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Home My WebLink AboutCertificate of Compliance - 502 WINTER STREET 8/6/2009 01 NORTH OL O '' 1- 70 IL O coc"h ..1-V1 A_ R^T E O Pl? (� 7�SSA C HUS�� PUBLIC HEALTH DEPARTMENT Community Development Division C1FRT[FIC.A(2 OF COM'GIANCE As of: August 6, 2009 This is to certify that the individuaCsu6surface dzsposafsystem received a SATISTAC7ORT INSTECTION of the: Compkte ftair1ftp&cement of the Septic Disposa[System By: David2Undred At: 502 'W nter Street 9Wap 104.A; CID arcel—78 .North Andover, MA 01845 The Issuance of this certiftcate shaCC not 6e construed as a guarantee that the system wiff function satisfactorify. F F Susan Sawyer 1Pu6 iCc%eafth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com TOWN OF NORTH ANDOVER aoerT#j Office of CON[,NIUNIT'V' DEN'EL.OPNIENT ,kND SERVICES ��ab,l�•° :°;"oo HEALTH DEPARTMENT (( II&„J � 'OSGOOD STREET Y ^,_ ,II! N'ORTH ,kN, DOVER, %v1ASS,kCHUSETTS 01845 AC14US ItTS � � A 978.688.9540-Phone yer, REHS/RS 978.688.8476-FAX - P U'r"-Hl Director E-MAIL: healthdeot,iztownofiiorthandover.com WEBSITE:http:',www.townofiiorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM ® INSTALL,ATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (constructed; ( ) repaired; (Print Name) located at e W, r- ' (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated '// 9 and 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 1 5.000, 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. " Bed inspection date: / ge Engineer Representative(Signature) And-a'rim'Name Final inspection date: .. .,/ . ^ 7.�"� .m.. ...,.... Engineer Representative(Signature) And- Print Name r Installer: - _ (Signature) Date:_�� And- Print Name F'nginE�r .� ; ..� ..... (Si �1r"' to t n" And-Print Name omu IvONM M January 14, 2009 North Andover Board of Health Susan Sawyer, Public Health Director 1600 Osgood Street, Bldg 20, Suite 2-36 North Andover, MA 01845 RE: 502 Winter Street (Permit#BHP-2008-0216) Dear Ms. Sawyer: Due to weather conditions we are unable to loam over the septic system. We will do so as soon as weather permits in the spring. Sincerely, David A. Kindred 1!k'd ?fA!fiAN KJVEi'.R :... 's f C d DE AR Mo,M ll.V^4 F Susan Y. Sawyer Health Director North Andover Health Department 1600 Osgood Street Building 20; Suite 2-36 North Andover, MA 01845 February 1.6, 2008 Dear Ms. Sawyer: As owners of the property at 502 Winter St.,we are requesting a certificate of compliance. The septic system has been backfilled and final graded. However, due to weather conditions, the loaming and seeding have not been completed, and have not been inspected by the Board of Health. We take full responsibility for the completion of same in the spring of 2009. Thank you, V4A Tracy and Kyle Vogt 270 Canal St. #416 Lawrence, MA 01840 'TOWN O NORTA ANDOVER Office of COMMt.]NI'I'N'F DEVEI.,OPMEN'I' AND SERVICE,''S 1iEA1.,TH DEPARTMENT' 1600 OSGOOD STREET, Building 2--36 '4 NOR,rf] ANDOVER, MASSAO IUSE'rTS 0 1845 cm SLISMI Y. Sawyo-, REHS/RS 978.68&9540-- Phone PUblic I lealth Director 978.68U476- FAX QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS. A MAP: LOT: INSTALLI DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OFFINAL GRADE INSPECTIO 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 F-1 Weep hole plugged [q,-"-"`1' 500. gallon tank has been installed H-10 loading Monolithic construction F-1 Watertightness of tank has been achieved J, (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 port F-1 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 F-1 Hydraulic cement around inlet & outlet Wastewater System Documentation-Feb 2006 Page I of 6 TOWN OF NORTH ANDOVER Office of COMMUNrry DEVE1,0PMENTAND SERVICES 14EA1,'1'H DEPARTMENr 1600 OSGOOD ST'RFTT; Building 2-36 NORTH ANDOVER, MASSACHUSETT'S 01845 3$ US Susan Y. Sawyer, REJIS/RS 978.688.9540 Phone PUNiC Health Director 978,688.8476 FAX Comments: PUMP CHAMBER F-1 Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: F-1 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) F-1 Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base F-1 Alarm float working F-1 Pump On/Off floats working ❑ Separate on/off floats F-1 Drain hole in pressure line F-1 24" inch cover to within 6" of final grade installed over pump access port F-1 Water tightness of tank has been achieved Visual testing F-1 Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY F-1 Type of treatment device: F-1 Installed per manufacturers requirements F-1 All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 TOWN OF NORT11 ANDOVER 2-4 P Office of COMMUNFIN DEVE1,01"MEN'r AND SERVICES 0 1-1EALTH DEPARTMENT 1600 OSCMD STRF'1FA`, Building 2-36 NORTH ANDMER, MASSACI-JUSE."T"I'S 01845 ITS Susan Y. Sawyer, REHS/RS 978,68&95,111 Phone Public Health Director 978.68&8476._..FAX D-BOX F-1 Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets F-1 Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM C �1' _ ll Bottom of SAS excavated down to soil layer, as provided on plan Size of SAS excavated as per plan B-....Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed F-1 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan F-1 Elevations of laterals installed as on approved plan F-1 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) r_1 Final cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 TOWN OFNORTI-1 ANDOVER Office of COMMI.A[TY DEVELOPMENTAND SERVIC'ES 11EAt,'TH DEfkART'MENT' 1600 OSGOOD s,rREEJ`, Building 236 NORTH ANDOVER, MASSACHUSE,"I"I'S 0 1845 04' SUSMI Y. Sawyer, RL"FIS/RS 978,688,9540- Phone Public Health Director l978A8,8476 FAX ,4 119soll?; QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: MAP: LOT: 'j INSTALLER: DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: '47 � ❑°� 60 14&1K > DATE OF BED BOTTOM INSPECTION x/ DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS El 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 F-1 Outlet tee (gas baffle or effluent filter) installed, centered under access port F-1 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 F-1 Hydraulic cement around inlet & outlet Wastewater System Documentation-Feb 2006 Page I of 6 TOWN OF' NORTH ANDOVER Office, of(I)MMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMEN'r 1600 OSGOOD STRET'J; Building 2-36 NORTH ANDOVI...R, MASSACHUSET'I'S 0 1845 04 Susan Y, Sawyer, RE14S/RS 978A&9540-- Phone Public Health Director 978,688.8476- FAX Comments: PUMP CHAMBER F-1 Bottom of tank hole has 6" stone base ❑ Weep hole plugged F-1 Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) F-1 Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base F-1 Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats F-1 Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY F-1 Type of treatment device: F-1 Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation-Feb 2006 Page 2 of 6 WANDOVER Offie of COMMUNV DEVELOPMENTANI) SERVICES 'A. ., 'H DEPARTMENT 1600 OSGOOD STMTT; Building 2-36 NORTH AND0V1.,-,R, MASSM-1 1USIll"I'S 01845 Susan Y. Sawyer, RE FIS/RS 9'7&688,9540 Phone Public Health Directol, 978,68&8476 FAX D-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: SOIL ABSORPTION SYSTEM Q" Bottom of SAS excavated down to soil layer, as provided on plan o Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan F-1 3/4-1 1/2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed F-1 Laterals installed and ends connected to header F-1 Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan F-1 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Wastewater System Documentation-Feb 2006 Page 3 of 6 T'OWN OFNORTH ANDOVER ac Office of COMMUM'"rY DEVEIMMENTAND SERM ES HEALTH DEPAR"I'MENT 1600 C) GOOD STREET,- Building 2-36 NORTI I AN DOVER, MASSACI II.JSETTS 018 5 04 Susan Y. Sawyer, RFJIS/RS 978.688.9540 Phone Public Health Director 978M&8476- FAX PRESSURE DISTRIBUTION F-I -- inch manifold F-I laterals installed with end sweeps size: material: ❑ Squirt test ft in height F-I Equal distribution to all laterals F-I orifice size inch as per plan Comments: CONTROL PANEL F-I Alarm & Pump are on separate circuits F-I Alarm sounds when float is tripped F-I Location of control panel: F-I Rated for exterior if placed outside Comments: Wastewater System Documentation-Feb 2006 Page 4 of 6 TOWN OF NORTH ANDOVER E. Office ot'C'OMMUNITY DEVELOPMENTAND SEAZVICIt'S qm .'k 0 HEALI'l-I DEPARTMEN'r 1600 OSGOOD STRETIT; Btjilding 2-36 NOfU1 I ANDOV't"1�, MASSACHUSETTS 011145 AC� Susan Y. Sawyer, REHS/RS 978 6W9540- Phone Public Health Director 978,688.8476- FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ❑ Property line 10 10 R Cellar wall 10 20 El Inground pool 10 20 ❑ Slab foundation 10 10 F-I Deck, on footings, etc 5 10 -- ❑ Waterline 10 10 101 F-I Private drinking well 75 1002 50 F-I Irrigation well 75 100 F-1 Surface Water 25 50 F-I Bordering Vegetated Wetland Salt Marsh, Hand/Coastal Bank 3 75 100 F-I Wetlands bordering surface water supply or trio, (in Watershed) 150 150 F-I Trib. to surface water Supply 325 325 F-I Public well 400 400 F-I Interim Wellhead Prot. Area F-I Reservoirs 400 400 ❑ Drains (wat, SUpply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other) Foun(lation 10 (5) 20(10) F-I Drywells 20 25 Suction line 222(2) 2 100 feet is a minfinum 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,PLII'SLiant to 15.211(3), also by NA wetland bylaws wastewater System Documentation-Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER oRT01 ,!2 0 Office of COMMUNITY DEV'EL,OPMENTAND SERNI(,,,I��,,s HEALM-1 DEPARTMEN't' 1600 OSGOOD STREET; Budding 2-36 NORTH ANDOVER, MASSACHUSEITTS 01845 &SC Susan Y. Sawyer, REIIS/RS 978M&9540 Phone flubfic Health Director 978.688,8476 FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6 FINAL =GRADENSP CTI ON Date: Address: GAMED? SEEDED? ❑ COVER PER PLAN? Other:' Appendix A - System Installation Form In accordance with the technology approval, for each new installation, installers of Eljen systems must complete and fax or mail a copy of this form to the local approving authority and to: Eljen Corporation 125 McKee Street East Hartford, CT 06108 Installer's Name: Company Name: Street Address: City: State: Zip: Property Owner: Site St et Address: I / 1 2 City: / State: Zip: /V 5�vs System Type: (Residential, Commercial, School, etc.) Design Flow: Installation D te: System Starttu)-Date: ad P� d o?oG Permit Number: Comments: COPIES: White System Owner Yellow Local Approving Authority Pink Inspector Gold Massachusetts Department of Environmental Protection 0730A-4/07-IM-CP t%/tai a fir c h ��an d a N—,IP, r 4, k� �'maimt IfBdQNC Q 9 VVV3 vend V'4 Gmn nf, r�Baulk"Ant. February 12, 2009 FEB 23 2OBJ North Andover Board of Health TOMy� OF WAN,11 r_ �w��s��vF: , 1600 Osgood Street HEAL, �a�.r r a��IL Suite 2-36 " North Andover, MA 01845 RE: 502 Winter Street, Sanitary Septic Disposal Systern Dear Members: As required in Section 2.10 of the Town of North Andover's Minimum Requirements for Subsurface Sewage Disposal, I am hereby certifying that the septic system at 502 Winter Street has been constructed in compliance with town's requirements, the State Environmental Code 31.0 CMR 15.000, and the approved design. The materials used to const:ruct the system conform with the plans specifications and the final grading has been completed in substantial conformance with the proposed design. The submitted as-built depicts the actual elevations and location of the system's (-.eo mponents as well as the pertinent features of the site existing to date. Please do not hesitate to call should you have any questions. Sincerely, Marchlonda & Associates, L.P. d ti ., JOHN A. BARROWS Jahn A. Barrows, PE � Project Manager g Cc: David Kindred A 'o s„s ”" mmnrArw,m 41A, � �sx (x`81) f�:,+ r;he�7a umwuu�u.,mdm„: °m�r:s./�unsmrurma,m�m om fi umm . .,a« u tmmm��V umoezu� � �i.�maoUru umuu��rte.R�reP�u i AS-BUILT CHECKLIST RECE IVED TOWN 01:NUTT)I ANDOVER LOT NUMBER, STREET NAME HEAL tRt �MjK4,` 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 o% ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE t/ DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK & D-BOX ORIGINAL STAMP& SIGNATURE IMPERVIOUS AREAS e DRIVEWAYS, ETC. --' NORTH.ARROW . LOCATION &ELEVATIONS OF BENCHMARK USED