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Home My WebLink AboutSoil Testing Permit and Results - Soil Testing Results - 106 ROCKY BROOK ROAD 7/6/2020 7/2/2019 Date: July 02, 2019 Soil Testing Permit #49295 This is an e-permit.To learn more,scan this barcode or visit northandoverma.viewpointcloud.com/#/records/52040 '` `' •. COMMONWEALTH OF MASSACHUSETTS 0� 0 • TOWN OF NORTH ANDOVER BOARD OF HEALTH I Kathy Molina 106 ROCKY BROOK ROAD is hereby granted a Soil Testing Permit This permit is granted in conformity with the statutes and ordinances relating thereto. Soil Evaluator Contact Number: 9-9955 � 240 Owner Contact Number#:978-235-1835-1852 Engineer Contact Number:978-777-8586 FRANCIS P. MACMILLAN,JR., M.D. Conditions: BOARD OF HEALTH CHAIRMAN 1/2 7/2/2019 " COMMONWEALTH OF MASSACHUSETTS � � ❑� • TOWN OF NORTH ANDOVER BOARD OF HEALTH Date: July 02, 2019 Soil Test Application Summary #49295 This is an e-permit.To learn more,scan this barcode or visit northandoverma.viewpointcloud.com/#/records/52040 Applicant: Kathy Molina Engineer: John Morin Owner (if different): Aleksandr Shneyderman Engineer Contact Number: 978-777-8586 Owner Contact Number: 978-235-1852 Address: Certified Soil Evaluator: Alex Parker 106 ROCKY BROOK ROAD Soil Evaluator Contact Number: 978-479-9955 NORTH ANDOVER, MA 01845 Location of Soil Test: Intended Use of Land: Back yard, back left hand side (see soil testing sketch) Single Family Home Type of testing: In the Lake Cochichewick watershed? Repair Testing No Conditions (if applicable): 1/1 TOWN OF NORTH ANDOVER Community & Economic Development G HEALTH DEPARTMENT 120 Main Street NORTH ANDOVER,MASSACHUSETTS 01845 978.688.9540—Phone 978.688.8476—FAX healthdept(@northandoverma.eov \R ' www.northandoverma.gov APPLICATION FOR SOIL TESTS DATE: June 24,2019 MAP&PARCEL: Mao 90A, Parcel 54 LOCATION OF SOIL TESTS: 106 Rocky Brook Road OWNER:Aleksandr&Irina Shneyderman Contact#: 978-235-1852 APPLICANT:Aleksandr&Irina Shneyderman Contact#: 978-235-1852 ADDRESS: 106 Rocky Brook Road North Andover MA 01845 ENGINEER:John M.Morin PE,The Morin-Cameron Group,Inc. Contact#: 978-777-8586 CERTIFIED SOIL EVALUATOR: Alex Parker Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: X Undeveloped Lot Testing: Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership(Tax bill,or letter from owner permitting test) ➢ 8 5"Y 11"Plot plan&Location of Testing(please indicate test pit sites on thelL1an) ➢ Fee of$585.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of S440.00 per lot for rgoairs 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: ® � Signature of Conservation Agent: Ile,`/ S"'e-4 Date back to Health Department: (stamp in): 4`/),4 /.� Authorization Form Re: 106 Rocky Brook Road North Andover I, Aleksandr Shneyderman, authorize The Morin-Cameron Group, Inc. to sign any and all applications to the Town of North Andover on my behalf regarding the above- referenced property. Aleksandr Shneyderman Date 7/2/2015 Payment Receipt � yt�^CLED � Town of North Andover, MA $440 .00 Paid via Check #596 Note: 106 Rocky Brook Road Thanks for using the Online Service Center Shneyderman Soil Testing Permit#49295 July 2, 2019 Repairs or Maintenance Fee $440.00 Total Paid $440.00 Powered by the ViewPoint Cloud platform Receipt number#15643 1/1 Of NOMT:'1�, 8668 � dr ` ` ',�•oL a o d Town of North Andover -•,,,,•..:• HEALTH DEPARTMENT CHECK#: 0- DATE: 7 LOCATION: H/O NAME: J GAL�r'i'►')a_/� CONTRACTOR NAME: ;TnAn 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 $ 1 SEPTIC Systems: xSeptic-Soil Testing $_y5ro - ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ 1 HeaTfAgent Initials White-Applicant Yellow-Health Pink-Treasurer Commonwealth of Massachusetts City/Town of North Andover =° Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information p rit.Cel Aleksandr Shneyderman Owner Name 106 Rocky Brook Road 90A LOT 54 IaQSEP OVER Street Address Map/Lot# �F MEN j� North Andover MA 01845 NF,0jj?PR� City State Zip Code B. Site Information 1. (Check one) ❑ New Construction ❑ Upgrade ® Repair 2. Soil Survey Available? ® Yes ❑ No If yes: NRCS 711C Source Soil Map Unit 711 C - Charlton-Hollis rock outcrop complex Depth to Restrictive Features Soil Name Soil Limitations Coarse-loamy lodgement till Rolling ground morraine Soil Parent material Landform 3. Surficial Geological Report Available? ® Yes❑ No If yes: 2006, Stone Qgm Year Published/Source Map Unit Ground moraine _ Description of Geologic Map Unit: 4. Flood Rate Insurance Map Within a regulatory floodway? ❑ Yes ® No 5. Within a velocity zone? ❑ Yes ® No 6. Within a Mapped Wetland Area? ❑ Yes ® No If yes, MassGIS Wetland Data Layer: Wetland Type 7. Current Water Resource Conditions (USGS): 7/12/19 Range: ❑ Above Normal ® Normal ❑ Below Normal Month/Day/Year 8. Other references reviewed: 3884 Form 11.doc•rev.3/15/18 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 5 � Commonwealth of Massachusetts City/Town of North Andover y Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: TP 19-1 7/12/19 9:15 75-800F, overcast, Hole# Date Time rain Latitude Longitude: Single-family dwelling Lawn 0-3 1. Land Use (e.g.,woodland,agricultural field,vacant lot,etc.) Vegetation Surface Stones(e.g.,cobbles,stones, boulders,etc.) Slope(%) Description of Location: 2. Soil Parent Material: Coarse-loamy lodgement till Rolling ground moraine BS/SS Landform Position on Landscape(SU,SH,BS,FS,TS) 3. Distances from: Open Water Body >200 feet Drainage Way >50 feet Wetlands >100 feet Property Line >10 feet Drinking Water Well >100 feet Other feet 4. Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ® Fill Material ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed:❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Soil Log Redoximorphic Features Coarse Fragments Soil Soil Horizon Soil Texture Soil Matrix:Color- %b Volume Depth(in) /Layer (USDA Moist(Munsell) Cobbles& Soil Structure Consistence Other Depth Color Percent Gravel Stones (Moist) 0-6 Ap SL 10YR3/2 GRAN V. FRI 6-46 C^ SL 10YR5/3 15 40 BLKY FIRM FILL 46-96 2Cd SL 10YR5/6 55 7.5YR5/8 15 40 BLKY FIRM STONY 10Y7/1 Additional Notes: REFUSAL AT 96" 3884 Form 11.doc•rev.3/15/18 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 5 _ Commonwealth of Massachusetts City/Town of North Andover W=' Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: 19-2 7/12/19 10:02 75-80°F, overcast, Hole# Date Time rain Latitude Longitude: Single-family dwelling Lawn 0-3 1. Land Use: g ) g ( g ) p (o ) (e.g.,woodland, agricultural field,vacant lot,etc. Vegetation Surface Stones e. cobbles,stones, boulders,etc. Sloe /o Description of Location: 2. Soil Parent Material: Coarse-loamy lodgement till Rolling ground moraine BS/SS Landform Position on Landscape(SU,SH,BS, FS,TS) 3. Distances from: Open Water Body >200 feet Drainage Way >50 feet Wetlands >100 feet Property Line >10 feet Drinking Water Well >100 feet Other feet 4. Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ® Fill Material ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed:❑ Yes ❑ No If yes: Depth Weeping from Pit Depth Standing Water in Hole Soil Log Redoximorphic Features Coarse Fragments Soil Depth(in) Soil Horizon Soil Texture Soil Matrix: %by Volume Soil Structure Consistence Other /Layer (USDA) Color-Moist Cobbles& (Munsell) Depth Color Percent Gravel Stones (Moist) 0-6 Ap SL 10YR3/2 GRAN V. FRI 6-33 C^ SL 10YR5/3 15 40 BLKY FIRM FILL 33-91 2Cd SL 10YR5/6 55 7.5YR5/8 >15 15 40 BLKY FIRM STONY 10Y7/1 Additional Notes: REFUSAL @ 91" 3884 Form 11.doc•rev.3/15/18 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 5 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Obs. Hole#19-1 Obs. Hole#19-2 ❑ Depth observed standing water in observation hole inches inches ❑ Depth weeping from side of observation hole inches inches ® Depth to soil redoximorphic features (mottles) 55 inches 55 inches ❑ Depth to adjusted seasonal high groundwater(Sh) inches inches (USGS methodology) Index Well Number Reading Date Sh = Sc—[Sr X(OWc—OWmax)/OWrl Obs. HoleMell# Sc Sr OWc OWmax OWr Sh 2. Estimated Depth to High Groundwater: 55 inches E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ® Yes ❑ No b. If yes, at what depth was it observed (exclude A and O Upper boundary: 46,33 Lower boundary: 96,91 Horizons)? inches inches c. If no, at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches 3884 Form 11.doc•rev.3/15/18 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 5 _ 1Commonwealth of Massachusetts City/Town of North Andover i' Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. 1 further certify that the results of y-so luation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. 7-/(-p• 17 Signature of Soil uator Date ALEXANDER F. PARKER Co-30.2022 Typed or Printed Name of Soil Evaluator/License# Expiration Date of License MS. ERIN KIRCHNER BOH WITNESS Name of Approving Authority Witness Approving Authority Note: In accordance Wth 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing, and to the designer and the property owner with Percolation Test Form 12. Field Diagrams: Use this area for field diagrams: Field locations shown on septic design plan. 3884 Form 11.doc•rev.3/16118 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 5 Commonwealth of Massachusetts City/Town of North Andover Percolation Test ' Form 12 M 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. Aleksandr Shneyderman key to move your Owner Name cursor-do not 106 Rocky Brook Road use the return Street Address or Lot# key. North Andover MA 0 City/Town State Zipp Code Contact Person(if different from Owner) Telephone Number ' B. Test Results 7/12/19 11:50 Date Time Date Time Observation Hole# TP 19-2 Depth of Perc 54" Start Pre-Soak 11:50 End Pre-Soak 12:05 Time at 12" 12:05 Time at 9" 13:06 Time at 6" 14:21 Time (9"-6") 75 min Rate (Min./Inch) 25 MPI Test Passed: ® Test Passed: ❑ Test Failed: ❑ Test Failed: ❑ Alexander F. Parker Test Performed By: Ms. Erin Kirchner, C.H.O. Board of Health Witness Comments: t5form12.doc•08/15 Perc Test•Page 1 of 1