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Home My WebLink AboutCertificate of Compliance - 100 OGUNQUIT ROAD 5/29/2015 • v i I f PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 5/29/15 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: Peter Breen At: 100 01!unq uit Rd. Lot 2 Map 090.A Lot 0076 Nortli Andover, MA 01845 The s uance of this certificate s X11" of be con rued as a guarantee that the system will function satisfactorily. ✓ q Michele Grant ��..._. Public Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnortliandover.com �aarer�� 1 A CHU PUBLIC HEALTH DEPARTMENT Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM-INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System 0 constructed;O repaired; By: Pear Breen (Print Name) Located at: L-0-r - 100 0 v r`a .a 1 t (Installation A dress) Was installed in conformance with the North Andover Board of Health approved plan,originally dated 101110-7 and last revised on 10/z?,/r 4- ,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 acc tely represented on the As-built which has been submitted to the Board of Health. NA AA 0 9 2015 Bottom of Bed Inspection Date: NON 2014 v"), Engineer Representative(Sign 'ture) JoHm M. Psis lc^J And—Print Name Final Construction Inspection Date: perm• 31 w4- ✓`'l., Engineer Representative(Signature) And—Print Name Installer: Mr ° sa` (Signature) Date: 1 +° Pe-ter re_era And—Print Name Enginer: ✓"'l. (Signature) Date: f JO�a� tit. �1� ,►�,1 And—Print Name 1600 Osgood Street, North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com I • d 1 North Andover Health Department Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 100 Ogunquit Rd. Lot 2 MAP:U1'440,A LOT:tJV�C/ INSTALLER: Peter Breen DESIGNER: Neve-Morin Group PLAN DATE: 10/1/07 Rev. 11/22/14 BOH APPROVAL DATE ON PLAN: 10/22/14 INSPECTIONS TANK INSPECTION: 10/29/14 DATE OF BED BOTTOM INSPECTION: 11/3/14 DATE OF FINAL CONSTRUCTION INSPE TION: 11/19/14 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑ Contractor reports any changes to design plan ❑ 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 ❑ Cleanouts per plan X Bottom of tank hole has 6" stone base ® Weep hole plugged X 1500 gallon tank has been installed H-10 loading X Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port i ® Outlet tee installed, centered under access port (gas baffle) ❑ inch cover to within 6" of finish grade installed over one access port ® Hydraulic cement around inlet & outlet (boots) Comments: MRC - Will need cover to within 6" of final grade over one opening of septic tank DISTRIBUTION-BOX ® Installed on stable stone base ❑ H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ❑ Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: MRC —Will need riser on d-box to bring to within 6" of finished grade if there is more than 9" of cover over it, which is likely 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 - 2 piles dropped ❑ 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 ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: 68' length, with overdig L77'xW38'6" FINAL GRADE 'Loamed Seeded Cover per plan . 1 Comments: DOC MENTS NEEDED Certification of Installation Form submitted y engineer and signed and dated by ngineer and installer As-Built Plan BM = 130.38 H R = 5.24 HI = 135.62 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 1.65 133.64 131.2 Septic Tank IN 2.08 133.21 131.0 Septic Tank OUT 2.44 132.85 130.75 Distribution Box IN 126.10 Distribution Box OUT 125.93 Lateral 1 TOP 9.39 125.90 125.93 Lateral 1 INVERT 9.71 125.58 125.60 Lateral 2 TOP 10.39 124.90 124.93 Lateral 2 INVERT 10.71 124.58 124.60 Lateral 3 TOP 10.49 124.80 124.83 Lateral 3 INVERT 10.82 124.47 124.50 SKETCH PLAN 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 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Banl, 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 t 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 .1 own of North over — Septic $ystem - AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected on the as-built 2) Is of suitable scale; (one inch = 40 feet or fewer for plot plans and one inch = 20 or fewer for details of system components) 3) Lot number,Street Name,Assessors Map and Parcel Number 4) Lot Lines and Location of Dwellings served by the system 5) Locations,Elevations and Dimensions of system,including reserve (if applicable) 6) tTies to dwelling or Permanent Structure &Wells a.. From Septic Tank&Distribution (D) Box b. From Leach Area Ties to Lot Lines from leach area 8) Locations of Deep Holes &Peres 9) ZTop of Foundation Elevation 10) Locations of Wells,Drains,Watercourses within 150 feet of system 11) Location of water,gas,electric lines,cable 12) Location of Structures within 6 Inches of Finished Grade 13) 7 Original Stamp &Signature 14) Location and holder of any easements which could impact the system 15) - Impervious Areas;Driveways,etc 16) North Arrow 1 7�_Location&Elevations of Benchmark used 18) STATEMENT ON PLAN (NA 5.3) a. "I certify the locations, elevations, ties, co ver inaterial;exposed component covers etc.,slio"m Oil this a8-built substantially agree WAII the approved plan and have determined that the break out elevations,Yapplicable,have been meL Signature of Designer Date b. "If a STUCTURAL WALL IS PRESENT(NA 4.9)a Letter or statement on the as-built indicating t11 wall- was or was not, constructed in actor dance with the intended design and any-manufacturer's sPecjfjcqtjons. Signature of Designer Date As of;Tuesday,July 30,2013