Loading...
HomeMy WebLinkAboutMiscellaneous - 325 Abbott Street (2) JaISAMMST, ►�� � ,,, gwl ao \\ TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ; permit NO: Date Received +A,�^T�p �SS�CHVs�t Date Issued: EMPORTANT: Applicant must complete all items on this page LOCATION_ 3 2 5 i4 5F ort' Pnnt j PROPERTY OWNER Print j MAP NO: PARCEL:M_ZONING DISTRICT: Histo is District yes no Macne Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New Building 9 One family ❑Addition ❑Two or more family ❑ Industrial VAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic ❑ Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer 74 rM f Vo 1�ilC� Identification Please Type or Print Clearly) � Phone: 178- X96 -2577 OWNER: Name: ('oM �at.2�+St Address: CONTRACTOR Name: /U+cK S�-H���E�- Phone: 7� �i7- TL-7S2 ( - Address: OZ TG 6 //-/S ��t-r S'r/1�.y-7 AJcv T�r�!� il/l Supervisor's Construction License: CS-/11 S SZy Exp. Date: 2/Z A/A Home Improvement License: Exp. Date: /'7S� S3 S za i 7 ARCH ITECUENGINEER= /� Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER$.F. Total Project Cost: $ 2 1. 7 Sa FEE: $ 2` /• QO Check No.: 7q4 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund signature of Agent/Owner r� �� r Signature of contractor �� lans Suthitted ❑ Plans Waived ❑ � - . RE OF SEWERAGE DISPOSAL NICK SCHIFFER Lblic Sewer ❑ Tanning/Massage/B �A&9ljad&A`&rWjdPh ................................................ ell ❑ Tobacco Sales 617.799.7521 nick@nsbuildersTria.com ivate(septic tank,etc. x Permanent Dumpste www.nsbuildersma.com THE FOLLOWING SE _ —— INTERDEPARTMENTAL SIGN OFF o U FORM -ANNING & DEVELOPMENT Reviewed On Signature_ DMMENT'S ?NSERVATION Reviewed on Signature )MMENTS :ALTH Reviewed on b Siqnatur���4 )MMENTS < Q,{(y), 6 l eDZVn�5 '�O I f-2 hJ?1L6t1 t S 0q I.' ling Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes -ining Board Decision: Comments iservation Decision: Comments 1 Lter& Sewer Connection/signature&Date Driveway Permit W Town Engineer: Signature: Located 384 Osgood Street ;EDEPARTMERI�TTerriumpster on�sfeyes„ a ; ' . ,4y �� '�"�'; `��t'�` ` ; �` ! ZZs-+1,31fIOt ated at 124 MaI& reet '6113655 m.._9ea�n..� -i�g.'tnfatre/d�ate V ` y.l _ � �r�� ” 4T`'tx'r—�,�'A'r i)rR "w"�"�"^�'."•'.."'-�..��"'1 +'jd`'�� y� 4LS�.tt" •.�yV,'t,1 `'1R r T yet +�'1a,. �- IVIMGN a _�, ,{• 4'ti,�..tu��V�li."i t,pA>F F'+, .. '1 .'ti, h�1t*�.. .�'C"D•. .. ate' ' Si.3a, a.....C:v,.. a n._. _..wt _ .♦ � ��i�,.:i,r_�....- �...r.< f�+,; � 6��'�D rsy6 • FILE COPY PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 9/11/2014 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Construction of an On-Site Sewage Disposal System By: Jesse Warren At: 325 Abbott Street (lot 3) Map 38 Lot 3 North Andover, MA 01845 The Iss /ce of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Ss'an Sawyer`s r /public Health ent I I i 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com �CTST;ED`76g6 • AUGRECEIVED 26 2014 C _7 y TOWN OF NOR 7 H ANDOVER HEALTH DEPARTMENT ATED Ar�`� PUBLIC HEALTH DEPARTMENT Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System constructed;( )repaired; By: J�S�P �UC.k C C 2 c.� �(d� �. L 1 AL1 I RJ (Print Name) Located at: A,�Iqz:> f4 ,>-I, C Ly I (Installation Address) Was installed in conformance with the North Andover Board of Hea th approved plan,originally dated 4 O �nd last revised on with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan;the system was installed in accordance with the provisions of 310.CMR 15.000,Title 5 and local regulations,and the final grading agrees substantially with the approved plan.All work is accurately represented on the As-built which has been submitted to the Board of Health. Bottom of Bed Inspection Date: Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name Installer: (Signature) Date: And—Print Name Engineer: (Signature) Date:, '2 1z )4 And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com Blackburn, Lisa From: Isaac Rowe <irowe@millriverconsulting.com> Sent: Wednesday, May 21, 2014 US PM To: Blackburn, Lisa; Grant, Michele Cc: 'Pam Lally'; 'Isaac Rowe' Subject: RE:Abbott Street Attachments: 303 Abbott St - Lot 1 - Final Construction Inpsection.doc; 303 Abbott St - Lot 2 - Final Construction Inspection.doc;303 Abbott St- Lot 3 - Final Construction Inspection.doc Michele/Lisa, Attached are the (3)final inspection reports for Lots 1, 2,3 Abbott St. Everything looked good and the installer Jesse Warren did a great job. From everything I observed this project appeared to be well engineered and well constructed. Lot 3-This still needs a pump test when the electricity is established at the site. Please let me know if MRC should do that inspection or if the BOH office wants to do the inspection. Please let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone:978-282-0014 ext.804 Fax:978-282-1318 irowe(a-),millriverconsulting.com www.millriverconsulting.com From: Blackburn, Lisa [mailto:LBlackburnCa>townofnorthandover.com] Sent:Tuesday, May 20, 2014 8:39 AM To: Dan Ottenheimer; Isaac Rowe; Pam Lally Subject: Abbott Street Good Morning, Could you please contact Dan MacRitchie regarding final construction for lots 1, 2, and 3 Abbott St.?Thank you. www.DCMacRitchie.com Phone (603) 845-3572 or (978) 801-0667 Lisa Blackburn Health Department Town of North Andover 1600 Osgood Street,Suite 2035 1 � Blackburn, Lisa From: Isaac Rowe <irowe@millriverconsulting.com> Sent: Tuesday,July 29, 2014 4:22 PM To: Blackburn, Lisa;Sawyer, Susan Cc: 'Pam Lally'; 'Isaac Rowe' Subject: Lot 3 Abbott St Attachments: 303 Abbott St - Lot 3 - Final Construction Inspection.doc Susan/Lisa, Please find the updated final construction inspection form.We conducted the pump inspection today. Everything looked good. Please let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager Mill River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 ext.804 Fax: 978-282-1318 irowe(a-)-millriverconsulting.com www.miliriverconsulting.com I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION. Print' PROPERTY OWNER Q 6 Q�,c t IV L L p Ga�G°- J ✓��^�" e� - P.rint i o0 Year Old Structure yes o ,MAP NO: S PARCEL: .020 . ZONING DISTRICT: 2� Historic District yes o Macli�ie Shop Village yes no TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential _ P_ New Building '. One family 11 Industrial Addition El Two or more family ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other q Septic ❑Well ❑ Flood Iain 0 Wetlands ❑ Watershed Dis.trio. ❑Water/.,$.ewer u DESCRIPTION OF WORK TO BE PERFORMED: 46 CA Identification Please Type or Print Clearly) OWNER: Name: gob er,.ftj LLe Qom!, Ga ACOgA6I_AAAl��+ Phone: V7 Address: h �it•� R Q� �� NO d f Qo Co GoR.AnJ _ Phone: /_ 7 �. J L _774 CONTRACTOR Name; _ ___ _ _ _ - /Address: �t/�► 'ni 2 y �, ©k {�@ r� 1�'I ,4 U / 9 r / Supervisor'sConstruction License: CJ7-__06 01.0 EXp: 'Date: Ho- lmprovemem License: _ __ ARCHITECT/ENGINEER Phone: ?.17 ' 11- 7 Address: _f--f, e ( arj I /4,4 d,;7l76 Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund S.ignatta�eofaAgent/Owner Signature of contractor ' _ _. Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans SubmittedA Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYFE OPSEWERAGEDISPOSAL Public Sewer ❑ Tanning/Massage/Body-Art ❑. . Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc.._ Permanent Dempster on Site ❑ THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Si nature COMMENTS�•� HEALTH Reviewed on Signature Ui CO MENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: ��f� —��j :Comments V,-z Water &Sewer Connection/signature Da6��-d(Z� Drivewav Permit DPW Tow;2.Engineer: Signature: l C7'0".Gze ► !15 l Located 384 O ood ttreet EIRE DEPARTM�atI�T Temp.Dumpster n-site a no Located at 124;Mair, Street - Fire Departmerit-signatiar`e/date COMMENTS North Andover Health Department Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 3Abbott St. Lot 3 MAP: 38 BLOCK: 20 LOT: 03 INSTALLER: Jesse Warren DESIGNER: Dan MacRitichie PLAN DATE: 10/10/13 BOH APPROVAL DATE ON PLAN: 12/5/13 INSPECTIONS TANK INSPECTION: 5/13/14 DATE OF BED BOTTOM INSPECTION: 5/13/14 DATE OF FINAL CONSTRUCTION INSPECTION: 5/20/14 DATE OF PUMP INSPECTION: 7/29/14 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS N/A Contractor reports any changes to design plan N/A Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base N/A Cleanouts per plan X Bottom of tank hole has 6" stone base X Weep hole plugged X 1500 gallon tank has been installed H-10 loading X Monolithic tank construction ® Watertightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (effluent filter) ® 24" inch cover to finish grade installed over outlet access port ® Neoprene boots around inlet & outlet Comments: PUMP CHAMBER ® Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1000 gallon Pump Chamber installed ® H-10 loading ® Monolithic tank construction ® Inlet tee installed, centered under access port ® Pump(s) installed on stable base ® Alarm float working ® Pump On/Off floats working ® Separate on/off floats ® Drain hole in pressure line ® 24" cover at final grade installed over pump access port ® Watertightness of tank has been achieved by Visual testing ® Neoprene boots around inlet & outlet Comments: CONTROLPANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: outside dwelling ® Alarm signal located inside: outside dwelling Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.087foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) i i Z Schedule 40 PVC Pipe Comments: SOIL ABSORPTION SYSTEM (General) X Bottom of SAS excavated down to C soil layer, as provided on plan X Size of SAS excavated as per plan X Title 5 sand installed, if specified on plan N/A 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder 1 concrete I timber/ block) ❑ Final cover as per plan i Comments: Tank is 10' 10" foundation to tank; A to D 67'6", A to C 67'6", stakes in bed L-37'xW20', W38' with overdig L48", moved the tank, 2nd tank 45 degree elbow out of tank, 45 degree elbow into D-box, engineer will put on as-built, the installer hit ledge, incorrect benchmark using a closer telephone pole, engineer will put on as-built. FINAL GRADE Loamed Seeded t Cover per plan Comments: DOCUMENTS NEEDED ❑ Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer I i � I As-Built Plan BM = 100.93 HR = 2.74 HI = 103.67 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 8.25 95.07 95.00 Septic Tank IN 8.45 94.87 94.80 Septic Tank OUT 8.69 94.63 94.55 Pump Chamber IN 8.84 94.48 94.45 (2") Pump Chamber OUT 9.10 94.40 ------ (2") Distribution Box IN 5.21 98.29 98.07 Distribution Box OUT 5.30 98.02 97.90 Lateral 1 TOP 5.29 /5.42 Lateral 1 INVERT 98.03 /97.90 97.90 /97.82 Lateral 2 TOP 5.29 /5.42 Lateral 2 INVERT 98.03 / 97.90 97.90 /97.82 Lateral 3 TOP 5.29 /5.42 Lateral 3 INVERT 98.03 / 97.90 97.90 /97.82 Bottom of Bed/Chamberl 6.44 97.23 97.32 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck,on footings, etc 5 10 -- Waterline 10 10 101 ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banka 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other)Foundation 10(5) 20(10) ® Drywells 20 25 I 1 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws Commonwealth of Massachusetts Map-Block-Lot �- •• 038.00020 BOARD OF HEALTH Permit No 4 North Andover BHP-2014-0548 ----------------------- FEE --- -------------- FEE $250.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Jesse-T.-Warren - --- -------------------------------------------------------------------------------------------------- to(Construct)an Individual Sewage Disposal System. atNo OLf�- -3-- -303- -ABB----TT-- -STREET- ------- ------------------------------------------------------------------------------------------------ as shown on the application for Disposal Works Construction Permit No. BHP-2-0.-4*054,-;Dated pr&29,2014 ---------- - - ---=--- - - ------------------------------------------ Issued On:Apr-29-2014 BOARD OF HEALTH a Application for Septic Disposal System 3�•`�° ''•'' °� TODAY'S DATE ° mConstruction Permit — TOWN OF t - ° 'i ORTH ANDOVERMA 01845 $250.00-Full Repair 3,°^•—��' $125.00-Component SS^ ,CHU Important: Applicati2h is hereby made fora permit to: When filling out Construct a new on-site sewage disposal system* forms on the computer,use ❑ Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component—What? cursor-do not use the return yA. Facility Information P- 2 key. -'S'L,S A6,44 Address or Lot# sl/o�h. �-ytdoi/�°dL CityfTown APR 2�-20 i4 2.-*TYPE OF SEPTIC SYSTEM*: 64 Pump ❑Gravity(choose one) TOWN OF NORTH ANDOVER ***If pump system, attach copy of electrical permit to applica LTH DEPARTMENT ❑Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S.(No D-Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D-Box Present)S.A.S. 2. Owner Information 5bj et'ih (-LC- Name c� nel rd Address(if different from abo e) ';6f4,1 "A C\ 0142 CityfTown StateZip Code X17 8900 Telephone Number 3. Installer Information Name Name of Company 107 Address CityfTown State Zip Code -2®- (2-t'�;k Telephone Number(Cell Phone#if possible please) 4. Designer Information f 6I1 44C C I C "( t`. (ffotb,�v G Cct Name Name of Company -"-)Lk I< Address CityfTown State Zip Code 2.$0 - loS-6 ��ii I Telephone Number(Best#to Reach) 1EX C"C,Ucl 03 Z40" . -� Application for Disposal System Construction Permit-Page 1 of 2 l ti •µ°RTN Application for Septic Disposal System °c TODAY'S DATE 1 pConstruction Permit — TOWN OF , $250.00—Full Repair ORTH ANDOVERMA 01845 $125.00-Component PAGE 2 OF 2 A. Facility Information continued.... 5. Type of Building: Oesidential Dwelling or❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code,as well as the Local Subsurface Disposal Regulations for the Town of North Andover,and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. 44,2,_ ((— Z, Name Date Application Approved BY (Board of Health Representative) Name Date Application Disapproved for the following reasons: For Office Use Only: Z Fee Attached.? Yes No 2. Project Manager Obligation Form Attached? Yes No 3. Pump System? If so,Attach copy ofElectrical Permit Yes No 4. Foundation As-Built?(new construction ronly): Yes No (Same scale as approved plan) 5. Floor Plans?(new construction only): Yes No Application for Disposal System Construction Permit•Page 2 of 2 i SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: Gi For Fplans bfi� (Address of septic system) P y + � r (En eer) Relative to the application of t5 �""� U-V, jv /Z 01-3(Installer's name) And dated ( ` rigina ate Dated "�,� Z S— Zoe� �������� o ay s ate With revisions dated (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plansrior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer, I must call for any and all inspections. If homeowner,contractor,project manager,or any other person not associated with my company schedules an inspection and the system is not ready,then item three shall be applicable. 3. As the installer,I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection,without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a 550.00 fine being levied against me and/or my company. a. Bottom of Bed—Generally, this is the first(1'D inspection unless there is a retaining wall,which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection—Engineer must first do their inspection for elevations,ties, etc. As-built of verbal OK(or e-mail to: healthdept(a,townofnorthandover.com) from the engineer must be submitted to the Board of Health,after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system,all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade—Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than simple excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of North Andover,significant fines to all persons involved are also possible. 5. As the installer,I understand that I must be on-site during the performance of the following construction steps: j a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board of Health staff or consultant. d. Installation of tank, D-Box,pipes, stone, vent,pump chamber, retaining wall and other components. 6. As the installer. I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner,general contractor,or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer: (Today's Date) (Name— Print ( a�—Signe i RECEIVED SPR `5 2014 TOWN Of NORTH ANDOVER HEALTH DEPARTMENT Date e° • th O�l i�•�-�� �•. OOL TOWN OF NORTH ANDOVER MIT p I'ER FOR WIRING HUS�t This certifies that has Permission to Perform .� .............:............. .. ...... .. �'u7ng in the building of � ..at `............................................ j Fee, — ................................. ...,North �z "°r'. Andover, ...................Lc.No. Mass. -`�� Check# 13��G cnt IrrsrEcro ' 12311 DC MacRitchie Inc. RECEIVED 7 Hillside Avenue II�� Exeter,New Hampshire 03833401 (603)845-3572/(978)801-0667 DCMacRitchie.com TOWN OF NORTH,AI.TH DEPARTMENT ANDOVER ER T August 27, 2014 Ms. Lisa Blackburn, Department Assistant Send via: USPS Board of Health Town of North Andover 1600 Osgood St. N. Andover, MA 01845 Reference: 315& 325 Abbott Street(Lots 2& 3)As-built Drawings Dear Ms. Blackburn: Attached for your records are the above referenced drawings I Please feel free to contact me by telephone at (603) 845-3572 or by email at dan&dcmacritchie.com if you have questions or require any additional information. Sincerely, D.C. MacRitchie, Inc. �iAtZ . II' Daniel C. MacRitchie P.E. President DC MacRitchie Inc. RECEIVEb 7 Hillside Avenue NOVxeter.New Hampshire 03833 IY26 213 (603)845-3572/(978)801-0667 TOWN OF NUN;i ANDOVER DCMacRitchie.com HEALTH pEPARTE November 20, 2013 Ms. Susan Sawyer,Health Agent Send via: USPS Town of North Andover 1600 Osgood St. N. Andover, MA 01845 Reference: 303 Abbott Lot 3 Revised Septic System Design Dear Ms. Sawyer: Attached for your review are the above-referenced drawings that have been revised to incorporate your review comments. Also attached are the requested buoyancy calculations. Please feel free to contact me by telephone at (603) 845-3572 or by email at dan&dcmacritchie.com if you have questions or require any additional information. Sincerely, D.C. MacRitchie, Inc. A-4- Daniel C.MacRitchie, P.E. President 303 ABBOTT ST, MAP/LOT 38-20-3 PREPARED BY: 11/21/2013 N.ANDOVER, MA D.C. MACRITCHIE, INC. PUMP TANK BUOYANCY CALCULATION A MANUFACTURER EF SHEA B MODEL NO. M1000 C TANK WEIGHT(LBS) 10,800 D TANK DIMENSIONS(FT) E WIDTH 4.67 F LENGTH 9.50 G1 HEIGHT 5.67 H VERTICAL DISTANCE FROM INVERT IN TO BOTTOM OF TANK 4.58 I ESHGW DEPTH TO EXISTING GRADE PER TP9 (FT) 2.33 ELEVATIONS (FT) J TANK INVERT IN (FROM PLAN) 94.45 K BOTTOM OF TANK=J - H 89.87 L TOP OF TANK = G + K 95.54 M EXISTING GRADE AT PROPOSED TANK LOCATION (PER PLAN) 94.50 N PROPOSED GRADE AT PROPOSED TANK LOCATION (PER PLAN) 97.50 O ESHGW ELEV= M - 1 92.17 G2 DEPTH OF TANK BELOW ESHGWT 2.30 P DEPTH OF SOIL OVER TANK (FT) = N - L 1.96 Q COVER SOIL DENSITY (LB/CF) 110 BUOYANCY COUNTER FORCES: COVER SOIL WEIGHT: GROSS WEIGHT OVER TANK= E X F X P X Q 9,565 LESS WEIGHT OF SOIL DISPLACED BY RISER= 3.14 X 2^2/4 X P X Q (957) R TOTAL SOIL WEIGHT 8,608 S PUMP & PUMP ACCESSORIES WEIGHT(LBS) 50 T WEIGHT OF RISER &COVER 50 U WEIGHT OFTANK(LBS) = C 10,800 N SOIL FRICTION FORCE -OMITTED FOR ADDITIONAL SAFETY FACTOR - W TOTAL COUNTER-BUOYANCY FORCE (LBS) 19,508 X TANK BUOYANCY FORCE (LBS) = (E x F x G2) x 62.f LBS/CF: 6,367 TOTAL COUNTER-BUOYANCY FORCE >TANK BUOYANCY FORCE -THERFORE OK 303 ABBOTT ST, MAP/LOT 38-20-3 PREPARED BY: 11/21/2013 N.ANDOVER, MA D.C. MACRITCHIE, INC. SEPTIC TANK BUOYANCY CALCULATION A MANUFACTURER EF SHEA B MODEL NO. TK-M1500 C TANK WEIGHT(LBS) 11,035 D TANK DIMENSIONS (FT) E WIDTH 5.67 F LENGTH 10.83 G1 HEIGHT 5.67 H VERTICAL DISTANCE FROM INVERT IN TO BOTTOM OF TANK 4.58 1 ESHGW DEPTH TO EXISTING GRADE PER TP9 (FT) 2.33 ELEVATIONS(FT) J TANK INVERT IN (FROM PLAN) 94.80 K BOTTOM OF TANK=J - H 90.22 L TOP OF TANK=G + K 95.89 M EXISTING GRADE AT PROPOSED TANK LOCATION (PER PLAN) 94.50 N PROPOSED GRADE AT PROPOSED TANK LOCATION (PER PLAN) 97.00 0 ESHGWT ELEV= M - 1 92.17 G2 DEPTH OF TANK BELOW ESHGWT 1.95 P DEPTH OF SOIL OVER TANK (FT) = N - L 1.11 Q COVER SOIL DENSITY(LB/CF) 110 BUOYANCY COUNTER FORCES: COVER SOIL WEIGHT: GROSS WEIGHT OVER TANK= E X F X P X Q 7,498 LESS WEIGHT OF SOIL DISPLACED BY RISER=3.14 X 2^2/4 X P X Q (542) R TOTAL SOIL WEIGHT 6,956 S PUMP & PUMP ACCESSORIES WEIGHT(LBS) 50 T WEIGHT OF RISER& COVER 50 U WEIGHT OFTANK(LBS) =C 11,035 N SOIL FRICTION FORCE-OMITTED FOR ADDITIONAL SAFETY FACTOR - W TOTAL COUNTER-BUOYANCY FORCE (LBS) 18,091 X TANK BUOYANCY FORCE (LBS) = (E x F x G2) x 62.f LBS/CF: 7,472 TOTAL COUNTER-BUOYANCY FORCE>TANK BUOYANCY FORCE-THERFORE OK North Andover Health Department Dv (ommunity Development Division L k.,.' 1 r November 18, 2013 Daniel MacRitchie, P.E. D.C. MacRitchie, Inc. 7 Hillside Avenue Exeter,NH 03833 Re: Subsurface Sewage Disposal System Plan for Lot 3 -303 Abbott Street(Map 38, Lot 3) Dear Mr. MacRitchie, The proposed wastewater system design plan for the above site dated October 10, 2013, revised November 12, 2013 and received on November 12, 2013 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. It appears the bottoms of the septic tank and pump chamber are within the ground water table. Please provide buoyancy calculations for both tanks (3 10 CMR 15.221(8)). 2. Please specify the pump chamber stone base requirement(310 CMR 15.221(2)). 3. Please specify the pump chamber shall be watertight (310 CMR 15.221(1)). 4. On sheet 2 of 2,the pump chamber model number and detail indicate a 2-piece tank is proposed. A monolithic pump chamber is required (NA 3.2). Please modify the detail and model number accordingly. 5. On sheet 2 of 2, in the profile view the pump chamber appears to have more than 36"of cover material. Please clarify this or indicate the proposed maximum elevation above the pump chamber(3 10 CMR 15.221(7)). 6. An effluent filter needs to provided before or inside the pump chamber(3 10 CMR 15.231(10)). 7. Please indicate clearly on the plan the depth of the crushed stone (3/4"-1 '/2") below the leach field distribution pipes. The profile and cross section show a 6 inch depth but it should be stated clearly for the installer. 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 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. /S,incerel Susan Y. S er HS/RS Public Health Director cc: Boberin LLC File Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 North Andover Health Department (ommunity Development Division December 5, 2013 Boberin LLC 9 Whitney Rd Boxford, MA 01921 Subsurface Sewage Disposal System Plan for 303 Abbott Street, Lot 3,North Andover, Massachusetts Map 38, Block 20, Lot 3 Dear Applicant, The North Andover Board of Health has completed the review of the septic system design plans for the above referenced'property, submitted on your behalf by D. C. MacRitchie, Inc. dated October 10, 2013, last revised on November 21, 2013 and received November 26, 2013. The design has been approved for use in the construction of a new onsite septic system for a 4- bedroom (max 9-room) home. This plan is good for 3 years from the date of approval. 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. This approval is also subject to the following conditions: 1. Prior to the issuance of a Disposal Works Construction permit the following must be submitted. a. A Foundation plot plan in a V=20' scale;the same as the approved plan b. Floor plans of the proposed home (must be 9 rooms or less) 2. 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(l)). 3. 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 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 j 303 Abbott Street, Lot 3 December 5, 2013 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. 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 might have. Since , S san Y. wyer, HS/RS Public Health D' or cc: Daniel MacRitchie file Encl. copy of the approved Installers List for N.A. Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 12/5/2013 TOWN OF NORTH ANDOVER PERMITTED SEPTIC INSTALLERS- RENEWED FOR 2013 Doing Business As Phone City Angelo Petrosino (978) 664-2030 NORTH READING,MA 01864 Arthur F.Hutton (978) 685-2667 METHUEN,MA 01844 Bill Hall (978) 689-3711 METHUEN,MA 01844 Blake Seale (978)697-8773 ROWLEY, MA 01969 Chad Jablonski (978)360-9358 WARD HILL,MA 01835 Daniel A. Giard (978) 686-7653 NORTH ANDOVER,MA 01845 Daniel R. Briscoe (978)372-2200 GROVELAND,MA 01834 David A.Kindred (978)265-7641 BOSTON,MA 02110 David Maynard (978-375-7228 BARNSTEAD,NH 03225 David V.Zaloga,Jr. (603) 765-9296 EXETER,NH 03833 James H. Currier (978) 774-6685 MIDDLETON, MA 01949 James Gallant (978) 841-5000 HUDSON,MA 01749 James Kellett (781)953-7146 LYNNFIELD,MA 01940 John J. Soucy (603)216-7175 SALEM,NH 03079 John L.DiVincenzo (978)372-7471 HAVERHILL,MA 01835 Joseph Surianello (978)458-9117 DRACUT,MA 01826 Michael W.Reilly (978)375-4811 ANDOVER,MA 0 18 10 Peter Breen (978)265-7580 NORTH ANDOVER,MA 01845 Robert T.Amor (978)948 3341 BOXFORD,MA 01921 Rocci DeLucia,Jr. (603) 974-1580 SALEM,NH 03079 Robert L.Innis (978) 663-6006 BILLERICA, MA 01821 Serge Beaulieu (603)235-3740 DERRY,NH 03038 Stephen Iacozzi (978)479-4407 METHUEN,MA 01844 Timothy Quinlan (978)457-0528 HAVERHILL, MA 01830 Todd Bateson (978) 815-2703 ANDOVER,MA 0 18 10 Warren Pearce,Jr. (978) 664-5264 NORTH READING,MA 01864 NORTH ANDOVER&KINGSTON,NH William (Tom) Sawyer (603) 642-8910 103848 Ot NORT: 6641 0 Town of North Andover HEALTH DEPARTMENT ,SSACNUSt� CHECK#: DATE: J LOCATION: n bEfi-' Si- I_ H/O NAME: y v r Y� CONTRACTOR NAME:K) r Type of Permit or License:(Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ 0 ?I�Septic-Design Approval X $ / ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ W-) Health gent Initials White-Applicant Yellow-Health Pink-Treasurer TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT .�ro,�+•^ 1600 OSGOOD STREET; SUITE 2035 NORTH ANDOVER, MASSACHUSETTS 01845 978.688.9540—Phone Susan Y.Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healtbdept@townofnorthandover.com WEBSITE:hto://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM Date of Submission: 11/12/2013 Site Location:303 Abbott Street - (Lot 3) Engineer: Daniel MacRitchie P.E. New Plans? Yes X $225/Plan Check# (includes 1St submission and one re- review only) Revised Plans?Yes $75/Plan Check# Site Evaluation Forms Included? Yes X No Local Upgrade Form Included? Yes No X Telephone#:978-801-0667 Fax#:866-571-1995 E-mail: dan@dcmacritchie.com RECEIVED Homeowner NOV Name:Estate of Regina Bomba TOWN OF NORTH ANDOVER OFFICE USE ONLY When the submission is complete(including check): ➢ Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File; Forward to Consultant ➢ Enter on Log Sheet and Database i Commonwealth of Massachusetts City/Town of North Andover Percolation Test Form 12 Y< 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, Estate of Regina Bomba use only the tab 9 key to move your Owner Name cursor-do not 303 Abbott Street use the return Street Address or Lot# key. N.Andover MA Ci r� CitylTown State Zip Code same Contact Person(if different from Owner) Telephone Number B. Test Results 8/22/13 10:15 8/22/13 10:53 Date Time Date Time Observation Hole# P9 P12 Depth of Perc 28"surface to top of perc hole 32"surface to top of perc hole Start Pre-Soak 10:15 10:53 End Pre-Soak 10:30 11:08 Time at 12" 10:30 11:09 Time at 9" 11:04 11:17 Time at 6" 11:47 11:27 Time(9"-6") 43 min 10 Rate(Min./Inch) 15 4 Test Passed: ® Test Passed: Test Failed: ❑ Test Failed: ❑ Dan MacRitchie Test Performed By: Isaac Rowe --- - Witnessed By: R ECIC 1 V Comments: TOWN OF NORTH ANDOVER HEALTH DEPARTMENT t5form12.doc•06/03 Perc Test•Page 1 of 1 I I Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal MassDEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information Estate OF Regina Bomba Owner Name 303 Abbott Street 38-20-3 Street Address Map/Lot# North Andover MA City State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 2. Published Soil SurveyAvailable? 8/11/08 1:15,840 420/421 ® Yes ❑ NO If yes: Year Published Publication Scale Soil Map Unit Canton fine sandy loam, 3 to 8 % slopes SAS -Very Limited Soil Name Soil Limitations 3. Surficial Geological Report Available? ® Yes El No 1:15840 242B No If yes: Year Published Publication Scale Map Unit Artificial Fill/Thin Till Geologic Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No Within the 500-year flood boundary? ❑ Yes ® No Within a velocity zone? ❑ Yes ® No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name Corcoran Test Pits 9-10.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 Commonwealth of Massachusetts Cityfrown of North Andover y Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information (Continued) 6. Current Water Resource Conditions (USGS): MonthNear Range: ❑ Above Normal ❑ Normal ❑ Below Normal 7. Other references reviewed: C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 9 8/21/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): reserve area 2. Land Use woodland 3-8 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) leaf litter Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 28 inches elevation Corcoran Test Pits 9-10.doc-rev.10107 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 Commonwealth of Massachusetts Cityrrown of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 9 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Cobbles& Structure Consistence Other Depth Color Percent Gravel Stones 3 O 11 A 10YR4/4 FSL 28 B 2.5Y7/6 FSL 66 C 2.5Y7/3 28 FSL 66+ REF Additional Notes: Corcoran Test Pits 9-10.doc•rev.10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 10 8/21/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): reserve area 2. Land Use WOODLAND (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) LEAF LITTER Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: TILL Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 41 inches elevation Corcoran Test Pits 9-10.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 2 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) obbles& Structure Consistence Other Depth Color Percent ravel Stones (Moist) 3 O 7 A 10YR4/4 FSL 28 B 2.5Y7/6 FSL 60 C 2.5Y7/3 FSL 60+ REF Additional Notes: Corcoran Test Pits 9-10.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 _ 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: ❑ Depth observed standing water in observation hole A. B. inches inches El Depth B.Depth weeping from side of observation hole inches inches ® Depth to soil redoximorphic features (mottles) A. 28 B. 41 inches inches ❑ Groundwater adjustment(USGS methodology) A. B. inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level 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? Upper boundary: acnes Lower boundary: 60nes Corcoran Test Pits 9-10.doc-rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover 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 my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. SiSi atr of Soil Evaluator Date Dan MacRitchie, Number 1447 7/24/1996 Typed or Printed Name of Soil Evaluator/License# Date of Soil Evaluator Exam Isaac Rowe N. Andover Name of Board of Health Witness Board of Health Note: In accordance with 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. Corcoran Test Pits 9-10.doc-rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 7 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: Corcoran Test Pits 9-10.doc•rev.10107 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 � Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal MassDEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information Estate OF Regina Bomba Owner Name 303 Abbott Street 38-20-3 Street Address Map/Lot# North Andover MA City State Zip Code B. Site Information 1. (Check one) ® New Construction ❑ Upgrade ❑ Repair 2. Published Soil Survey Available? ® Yes ❑ No If yes: 8/11/08 1:15,840 420/421 Year Published Publication Scale Soil Map Unit Canton fine sandy loam, 3 to 8% slopes SAS-Very Limited Soil Name Soil Limitations 3. Surficial Geological Report Available? ® Yes E] 2/10 1:15840 2428 No If yes: Year Published Publication Scale Map Unit Artificial Fill/Thin Till Geologic Material Landform 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No Within the 500-year flood boundary? ❑ Yes ® No Within a velocity zone? ❑ Yes ® No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Unit Name Corcoran Test Pits 11-12.doc-rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 1 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information (Continued) 6. Current Water Resource Conditions(USGS): Month/Year Range: ❑ Above Normal ❑ Normal ❑ Below Normal 7. Other references reviewed: C. On-Site Review (minimum of two holes required at every proposed primary and reserved disposal area) Deep Observation Hole Number: 11 8/22/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): Primary area 2. Land Use woodland 3-8 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) leaf litter Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: till Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock Z Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 39 inches elevation Corcoran Test Pits 11-12.doc-rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 11 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Structure Consistence Other Depth Color Percent Gravel Cobbles 8 Stones (Moist) 3 O 10 A 10YR4/4 FSL 27 B 2.5Y6/6 FSL 66 C 2.5Y6/4 39 FSL 66+ REF Additional Notes: Corcoran Test Pits 11-12.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 12 8/22/13 Date Time Weather 1. Location Ground Elevation at Surface of Hole: Location (identify on plan): primary area 2. Land Use WOODLAND (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones Slope(%) LEAF LITTER Vegetation Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other feet 4. Parent Material: TILL Unsuitable Materials Present: ® Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ® Bedrock 5. Groundwater Observed: ❑ Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 37 inches elevation Corcoran Test Pits 11-12.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 4 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number: 2 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil Soil Depth(in.) Layer Moist(Munsell) (USDA) Structure Consistence Other Depth Color Percent ravel Cobbles 8 (Moist) Stones 3 O 8 A 10YR4/4 FSL 32 B 2.5Y6/6 FSL 65 C 2.5Y6/4 FSL 65 REF Additional Notes: Corcoran Test Pits 11-12.doc-rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 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: ❑ Depth observed standing water in observation hole A. B. inches inches ❑ Depth weeping from side of observation hole A. B. inches inches ® Depth to soil redoximorphic features (mottles) A. 39 B. 37 inches inches ❑ Groundwater adjustment(USGS methodology) A. B. inches inches 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level 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? Upper boundary: 10 inches inches boundary. 66nes Corcoran Test Pits 11-12.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8 Commonwealth of Massachusetts City/Town of North Andover d 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 my soil evaluation, as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. Si9 nature of Soil Evaluator Date Dan MacRitchie, Number 1447 7/24/1996 Typed or Printed Name of Soil Evaluator/License# Date of Soil Evaluator Exam Isaac Rowe N.Andover Name of Board of Health Witness Board of Health Note: In accordance with 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. Corcoran Test Pits 11-12.doc-rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 Commonwealth of Massachusetts City/Town of North Andover Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: Corcoran Test Pits 11-12.doc•rev. 10/07 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8