HomeMy WebLinkAboutMiscellaneous - 64 FOREST STREET 11/18/2015 (3) F
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North Andover Health Department
Community Development Division
June 30, 2015
Dogan Gunes
64 Forest Street
North Andover, MA 01845
Re: Subsurface Sewage Disposal System Plan for 64 Forest Street (Map 106A,Lot 61
Dear Mr. Gunes:
The proposed wastewater system design plan for the above site dated June 5, 2015 with a final
revision date of Jun 25, 2015 and received on June 26, 2015 has been approved.
The design plan has been approved for use in the construction of a new on-site septic system for
a 4-bedroom (max 9-room)home utilizing a Quick 4 High Capacity Infiltrator Chamber system.
This design plan approval is valid until June 25, 2017.
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)).
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
June 30, 2015
,64 Forest Street
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.
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,
ULU-
Michele Grant
Health Inspector
Encl. Installers list
cc: Vladimir Nemchenok
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01.845 Phone: 978.688.9540 Fax: 978.688.8476
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North Andover Health Department
Community and Economic Development Division
June 22,2015
Vladimir Nemchenok
Merrimack Engineering Services
66 Park Street
Andover,MA 0 18 10
Re: Subsurface Sewage Disposal System Plan for 64 Forest Street(Map 106A,Lot 6)
Dear Mr.Nemchenok:
The proposed wastewater system design plan for the above site dated June 5,2015 and received on June 11,2015
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. The loading rate used is incorrect based on the soil texture of the Bw2 layer(3 10 CMR 15.242). The
percolation test was conducted in the Bw2 layer.
2. Since the Infiltrator Chambers 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 systein that could be installed in the event that the proposed Alternative Soil
Absorption System fails or it is determined that it is not capable ofproviding equivalent
environmental protection;
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,
Michele Grant
Health Inspector
cc: Dogan Gunes
File
Page 1 of 1
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.1x88.9540 Fax: 978.688.847
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TOWN OF NORTH ANDOVER
()ffice()l"(,'OMMIJNI'I'V DEVELOPMENT l��fi.�01� 1+.,��9"f,g N SERVICES
1600 O SG' ( D( t.t .t iT; .SUITE,2035
VOR I fND , YpS S %$L1 WA"f S 01845
Stisan Y. Sawyer, EHS/IRS 978,688.8476 FAX
Public Health Director 17-MAIL heat;lth, t(�r11c�
&I Ifwww. o no Rn<t°idc>vc
SEPTIC PLAN SUBMITTAL FORM RECEIVED
Date of Submission: J[J N ) 1 "01
Site Location: � "� " :L ��I�"' � I�.A ENT
Engineer: "G' ry 'r
New Plans? Yes V-,"$"
$225/Plan Check#(includes I"submission and one re-
review only)
Revised Plans?Yes $75/Plan Check#
Site Evaluation Forms Included? Yes Na
Local Upgrade Form Included? Yes No
Telephone#: Fax#: j �
E-mail: V O U L,gk 64,,
Homeowner
Name:
OFFICE USE ONLY
When the subrnission is complete(including check):
a Date stamp plans and letter
t✓ Complete and attach Receipt
L/ Copy File;Forward to Consultant
--( --Enter on Log Sheet and Database
Infiltrator Chamber I/A technology Cert*#fj,9LpD
U
ANDOVER
H ',kPINIENT
DILL,
I hereby certify that I have been given a copy of the Title 5 I/A technology
approval letter, and the Owner's Manual for the above technology and I
agree to comply with all terms and conditions.
I further certify that I am aware that this design does not allow use of a
garbage grinder in the dwelling and that I understand my requirement to
repair, replace or modify or take any other action 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.
signattj* (7 date:
FINN 0 CC/
certified by: (please print)
MERRIMACK ENGINEERING SERVICES,INC.
66 PARK STREET•ANDOVER,MASSACHUSETTS 01810
Commonwealth of Massachusetts
City/Town
' OOfNohh Andover
Dorm 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 mus t be substantially the same as that provided here. Before using this form, check with your
|ooe| Board of Health ho 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 CIVIR
15.404(l), is not feasible.
System upgrades that cannot be performed in accordance with 310 CIVIR 15.404 and 15.405, or in full
compliance with the requirements of 310 CIVIR 15.000, require a variance pursuant to 310 CMR 15.410 �
through 15.415.
NOTE: Loca| upDnadeopprovm\ ehoUnotboOnsntedfuranupgradapnJpVsa|thmtinc)udosthemddiUonnf
----- 0owtom cesspool or privy, or the addition ofo new design Dowabove the exiaUngapproved
u '/=,,idesign nonsitgayohenncmnskuotedin accordance vvitheither the 1Q78<�odeor31O{|W1R15.00D,
RECEIVED
A. Facility information AJN 11 2,015)
oapaog/ora -
odant'
�||i � 1 F��iUtyNonoe�ndAddreeu� NOFNORTHANDDVER
�n ngou � Tow
monthe ]0 RT�ENT
muhar.uso 04�Gunes Residence
'the tab key Name
ipveynur 64 Forest Street
mr-dunot Street
Uhommm --A- U1�46
N�
� '^~^'' State �pCode
CK �
yu*n
/±--U 2. Owner Name and Address (if different from above):
SAME
Name Street Address
8� a
CU�TuwState
7 889O2
Zip Code Telephone Number
3. Type of Facility(check all that gpp\y):
M Residential |nebtutk}no| Cornrnenja) F1 School
4. Describe Facility:
4BDRKUHouse
5. Type cf Existing System:
Fl Privy Fl Cesspool(s) Conventional Other(describe be|ow):
G. Type of soil absorption system (trenches, chambers, leach field, pits, etc):
Unknown
5honmga.dnx^rev.7/08 Application for Local Upgrade Approval, Page 1of4
C
oar nw
moealth of Massachusetts
City/Town of North Andover
Form 9A - Application for Local Upgrade Approval
W 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:
Unknown
Design flow of existing system: gpd
440
Design flow of proposed upgraded system gpd
440
Design flow of facility: gpd
B. Proposed Upgrade of System
1. Proposed upgrade is (check one):
Z 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:
Complete System, see plans
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
Percolation rate min./inch
Depth to groundwater
t5form9a.doc^rev.7/06 Application for Local upgrade Approvale Page 2 of 4
'
Commonwealth of Massachusetts
C ^ Df North Andover
rov ~A
Form 9A - Application for Local Upgrade App
DEp has provided this form for use by local Boards of Health. Other forms may be ueed, butthe
information must be substantially the same as that provided hens. Before using this form, check with your
|ncm\ Board of Health to determine the form they use.
B. Proposed Upgrade of System (continued)
n 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
Fl
Use ufo sieve analysis esm substitute for aperctest
�l
Other requirements of 310 CIVIR 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 ovotamand the high groundwater elevation, an /\pprVved Soil Evaluator must determine the
high `ound^aharelevation pursuant ho31UCK8R15.4OS(1)(h)(1). The soil evaluator must be a
member or agent wf the local approving authority.
High groundwater evaluation determined by:
Evaluator's Name(type orprint) Signature °=""."=""""'.
C. Explanation
Explain why full compliance, as defined in 310 CIVIR 15.404(l), is not feasible. (Each section must be
completed)
1. An upgraded system in full compliance with 310 CK0R 15.000 is not feasible:
NA
2. An alternative system approved pursuant to 310 CN4R 15.283 to 15.288 is not feasible:
NA
t5fnmo9odoo^rev.7/0O Application for Local Upgrade Approval* Page 3of4
Commonwealth of Massachusetts
City/Town of North Andover
Form 9A - Application for o=~u 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.
C. Explanation (continued)
3. Aehanad system is not feasible:
NA �
4. Connection to m public sewer is not feasible:
None Available
5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the
appropriate boxes):
M Application for Disposal System Construction Permit
Z Complete plans and specifications
Site evaluation forms
�l A list ofabub wells
Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2).
F-1 Other(List):
D. Certification
" ' the facility owner, certify under penalty oflawthmtthiodocunentandaU
attachments, b}the best
of my
knowledge and belief, are true, acou[ate, and complete. | am aware that there may be significant nonoequonoea fo raubniomQ ha|oeinfmrmotion` including, but not limited to, penalties or fine and/or
imprisonment for deliberate vio|ebone.,
6-1O-16
Deha
v=
Gunes
Print Name
Bill 0
Dufresne 6-10-15
Dob,
G6 Park Street Andover
Preparer's address City/Town
8 475-3S55
MA/01810
State/ZIP Code Telephone
t5fonn8adnu^rev,D0O Application for Local Upgrade Approval,Page 4of4
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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: A. Site Information
When filling out 'PVc iAVI
forms on the
computer, use Gunes
only the tab key Owner Name
to move your 64 Forest Street
cursor-do not Street Address or Lot#
use the return
key. North Andover MA 01845
City/Town State Zip Code
(978)688-6962
Contact Person(if different from Owner) Telephone Number
B. Test Results
5-19-15
Date Time Date Time
Observation Hole# P-1
Depth of Perc 4511
Start Pre-Soak 10:24
End Pre-Soak 10:39
Time at 12" 10:39
Time at 9" 10:47
Time at 6" 10:58
Time (9"-6") 11
Rate (Min./Inch) 4
Test Passed: Test Passed: ❑
Test Failed: ❑ Test Failed: ❑
William Dufresne
Test Performed By:
Isaac Rowe
Witnessed By:
Comments:
t5form12.doc-06/03 Perc Test-Page I of 1