HomeMy WebLinkAboutMiscellaneous - 29 BRADFORD STREET 1/14/2016 (2) TOWN OF NORTH ANDOVER t NORTH ,
Office of COMMUNITY DEVELOPMENT AND SERVICES o?•`' °ti°
HEALTH DEPARTMENT
400 OSGOOD STREET +
NORTH ANDOVER, MASSACHUSETTS 01845 CNUSEt
Susan Y. Sawyer, REHS/RS 978.688.9540—Phone
Public Health Director 978.688.8476—FAX
July 29, 2005
Elizabeth Poirier
29 Bradford Street
North Andover, MA 01845
RE: Septic System Design,29 Bradford Street, North Andover,Map 61,Lot 36
Dear Ms Poirier:
The North Andover Board of Health has completed the review of the septic system design plan
for the above referenced property, submitted on your behalf by New England Engineering
Services, Inc. dated June 2, 2005, last revision date of July 29, 20051
At the Board of Health meeting on July 28, 2005,the board members made a motion to approve
the local variance to allow a 3-bedroom design; however,they did not approve the local upgrade
requested regarding reduction in setback to the dwelling from the leaching area. The members
noted that the property has substantial room to meet the codes and requested that the engineer
design a system that met the full compliance of the local and state regulations. A redesign has
been submitted in that regard.
The design has been approved for use in the construction of an upgrade onsite septic system.
This approval is generally valid for three years from the date of the approval and 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. The time
period for which this plan is valid is reduced to two years from the date of a septic system
inspection that did not meet the acceptable criteria in the state regulations. 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 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.
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 Boarc' uilding Inspector, Plumbing Inspector 1/or Electrical Inspector.
The issuance of a Disposal System Construction Permit shall not construe or imply
compliance with any of the aforementioned requirement
3. The plan does not call for the installation of a septic tank effluent filter but one is
recommended. Please be advised that only certain brands of filters are permitted for use in
Massachusetts and each is required to follow certain approval criteria. Your designer or
installer should work with you to assure a licensed brand is selected for use if you choose to
install one.
4. A deed restriction shall be drafted which indicates the dwelling is limited to three bedrooms.
The document is to be created, signed and then recorded at the Registry of Deeds. A copy of
the recorded document must be presented prior to issuance of a Disposal Systems
Construction Permit.
Your effort to provide a properly functioning septic system for your dwelling is greatly
appreciated. The Health Department may be reached at 978-688-9540 with any questions you
may have.
Sincerely
�s
� Susan Y. Sawyer, REHS/Rft
Public Health Director
Encl: list of licensed septic system installers
Cc: New England Engineering Services, Inc.
File
_.-_. ............._- ___. ,.,_.... . ............................
__...
J
July 29, 2005
Susan Sawyer
North Andover Board of Health r -��.
400 Osgood Street �
North Andover, MA 01845
JUL 2 9 2005
6'(`
Re: 29 Bradford Street North Andover MA
VVI'R o, at.,1fE::F'
Septic System Design Plan Re-Submittal �� �� ��� � ��� � �c
Dear Ms. Sawyer,
The following plans and enclosures for the above referenced property are being re-submitted for
approval.
1. (3) Copies of the Septic System Design Plans.
Changes to this revised plan include moving the proposed leach field away from the existing
dwelling to comply with Title 5 setback requirement of a minimum distance from a leach bed to
a foundation wall.
Please contact this office with any questions or concerns.
Sincerely,
1
Thomas Hector
Project Engineer
60 BEECHWOOD DRIVE- NORTH ANDOVER, MA 01845 (978)666-1768.-(888)359-7645- FAX(978)685-1099
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TOWN OF NORTH ANDOVER
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HEALTH DEPARTMENT
4U003GUDDSTREET
NORTH ANDOVER, MASSACHUSETTS 0\845 &$A so
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978�688.�540—Phono
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« ^ 97868O.9542—FAX
Public Health Director
LE
July 5,2O05
|
E|izabethyoirkx |
2y Bradford Street
North Andover,h8/\Ol845
RE: Septic Syste t 36
Dear K4oPoirin:
The North Andover 8ourdofBeukh has coop|�edon(cwof�eyxoduoyo�m design plan Kxthe above referenced
proper�aubmiVudon--�your behalf hy}Jop England Engineering Services,
1oc. d��JJun�2,2O03mod,�omiv�dby
this office on June |O,2005.
Accompanying the plan ie the following requests to the Board ofHealth;
Local Upgrade Approval ro reduce the setback from the soil absorption system to the cellar wall fi-onn,the
required 20`to \0`
2) A varhince request to reduce the design criteria from the required 4 bedrooms to 3 bedrooms was be �
reviewed u1 the Board uf Health meeting of July 28,2OOS. �
�
The next Board of Health meeting is scheduled for July 28,2005.At that meeting,your engineer will address the |
Board Members with his requests. If these requests are granted as listed above,your design will be stamped �
approved on the next business day and a subsequent approval letter will be sent to you. Due to local regulations |
regarding system sizing,please bo aware of the following.
l. A deed restriction shall be drafted which indicates the dwelling is limited to three bedrooms. The document io
noho created,signed and then recorded u1 the Registry ofDeeds. /\copy of the recorded document must he
presented prior tu issuance ofx Disposal Systems Construction Permit.
Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health
Department may bo reached nt978-688-954O with any questions you may have,
Sincere]
�sunY.Sawyer,REB3/D8 �
~'
Public Health Director
Cc: New England Engineering Services, Inc.
fi|* �
|
|
/
NEW ENGLAND ENGINEERING SERVICES
June 8, 2U05
Susan Sawyer
North Andover Board o[Health
400 Osgood Street
North Andover, M/\ 0l845 1"(,)WN OF- rq0RNi ANDOVER
Re: 29 Bradford Street,North Andover, MA -
Local Upgrade Approval Request &
Local Bylaw Variance Request
Dear Ms. Sawyer, -
The purpose of this letter is to request that the above referenced property be included in the
upcoming Board 0[Health meeting agenda to discuss the following local upgrade approvals and |
Title 5 variance requests: .
Local Upgrade Approval Require
�
�
1. Allow reduction iuoffset distance between the leach bed and o foundation wall from 20
feet required b«Title 5` section 15.211(1) io 10 feet.
Local Bylaw Variance Requir
I. Allow a design based oo3 bedrooms io lieu n[o4 bedroom minimum required by the
North Andover Health Bylaw. Approval of this plan requires that u deed restriction
limiting the dwelling 1o3 bedrooms bc recorded ut the registry o[deeds.
lf you have any questions orcomments, please do not hesitate to contact this office.
Sincerely,
-"'le 101�i--
Steven|B. Pouliot
Project Manager
6oBEECHVVOOD DRIVE-NORTH ANDOVER, M&Oix45-(B7n)686'176$-(888)35S'7n45' FAX(g78)8n5-1O0S
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NEW ENGLAND ENGINEERING SERVICES
June 8, 2005
Susan Sawyer -
North Andover Board of Health RECEIVED
400 Osgood Street
North Andover, MA 01845 ,1 U N 1 () 20
TOWN OF NORTH ANDOVER
L..YEAL 6'H D PARTGV91w,fl
Re: 29 Bradford Street,North Andover, MA �
Septic System Design Plan Submittal
Dear Ms. Sawyer,
The following plans and enclosures for the above referenced property are being submitted for
approval.
1. (3) Copies of the Septic System Design Plans.
2. (2) Copies of the Form I 1 Soil Evaluator Sheets.
3. (2) Copies of the Local Upgrade and Variance Request Letter.
4. (2) Copies of the Form 9A-Request for Local Upgrade Approval.
5. (2) Copies of the Form 913-Local Upgrade Approval.
6. (2) Copies of the Infiltrator Approval Form.
7. Check for the Town approval fees.
Please contact this office with any questions or concerns.
Sincerely,
Steven E. Pouliot
Project Manager
60 BEECHV11000 DRIVE«NORTH ANDOVER, MA 01845-(978)666-1766-(888)359-7645-FAX(978)685-10199
1
` Torn`of Nortlr Andover'
HEALTH DEPARTMENT
27 Charles Street �
North Andover MA 01845
978.688 9540
lteatiltdcoWoivnoLnortltandover.cont
SEPTIC PLAN SUBMITT L .
DATE OF SUBMISSION: /
HEALTH ESE DEPARTMENT
SITE LOCATION: r~ad•Far :S - ..
ENGINEER: 10,ew
NEW PLANS: YES X $225.00/Plan Check#:
(Includes Is'(Wone Re-Review Only)
REVISED PLANS: YES $75.00/Plan Check#:
SITE EVALUATION FORMS INCLUDED: YES NO
LOCAL UPGRADE FORM INCLUDED: YES, NO-
Telephone#: 7 6 m I Fax#:
E-mail:
a
HOMEOWNER NAME: I 1
t
OFFICE USE ONLY
When the submission is complete(including check):
1. Date stamp plans and letter
2. Complete and attach Receipt
3. opy File; Forward to Consultant
4. Enter on Log Sheet and Database
I
I
W ENGLAND ENGINEERING SERVICES
INC
1
June 8,2005
w ,_.. . . . ...__ ,w ..
' �
Susan Sawyer JUN 1 0 2005
North Andover Board of Health TOWN O I.N RT H ANDOVER
400 Osgood Street HEALTH T H DE€AF1,1 MENT
North Andover,MA 01845 .
Re: 29 Bradford Street,North Andover,MA
Local Upgrade Approval Request &
Local Bylaw Variance Request
Dear Ms. Sawyer,
The purpose of this letter is to request that the above referenced property be included in the
upcoming Board of Health meeting agenda to discuss the following local upgrade approvals and
Title 5 variance requests:
Local Upgrade Approval Required
1. Allow reduction in offset distance between the leach bed and a foundation wall from 20
feet required by Title 5, section 15.211(1)to 10 feet.
Local Bylaw Variance Required
1. Allow a design based on 3 bedrooms in lieu of a 4 bedroom minimum required by the
North Andover Health Bylaw. Approval of this plan requires that a deed restriction
limiting the dwelling to 3 bedrooms be recorded at the registry of deeds.
If you have any questions or comments,please do not hesitate to contact this office.
Sincerely,
Steven E. Pouliot
Project Manager
60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685 1099
FORM I I.- SOIL EVALUATOR FORM
E ...,_ Page 1 of 3
JUN 0 2005
N qq T��WN tar
o.
„AI
d , .,_ P....-.:PAR' E::. ? Date: C ► "
Commonwealth of Massachusetts
A ' -A vi, over . Massachusetts
Soil Suitability Assessment for On-site Sewage Disposal
Performed By: ..70)-m oz ...................... Date: 17 C)
Witnessed By: .. ..:.wnAce ....../�Z....:: r t :�: .j.... ,.��....... �.�v .,......... �. �.✓► .................: ..... _.
fc � � .
Location Address or O C *' t Owner's Nam, r Y i C""t G:-Ir
1.o�r p lal� ��
��n1�� address,and
/)o r i ./l Y\d o vo,t) A Tdeptwne r q (ca����r' �r� �-
ew construction ❑ Repair '7 686 - 0 66,
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published .. ....... Publication Scale Soil Map Unit ,:..:.._..
Drainage, Class W911..... Soil Limitations .V.e r4y R.0, ' c r
surficial Geologic Report Available: No X Yes ❑
Year Published Publication Scale
Geologic Material (Map Unit) ..................................................................................
.......:.......................------
_....._..__.:
Landform .....-...................................
..................................................,.............,...............................:................................_.........:.......__,..-.. _....
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑Yes L�4J
Within 500 year flood boundary No ❑Yes ❑
Within 100 year flood boundary No ❑Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit) . ,
Wetlands Conservancy Program Map (map unit) ............ ,1,e .............................
..........:....................__._._
Current Water Resource Conditions (USGS): Month r.:�,. d 00,5
Range :Above Normal ❑Normal 0 Belciv Normal ❑
Other References Reviewed:
DEP APPROVED FORM-12107/95
FORM 11 = SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot No. 01 q (`a(E St) �'�,`�lr� AVX(I&J,2
On-site Review
Deep Hole Number Date:.: '1.r1 0 .:::.Y.c. ;. c� °
Time: . .01D.. Weather ! :... .
Location (identify on site plan)
Land Use :::. � 1,.., ►!1:.,1.: � ..::. ..::. Slope {%) Surface Stones .:. :: :°�.:;...: :. .......:. .
Vegetation .....0-f-
Landform .:��!��.<4th.�....:pl:�r,:!-.vr...:....:.. .._. .: ....... .:........�..... .... ....:.. ..
Position on landscape (sketch on the back) ...........
...:..::.:.:::::...:.:.:.:....::::.:..::.:.:.:.:,..:. . . ...
Distances from:
Open Water Body feet Drainage wa y.JA ,C.:
: feet
Possible:Wet AceaCf ..:.: feet Property Line .:. ....:., feet ,
Drinking Water Well feet Other :..... , ... .:-. :.-
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color -Soil Other
Surface(inches) (USDA) (Munselq Mottling (Structure,Stones,Boulders,Consistency, %
Gravel)
d �J�
1K
aq
aq _qo
A
Parent Material(geologic) C'0 _ln .o;1. DepthtoBedrock:
t� �+
,Depth to Groundwater: 'Standing Water in the Hole: g�i Weeping from Pit Face:
ei
Estimated Seasonal High Ground Water. 7r
DEP APPROVED FORM-12!07/95
FORM II - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot iio. �� � ct c� c�r � � , � AiI vej-
On-site Review
Deep Hole Number :.P(R:, Date:. )!..
Weather
Location (identify on site Ian) .:... ?.�t ..:::::.:.. ► '1 :.....:...:.:...:..:...:.:.:::.::..:::::::::::..:.:.::...:.::.:.:...::...:...::...:::......:..... ,
i
Land Use Slope (%) / .. Surface Stones :. ..:..:.. ...:...:.:..... .._:.. ..
Vegetation :. .t` a :.::....::.;..:::....:.:.:. . ..::::::.:::.......:. .. ...:.
Landform :. .V : Gt :1.. ...:f....�.a1.�1. ......::..:.::..:.
Position on landscape (sketch on the back) .. .. a :SI. _ . .. .::
Distances from:
Open Water Body J000... feet Drainage way.I .0 .:. feet
Possible'.We Area >.�: 7...::: feet Property Line .:.a ;....::. feet
'Drinking Water Well : .::. feet Other
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders,Consistency,
Gravel)
- °
3f
.,A
Lo I Of
a5
5v
M11 LES REQUIRED SPOS A
Parent Material(geologic) !` >y DepthtoBedrock:
Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face:
Estimated Seasonal High Ground Water: w
DEP APPROVED FORM-12107/95
FORM 11 - SOIL EVALUATOR FORM
Page 2 of 3
Location Address or Lot i-4o. _o(q 8 r6Id�n 54 ���,� � 1vtc�aVev"
On-site Review
Deep Hole Number . ) :::. Date:,_v�. �?��'y ` Time:... oa. ,.. Weather
Location (identify on site plan) :,:,. .� ,:,. .(c�
Land Use ,.K—Sd�Uj 1: �..:..:::.. .._._... Slope p.. Surface Stones .,:..:
Vegetation C -rj
Landform .. � ? >? ....:::..:.:. 1 .:....... ......
Position on landscape (sketch on the back)
Distances from:
Open Water Body feet Drainage way...0-,: ?:. feet '
Possible:We> Area .�.,` j....: feet Property Line .:!? ::._.:., feet
Drinking Water Well feet Other ...... , ......::.� ..:.:.., :,..
DEEP OBSERVATION HOLE LOG*
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(Inches) (US.DA) (Munselp Mottling (Structure,Stones,Boulders,Consistency,
Gravel)
oil
.L IoYR
aq-
57''
4 W6
5--YR I
A
Parent Material(geologic) Pr,!I-CA C .i.3�' DepthtoBedrock:
�
Depth to Groundwater: 'Standing Water in the Hole: .(� 1e Weeping from Pit Face: J�
t.
Estimated Seasonal High Ground Water: _
DEP APPROVED FORM-12/07/95
FORM 11 - SOIL EVALUATOR FORM
Page 3 of 3
Location Address or Lot No. ` � (`�,. ,0(-J , ALA AlA CLved°
Determination -for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole................... inches
❑ Depth weeping from side of observation hole ..._............. inches
Depth,to soil mottles _777: inches (?d,'` -T-0�1)C�
❑ 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 Il areas
observed throughout the area proposed for the soil absorption system? ye-5
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on I Jbs— (date) I have passed the soil evaluator examination
approved by the De a tment 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
>j Date 6
DEP APPROVED FORM-12/07/95
1
Commonwealth of Massachusetts
City/Town of
_ W
Form 9A — Application for Local pgrrl .4ro al
R)vvr,j a i/ r
DEP has provided this form for use b local Boards of Health. O> ❑��tb
p Y ' I'%i l� '#���t1�i u 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
5.404(1), is not feasible.
310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the
appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource
Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before
commencement of construction.
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 15.417.
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 accordance with either the 1978 Code or 310 CMR 15.000.
A. Facility Information
Important:
When filling out 1. Facility Name and Address:
forms on the
computer, use Elizabeth Poirier
only the tab key Name
to move your 29 Bradford Street
cursor-do not
use the return Street Address
key. North Andover MA 01845
City/Town State Zip Code
tab
2. Owner Name and Address (if different from above):
f
same
return Name Street Address
City/Town State
Zip Code Telephone Number
3. Type of Facility (check all that apply):
® Residential ❑ Institutional ❑ Commercial ❑ School
4. Describe Facility:
Single family dwelling
5. Type of Existing System:
❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other(describe below):
Form 9A Application for Local Upgrade Approval-29 Bradford Street, Application for Local Upgrade Approval* Page 1 of 4
North Andover•rev.5/02
Commonwealth of Massachusetts
City/Town of
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.
A. Facility Information (continued)
6. Type of soil absorption system (trenches, chambers, leach field, pits, etc):
leach trenches
7. Design Flow per 310 CMR 15.203:
Design flow of existing system: 330
gpd
Design flow of proposed upgraded system 330
gpd
Design flow of facility: 330
gpd
B. Proposed Upgrade of System
1. Proposed upgrade is (check one):
❑ Voluntary ❑ Required by order, letter, etc. (attach copy)
® Required following inspection pursuant to 310 CMR 15.301: 4-8-05
date of inspection
2. Describe the proposed upgrade to the system:
Installation of a new subsurface sewage disposals stem.
3. Local Upgrade Approval is requested for(check all that apply):
® Reduction in setback(s)—describe reductions:
Reduction in offset distance between a foundation wall and a leach bed from 20 feet required by Title
5, Section 15.211 (1) to 10 feet.
❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction
❑ Reduction in separation between the SAS and high groundwater:
Separation reduction ft
Percolation rate
min./inch
Depth to groundwater ft
Form 9A Application for Local Upgrade Approval-29 Bradford Street, Application for Local Upgrade Approval, Page 2 of 4
North Andover•rev.5/02
Commonwealth of Massachusetts
City/Town of
Form 9A — Application for Local Upgrade Approval
'4M
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):
n/a
❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the
Code:
n/a
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)(i)(1). The soil evaluator must be a member
or agent of the local approving authority.
High groundwater evaluation determined by:
Evaluator's Name(type or print) Signature Date of evaluation
C. Explanation
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:
Site conditions allow limited area for location of upgraded system.
2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible:
Alternative systems are cost prohibitive.
Form 9A Application for Local Upgrade Approval-29 Bradford Street, Application for Local Upgrade Approval* Page 3 of 4
North Andover-rev.5/02
Commonwealth of Massachusetts
City/Town of
Form 9A — Application for Local Upgrade Approval
r�^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.
C. Explanation (continued)
3. A shared system is not feasible:
NO
4. Connection to a public sewer is not feasible:
NO
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."
6/8/05
Facility Owner's Signature Date
Benjamin C. Osgood, Jr., P.E. (Agent)
Print Name
New England Engineering Services, Inc. 6/8/05
Name of Preparer Date
60 Beechwood Drive North Andover
Preparer's address City/Town
MA, 01845 978-686-1768
State/ZIP Code Telephone
Form 9A Application for Local Upgrade Approval-29 Bradford Street, Application for Local Upgrade Approval, Page 4 of 4
North Andover•rev.5/02
� ( (
Commonwealth of Massachusetts
City/Town of
Local Upgrade Approval 1 0 2005
Form 913 'JUN
E N1
DEP has provided this form for use by local Boards of He�LiiA"�`
The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided
ho the system owner. The system owner shall provide a copy of the Local Upgrade Approval h)the
appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource
Protecbon. Title 5 Permitting Program, upon issuance by the local approving authority and before
commencement ofconstruction.
A. Facility Information !
Important:
When filling out 1. Facility Name and Address
forms onthe
computer, use Elizabeth Poirier
only the tab key wxmo
m move your 29 Bradford Street
ou,ao, do not
uonthamtum ~''~~^'~~'~~^
key. North Andover MA 01845
City/Town State Zip Code
~Q 2. Owner Name and Address (if different from above):
Same -
Name Street Address
City/Town State �
�
-
Zip Code Telephone Number
�
8. Type of Facility (check all that apply):
M Residential El Institutional F-1 commercial School
4. Design flow per 310 CyWH 15.208: 330
gpd
Be
5. Gya�mDeei nor Name
M PE El RS
6OBeeohwoodDrive North Andover MA
Address City/Town State,ZIP
B. Approval
1. Local Upgrade Approval is granted for:
M Reduction ineetbaok(o)—specify: �
Reduction in offset distance between a foundation wall and a leach bed form 20 feet required by Title |
5. Section 15.211
'
�]
Reduction in SAS area ofupbo2596�
�
SAS size,sq.ft. %mduu8on
Form SB Local Upgrade Approval-29 Bradford Street, North Andover Local Upgrade Approval* Page 1vfu
Commonwealth of Massachusetts
City/Town of
Local Upgrade Approval
Form 913
iG^M
B. Approval (continued)
❑ Reduction in separation between the SAS and high groundwater:
Separation reduction ft
Percolation rate min./inch
Depth to groundwater ft
❑ Relocation of water supply well (explain):
List local variances granted not requiring DEP approval per 310 CMR 15.412(4):
Allow a design based on 3 bedrooms in lieu of 4 bedrooms required by the North Andover Health
Bylaw. Approval of this plan requires that a deed restriction limiting the dwelling to 3 bedrooms be
recorded at the registry of deeds.
List variances granted requiring DEP approval:
Approving Authority
Print or Type Name and Title Signature Date
Form 9B Local Upgrade Approval-29 Bradford Street, North Andover Local Upgrade Approval* Page 2 of 2
•rev.5/02
l
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL. PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617.292-5500
ML'I"P ROMNEY ......,_ . -..�.___._,.._..�......FRECEIVED ELLEN ROY HERZFELDER
Governor
Secretary
KERRY BFALEY JUN 1 0 2005 EDWARD P.KUNCE
Lieutenant Governor Acting Commissioner
..0.Ov11N OF l^K)R.I"H MZOVi:=R
V is V_'T H Dfa PARI CkflE rJ
MODIFIED CERTIFICATION FOR GENERAL USE
Pursuant to Title 5,310 CMR 15.000
Name and Address of Applicant:
Infiltrator Systems,Inc.
P.O. Box 768
6 Business Park Road
Old Saybrook,CT 06475
Trade name of technology and model: High Capacity Chamber, Standard Chamber,Infiltrator 3050
(Storm Tech SC-740)and Equalizer 24 and 36 (hereinafter the"System"),
Transmittal Number: W023699
Date of Issuance: February 21,2003
Date of Expiration: February 21,2008
Authority for Issuance
Pursuant to Title 5 of the State Environmental Cade, 310 CMR 15.000, the Department of
Environmental Protection hereby issues this Certification to: Infiltrator Systems,Inc.,P.O. Box 768,
6 Business Park Road,Old Saybrook,CT 06475(hereinafter"the Company"),for General Use of the
System described herein. Sale and use of the System are conditioned on and subject to compliance by
the Company and the System owner with the terms and conditions set forth below. Any
noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR
15.000,
Glenn Haas,Director Date
Division of Watershed Management
Department of Environmental Protection
This information is available in alternate format Call Aprel McCabe,ADA CoordinnWr at 1.617-5561171.TDD Service-1-800-298-2207.
DEP on the World Wide Web: http:Nvnvw.mass.gov/dep
j Prirted on Recycled Paper
i
I
Infiltrator Modified Certification for General Use
Page 2 of 8
I. Purpose
1. The purpose of this Certification is to allow use of the System in Massachusetts,
on a General Use basis.
2. With the necessary permits and approvals required by 310 CMR 15.000, this
Certification authorizes the use of the System in Massachusetts.
3. The System may be installed on all facilities where a system in compliance with
310 CMR 15.000 exists on site or could be built and for which a site evaluation in
compliance with 310 CMR 15.000 has been approved by the local approving
authority,or by DEP if DEP approval is required by 310 CMR 15.000.
II. Design Standards
1. The models listed below are covered under this Certification.
Dimensions Invert
Model W x L x H Height
Inches Inches
Equalizer 24 15 x 100 x 11 6
Equalizer 36 22 x 100 x 13.5 6
Standard Chamber 34 x 75 x 12 6.5
Infiltrator 3050 or 51 x 85.4 x 30 24
StormTech SC-740 1 11
High Capacity Chamber 1 34 x 75 x 16 11
2, The System is an open-bottom leaching unit molded from polyolefin resin. It can
be installed without aggregate or distribution pipe as an absorption trench in
accordance with the requirements in 310 CMR 15.251.
3. The use of aggregate as specified in 310 CMR 15.247 is not necessary with the
System when installed as a trench,bed or field.
4. The minimum separation between any two trenches shall be as specified in 310
CMR 15.251.
5. For new construction, the applicant can size the System in a trench configuration
without aggregate, using the effective leaching areas presented in the following
table. No System shall be designed and constructed with a soil absorption system
area of less than 400 square feet.
Infiltrator Modified Certification for General Use
Page 3 of 8
Effective Effective
Model Leaching' Leaching2
Area Area
SF/LF SF/LF
Equalizer 24 3.75 NA
Equalizer 36 4.73 NA
Standard Chamber 6.53 NA
Infiltrator 3050 or NA 8.2
StormTech SC-740
High Capacity Chamber 7.79 1 NA
1. Effective leaching area is equal to 1.67 times the bottom width plus two x invert.
2. Effective leaching area is equal to 1.0 times the bottom width plus two x invert.
6. Systems shall be sized in accordance with the following table for new
construction in DEP designated nitrogen limited areas as defined in 310 CMR
15.214 and 15.215. The effective leaching area, as shown in the following table,
shall be used for any System installed in a Department designated Nitrogen
Sensitive Area or for any System that is installed for new construction where a
private drinking water supply well is proposed to serve the facility, as defined in
310 CMR 15.214 (2) and for which a variance to the minimum setback distance
of 100 feet has been granted.
Effective
Model Leaching'
Area
SFILF
Equalizer 24 2.3
Equalizer 36 2.8
Standard Chamber 4.0
Infiltrator 3050 and 8.2
Storm Tech SC-740
I-Ii h CapacLty Capacity Chamber 4.5
1. Effective leaching area is equal to 1.0 times the bottom width plus two x invert.
7. Systems installed on remedial sites shall be allowed to utilize the effective
leaching areas presented in item 5 above or additional reductions in soil
absorption leaching area approved by the approving authority in accordance with
310 CMR 15.284. In no instance shall the reduction in the soil absorption system
required in 310 CMR 15.242 exceed the maximum reduction allowed for
alternative systems approved in accordance with 310 CMR 15.284. The effective
leaching areas presented in item 6 above shall be used for remedial sites located
in Department designated Zone II or IWPA when the facility is to be brought into
full compliance in accordance with 310 CMR 15.404.
Infiltrator Modified Certification for General Use
Page 4 of 8
8. In accordance with 310 CMR 15.240 (6) absorption trenches should be used
whenever possible. When the System is installed for new construction without
aggregate in a bed or field configuration, as defined in 310 CMR 15.252, the
System shall be designed using the effective leaching area for the bottom width
presented in the following table. Chambers shall be spaced a minimum of six
inches apart(edge-to-edge)when used in a bed configuration. No system shall be
designed and constructed with a leaching area of less than 400 square feet. The
effective leaching area shall only be equal to the bottom width for any System
installed in a Department designated Nitrogen Sensitive Area or for any System
that is installed for new construction where a private drinking water supply well is
proposed to serve the facility, as defined in 310 CMR 15.214 (2) and for which a
variance to the minimum setback distance of 100 feet has been granted.
Effective
Model Leaching'
Area
SF/LF
Equalizer 24 2.08
Equalizer 36 3.05
Standard Chamber 4.72
Infiltrator 3050 or 4.25
StorrnTech SC-740
High Capacity Chamber 4.72
1. Effective Leaching area is equal to 1.67 times bottom width only.
2. Effective leaching area for Infiltrator 3050 or StonnTech SC-740 is equal to 1.0
times the bottom width
9. The System, when installed in a bed or field configuration without aggregate on
remedial sites, shall utilize the effective leaching areas presented in item 8 above
or additional reductions in soil absorption system area approved by the approving
authority in accordance with 310 CMR 15.284. In no instance shall the reduction
in the soil absorption system area required in 310 CMR 15.242 exceed the
maximum reduction allowed for alternative systems approved in accordance with
310 CMR 15.284.
10. The System, when installed as specified in 310 CMR 15.253: Pits, Galleries, or
Chambers, shall have an aggregate base and/or be surrounded by aggregate and
shall be sized as specified in 310 CMR 15.253 (1) (a) and (b). Effective depth
can be increased up to two feet with the corresponding addition of up to 14 inches
of base aggregate. Bottom width can be increased by two to eight SF/LF with the
corresponding addition of one to four feet of aggregate per side.
Infiltrator Modified Certification for General Use
Page 5 of 8
11. The requirement that Chambers installed in trench configuration as specified in
310 CMR 15.253(6) be provided with inlets at intervals not to exceed 20 feet is
not applicable to the System.
III. General Conditions
1. The provisions of 310 CMR 15.000 are applicable to the use of the System,
except those that specifically have been varied by the terms of this Certification.
2. The facility served by the System, and the System itself, shall be open to
inspection and sampling by the Department and the local approving authority at
all reasonable times.
3. In accordance with applicable law, the Department and the local approving
authority may require the owner of the System to cease use of the System and/or
to take any other action as it deems necessary to protect public health, safety,
welfare or the environment.
4. The Department has not determined that the performance of the System will
provide a level of protection to the environment that is at least equivalent to that
of a sewer. Accordingly,no new System shall be constructed,and no System shall
be upgraded or expanded, if it is feasible to connect the facility to a sanitary
sewer,unless allowed pursuant to 310 CMR 15.004.
5. Design, installation and use of the System shall be in strict conformance with the
Company's DEP approved plans and specifications and 310 CMR 15.000, subject
to this Certification.
IV. Conditions Applicable to the System Owner
1. The System is approved for the treatment and disposal of sanitary sewage only.
Any wastes that are non-sanitary sewage generated or used at the facility served
by the System shall not be introduced into the on-site sewage disposal system and
shall be lawfully disposed of
2. For new construction, the owner initially shall size a soil absorption system in
accordance with 310 CMR 15.242 to demonstrate that a conventional Title 5 soil
adsorption system using aggregate, including a reserve area, can be installed on
the site. The owner may than size the soil absorption system for the System. The
total area required for the aggregate system, which may include the area
designated for the System, and a reserve area shall be preserved and the owner
shall ensure that no permanent structures or other structures are constructed on
that area and that the area is not disturbed in any manner that will render it
unusable for future installation of a conventional Title 5 soil absorption system.
3. The owner of the System shall at all times properly operate and maintain the on-
site sewage disposal system.
Infiltrator Modified Certification for General Use
Page 6 of 8
4. The owner shall furnish the Department any information that the Department
requests regarding the operation and performance of the System, within 21 days
of the date of receipt of that request.
5. No owner shall authorize or allow the installation of the System other than by a
person trained by the Company to install the System.
V. Conditions Applicable to the Company
I. By January 31st of each year, the Company shall submit to the Department a
report, signed by a corporate officer, general partner, or Company owner that
contains information on the System for the previous calendar year. The report
shall state known failures, malfunctions, and corrective actions taken for the
System as well as the date and address of each event.
2. The Company shall notify the Department's Director of Watershed Permitting at
least 30 days in advance of any proposed transfer of ownership of the technology
for which this Certification is issued. Said notification shall include the name and
address of the proposed new owner and a written agreement between the existing
and proposed new owner containing a specific date for transfer of ownership,
responsibility, coverage and liability between them. All provisions of this
Certification applicable to the Company shall be applicable to successors and
assigns of the Company, unless the Department determines otherwise.
3. The Company shall furnish the Department any information that the Department
requests regarding the System, within 21 days of the date of receipt of that
request.
4. Prior to any sale of the System, the Company shall provide the purchaser with a
copy of this Certification. In any contract for distribution or We of the System,
the Company shall require the distributor or seller to provide the purchaser of the
System, prior to any sale of the System,with a copy of this Certification.
5. If the Company wishes to continue this Certification after its expiration date, the
Company shall apply for and obtain a renewal of this Certification. The Company
shall submit a renewal application at least 180 days before the expiration date of
this Certification, unless written permission for a later date has been granted by
the Department.
6, The Company shall prepare an installation manual specifically detailing
procedures for installation of its System. The Company shall institute and
maintain a training program in the proper installation of its System in accordance
with the manual and provide a training course at least annually for prospective
installers. The Company shall certify that installers have passed the Company's
training qualifications, maintain a list of certified installers, submit a copy to the
Infiltrator Modified Certification for General Use
Page 7 of 8
Department, and update the list annually. Updated lists shall be forwarded to the
Department.
7. The Company shall not sell the System to installers unless they are trained to
install these Systems by the Company.
VI. Conditions Applicable to Installers of the System
1. Each Installer shall install the System in accordance with Company training on
the installation of the System and the conditions of this Certification.
2. No Installer shall install the System unless the Installer has been trained by the
Company on installation of the System,
VII. Reporting
1. All submittals of notices and documents to the Department required by this
Certification shall be submitted to:
Director
Watershed Permitting Program
Department of Environmental Protection
One Winter Street- 6th floor
Boston,Massachusetts 02108
VIII. Rights of the Department
1. The Department may suspend, modify or revoke this Certification for cause,
including, but not limited to, non-compliance with the terms of this Certification,
non-payment of an annual compliance assurance fee, for obtaining the
Certification by misrepresentation or failure to disclose fully all relevant facts or
any change in or discovery of conditions that would constitute grounds for
discontinuance of the Certification, or as necessary for the protection of public
health, safety, welfare or the environment, and as authorized by applicable law.
The Department reserves its rights to take any enforcement action authorized by
law with respect to this Certification, the System, the owner, or operator of the
System and the Company.
IX. Expiration Date
1. Notwithstanding the expiration date of this Certification, any System installed
prior to the expiration date of this Certification, and approved, installed and
maintained in compliance with this Certification (as it may be modified) and 310
CMR 15.000, may remain in use unless the Department, the local approving
authority, or a court requires the System to be modified or removed, or requires
discharges to the System to cease.
Infiltrator Modified Certification for General Use
Page 8 of 8
W 023699Infil.Reduced Size-Jan.2003SHC