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Home My WebLink AboutCertificate of Compliance - 31 GRAY STREET 4/17/2007 of: U) QXIII(y that the WhtidrQat,^,ufssurlice daqwhaf,�ptell', trce"'u.e f a. w.. 111"�°i t,? I q � pair i? f Met�r `/she f"",a'k olue a➢f IS !en4i',(lad/" ..",b a'fi lw/ be d Tl ."`C`;R`kPL'li (-.is a {ua/%!I an<.e dial the 'wilf e 3600 flu^rgawmi xrHoen Muw lh,@BbrUawm`,Mus saal usmis U1801i Phone 9l'K6083540 fox 918 4HR A416 M w wwnr w wumNaw4@aowA'rueump tk07P'' � rcr� � 7'1 �v„��,ry r.0.i•gaa Af PUBLIC HEALTH DEPARTMENT I /I (I f fl fell Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned h age Disposal System( )constructed;( )repaired; un er By. -� hereby certify that the - - - - (Print Name) Located at: N,..• Nation A/ u N - -------- - Ins Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated '�)I NA'- 2,006 and last revised on �with a design flow of ,C 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 n._ the As-built which has been submitted to the Board of Health. Bottom of Bed Inspection Date: g' 1 ive(Signature) rneer Re Tres entat" And— Print Name d Final Construction Inspection Dater gineer Represe i—fi ive(Signature) n And—Print Name Installer: ,� ��f� �. (Signature) Date: o -- r t t �'t And—Print Name Enginer:�- w' '"," (: (Signature) Date: °� xL dCtil ! �y And—Print Name y r �yv � i 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 970.688.9540 Fax 978.688.8476 Web l ittp://www.townofnorthcindover.coiii N.Andover Health Department facsitmle transmitbI To: Kevin Borselli Fax: 800 866-1471 From: Susan Sawyer,Health Director.,`"` ' 5/2/2007 Re: 31 Gray Street �� Pages: 2 CC: 0 Urgent ®For Review 0 Please Comment 0 PWm Reply ® Please Recycle Mr.`_Boreselli, P find the attached checklist for the As-buitt submitted for 31 Gray checked of the missing items that North Andover's local regulations require. The ties or a schedule of ties must be on As-built to the center of the tank and D-Box. I was also unable to locate the BM used.I would appreciate it if is there that you highlight it for me.All other items necessary were identified.I appreciate your cooperation with this matter and look forward to closing this project. Thank you . . . . . . . . . . . . . . . . . . . . . . . . . . . AS-BUILT CHECKLIST LOT NUMBER, STREET NAME w w ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES &PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D-BOX ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW LOCATION & ELEVATIONS OF BENCHMARK USED I 10 WINN STREET, Suite 209 WOBURN, MA 01801 (781)937-9947 (800)866-1 471 (fax) 06 July 2007 North Andover Health Department 1600 Osgood Street l Building 20, Suite 2-36 North Andover, MA 01845 'OU 1 OVV�,�OF I!E)hr1�1�, R ,,rl :4 Attn: Michelle Grant 11L P 7111 Subject: Septic System Repair 31 Gray Street Revised AS-BUILT Plan submission Dear Ms. Grant: Please find attached three (3) copies of the REVISED "As-Built"plan for the subject project. Based on your comments, we made the following changes: I. Noted that the top of the foundation was utilized as a vertical bench mark. 2. Inserted dimension ties from the corners of the structure to the d-box and the septic tank. If you have any questions or comments regarding this submission, please do not hesitate to contact this office. Sincerely, XM/nR. Borselli,PE Borselli Engineering & Development, Inc. CC: Bill Penny—Andover Renovations, Inc. 1 I 10 WINN STREET, Suite 209 WODURN, MA 01801 (781)937-9947 (800)866-147 1 (Pax) �r 03 April 2007 North Andover Health Department 1600 Osgood Street Building 20, Suite 2-36 I North Andover, MA 01845 f Attn: Michelle Grant i`f)Il f r 1 Subject: Septic System Repair 1 31 Gray Street AS-BUILT Plan submission Dear Ms. Grant: Please find attached three (3) copies of the"As-Built"plan for the subject project as well as a partially filled out"Certificate of Compliance". I would like to apologize as this as-built was completed some time ago, however, apparently they were not forwarded to your office due to an administrative problem. If you have any questions or comments regarding this submission, please do not hesitate to contact this office. Smceiely/ f �ev'i R Botsel Borselli Engineering & Development, Inc. CC: Bill Penny—Andover Renovations Inc. 4w. iE. G � „ ✓ .- 1 4 � F Commonwealth ®f Massachusetts F� City/Town of NORTH ANDOVER Certificate of Compliance y: Form 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. This is to Certify that the following work on an On-Site Sewage Disposal System Important: When filling out ❑ Construction of a new system forms on the ® Repair or replacement of an existing system computer, use ❑ Repair or replacement of an existing system component only the tab key to move your cursor-do not Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): use the return key. DSCP Number DSCP Date CHARLES JENKINS -. --- -- Facility Owner 31 GRAY STREET e" Street Address or Lot# N. ANDOVER MA 0 City/Town State Zip Code Designer Information: KEVIN R. BOA RSELLI_,P...E- Al BORSELLI ENGINEERING & DEV., INC. Name - Name of Company 04iO3i07 Si u �„ Date — -- ...--------- Installer Information: — - — ----- -------- --... Name Name of Company .....-..__...--- ---------------------------------- Signature Date Use of this system is conditioned on compliance with the provisions set forth below: NO GARBAGE DISPOSAL The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. N. ANDOVER BOARD OF HEALTH Approving Authority -- --... - Signature Date t5form3.doc•06/03 Certificate of Compliance•Page 1 of 1 oRT#j r° Argo U PUBLIC HEALTH DEPARTMENT fommunity Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 31 Gray Street MAP: d 6 LOT: INSTALLER: Bateson Enterprises DESIGNER: Kevin Borselli PLAN DATE: May 31, 2006 BOH APPROVAL DATE ON PLAN: November 20, 2006 INSPECTIONS TANK INSPECTION: _ DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 12/11/06 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ® Inlet tee installed, centered under access port ® Outlet tee (gas baffle or effluent filter) installed, centered under access pork 1600 Osgood Street,North Andover,Mossochosetts 01645 Phone 478.688.9540 Fox 979.688.8476 Web www.townofnorthandover.coni ttORTPI g iK 16 c.eairt a UC PUBLIC HEALTH M Community Development Division ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ® Hydraulic cement around inlet & outlet Comments: Septic tank dropped slightly to incorporate additional sewer waste pipe not shown on plan. Still maintained 1% slope from septic tank out to ®-box in, 12-11-06. DISTRIBUTION-BOX ® Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: Rubber seals used in place of hydraulic cement. 12-11-06. SOIL ABSORPTION SYSTEM (General) ❑ Bottom of SAS excavated down to 6 in into C soil layer, as provided on plan ® Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Infiltrator Standard ® Number of chambers per row_12_ ® Number of rows (trenches) 5 ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978,688.9540 Fox 978,688,8476 Web www.townofnorilrandover.coni t4OR141 *'N °'q r PUBLIC HEALTH DEPARTMENT Community Development Division SYSTEM ELEVATIONS INVERT IN FIELD PLAN INVERT ELEV. Distribution Box IN 95.82 95.77 Distribution Box OUT 95.66 95.60 Building Sewer Out #1 98.27 Building Sewer Out#2 96.78 Septic Tank In #1 96.66 96.75 Septic Tank In #2 96.65 96.75 Septic Tank Out 96.34 96.50 Lateral 1 INV 95.41 95.41 Lateral 1 TOP Lateral 2 INV 95.41 95.41 Lateral 2 TOP Lateral 3 INV 95.41 95.41 Lateral 3 TOP Lateral 4 INV 95.39 95.41 Lateral 4 TOP Lateral 5 INV 95.39 95.41 Lateral 5 TOP 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townotnorthandover.com fO§®® 216 //4,6, At 0 Are C!s, i PUBLIC HEALTH DEPARTMENT Rmm#|\Development Division 1600 Grk Street,wm Andover,Massachusetts e#; Phone 978.688.9540 U 978,688.8476 +bwwy¥m+Www#rmm FINAL GRADE INSPECT ON Date: �✓,� �.�� ( �'�'"��" ,� ��ff �"""" /�� "N� r� r, ��'�„�� Address: 6 , �'”L,OAMED? SEEDED? Ll COVER PER PLAN? Other: ,o i