North Andover, Massachusetts 01845 to , November 17, 1997 Gordon Rogerson Hayes Engineering, Inc. 603 Salem Street Wakefield, MA 01880 RE: 99 Gray Street Dear Mr. Rogerson: This is to inform you that the proposed plans for the site referenced above have been disapproved for the reasons below. If new plans satisfactorily addressing all these issues are submitted to the Health Department by November 28, 1997, then approval for the plans should be given by December 5, 1997. 1. Profile is not to scale. (N.A. 8.02c) 2. Perc elevations are missing. (N.A. 8.02n) 3. Trenches are to be used whenever possible; please justify choice of field. (310 CMR 15.240(6)) 4. Assessor's map and parcel number missing. (N.A. 8.02a) 5. No scale indicated for site plan. (310 CMR 15.220(4). 6. Pipe ends of leach area to be joined. (N.A. 15.01) 7. First 2 feet of pipe from D -box to be laid level. (310 CMR 15.232(c). Please be aware that all revision submittals must be accompanied with a $25.00 fee. If you have any questions, please do not hesitate to call the Board of Health Sincerely, Sandra Starr, R.S. Health Administrator Cc: B. Scott, Dir. CD&S B. Benincasa File CONSERVATION - (978) 688 9530 • HEALTH - (978) 688-9540 • PLANNING - (978) 688-9535 *BUILDING OFFICE - (978) 688-9545 • *ZONING BOARD OF APPEALS - (978) 688-9541 *146 MAIN STREET No. COMMONWEALTH OF MASSACHUSETTS Board of Health, ko, gt1jov er—, MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair 0 Upgrade ( ) Abandon ( ) - ❑ Complete System ❑Indvidual Components Location &/e/fi ST Owner's Name 1904J'/C CI Ala A Map/Parcel# Address G2 :5'7-- A/QP/j Q✓� Lot# �T Telephone# �— � ?3 —15-11? Installer's Name Designer's Name Q eSFngmegrme Address Address &afev 02 Telephone# Telephone# lrl8'/—�Zdl� The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees tace the system in operation until a Certificate of Compliance has been issued by the Board of Health. no o l Signed Date DEP APPROVED FORM 5/96 No. COMMONWEALTH OF MASSACHUSETTS Board of Health, , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded ( ), Abandoned ( ) by: Fee has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated . Approved Design Flow _ (gpd) Installer_ Designer: Inspector The issuance of this permit shall not be construed as a guarantee that the system will function as designed. DEP APPROVED FORM 5/96 No. COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Fee Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. , dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. DEP APPROVED FROM 5/96 Date Board of Health Lot Size 4.�t.Jt(.r� Type of Building: sq.ft. A / Dwelling - No. of Bedro ms t'1 Garbage grinder( ) Other - Type of Building No. of persons Showers( ). Cafeteria( ) Other Fixtures ��[[ Design Flow(min. required) //O gpd, Calculated design flow, Design flow provided Mgpd Plan: D teLW 1, V% Number o sheets Revision D e Tide/ Description of Soil(s) _ Soil Evaluator Form No.��_ ame of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees tace the system in operation until a Certificate of Compliance has been issued by the Board of Health. no o l Signed Date DEP APPROVED FORM 5/96 No. COMMONWEALTH OF MASSACHUSETTS Board of Health, , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded ( ), Abandoned ( ) by: Fee has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated . Approved Design Flow _ (gpd) Installer_ Designer: Inspector The issuance of this permit shall not be construed as a guarantee that the system will function as designed. DEP APPROVED FORM 5/96 No. COMMONWEALTH OF MASSACHUSETTS Board of Health, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Fee Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. , dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. DEP APPROVED FROM 5/96 Date Board of Health PLAN REVIEW CHECKLIST ADDRESS 79 6,00 ENGINEER I GENERAL 3 COPIES STAMP LOCUS t/ NORTH ARROW SCAL CONTOURS �'� PROFILE ( Sc SECTION BEHMARK SOIL & PERCS ✓ ELEVATIONS WETS. DISCLAIMEFe WELLS & WETS WATERSHED?f-O-- DRIVEWAY G"" WATER LINEy FDN DRAIN - M&PA�- SCH40 L,'-' TESTS CURRENT?y SOIL EVAL (-� . 126)GCIL5OO SEPTIC TANK 20' TOI'FND & INTRCPTR DRAINS '-`� 400' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY BREAKOUT MET? TRENCHES No MIN 12" COVER FILL? (15') MIN 440 gpd SLOPE (min .005 or 6"/100') SIDEWALL DIST. 3X EFF. W OR DI(MIN 6') RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? VENT? (>3' COVER; LINES >50') BOT + SIDE - X LDNG = TOT (L x!W x #) (DxLx2x#) (G/ft2) Copyright 0 1996 by S.L. Starr MIN 150OG .17 INVERT DROP GARB. GRINDER_&(2 comps +200) 10' TO FDN MANHOLE ELEV GW # COMPS. GB D -BOX SIZE # LINES 3 FIRST 2' LEVEL STATEMENT INLETA67, OUTLET 90 % 3 = % (2" OR .17 FT) TEE REQ' D? LgACHING MIN 440 GPD')y RESERVE AREA 4' FROM PRIMARY? � 20 SLOPE 100' TO WETLANDS 100' TO WELLS ✓ 4' TO S.H.GW i-/-(5'>2M/IN) 20' TOI'FND & INTRCPTR DRAINS '-`� 400' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY BREAKOUT MET? TRENCHES No MIN 12" COVER FILL? (15') MIN 440 gpd SLOPE (min .005 or 6"/100') SIDEWALL DIST. 3X EFF. W OR DI(MIN 6') RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? VENT? (>3' COVER; LINES >50') BOT + SIDE - X LDNG = TOT (L x!W x #) (DxLx2x#) (G/ft2) Copyright 0 1996 by S.L. Starr PITS MIN 440 LEACHING GW MIN 4' BELOW BOTTOM BOT MIN 1 (13'x16') PIT EXC 2x EFF W OR D MANHOLE/PIT 12"-48" STONE + SIDE x LOAD = TOTAL. (2x(L+W)xD x #) (G/ft2) e CHAMBERS' MIN 440 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT' MANHOLES. 12"-48" STONE SPLASH. PADS SLOPE _0;05 BED TRENCH / (Bed max. 60' X 601) MIN 131 X 16.' PIT BOT + ' SIDE' X -LOAD = TOTAL ( L x W X. # )' (:2 x (L+W) xD. x: #) (G/ f t2 ). FIELDS:. MIN 440 GPD '9.0,0 ft2 BED '` . `GW MIN. 4' BELOW: BOTTOM OF FIELD PIPE ENDS' JOINED?Z­ " PEA STONE?. D l` DIST LINE SLOPE'' _ GGS?' } >3.'"COVER-!VENT:^�'' SCH 40MIN 12" COVER : RATE (. c5 d ` X .� aX .�� = TOTAL��� I; :. W i f DOSING TANKS.AND'P S DIMENSIONS X. X 'gpm., = PUMP CAPACITY L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE' TIME Spm MANHOLES TO GRADE ALARM SEP.. CIRC. GW L''' below inlet),: HWL. LWL CHECK.:VALVE BLEEDER HOLE MANUAL OP. SWITCH ENUF STORAGE? Copyright 0 1996 by S.L. Starr,