The URL can be used to link to this page

Home My WebLink AboutCertificate of Compliance - 445 FOREST STREET 6/15/2007 tAORTH O��S�ec ibgti0 OL O ~' IL ^ ,f O 1.1.1c.w11.y7 ATE 0 �SSACHUS�� PUBLIC HEALTH DEPARTMENT Community Development Division CFRTI(V Tr Ar F O F COqq(Pf- T OX( F As of: ,dune 15, 2007 This is to certify that the individuafsu6surface dzsposasystem received a SATISFACTORTINS(EC IONof the: Complete Septic System Repair By� ,john Soucy .fit: 445 Forest Street Wap 106A; Farce( 131 North Andover, 9KA 01845 The Issuance of this certificate shaC not 6e construed as a guarantee that the system will function satisfactorily. lZn awy er, 9 ES/9S Tu6Cic YfeaCth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com TOWN OF NORTH ANDOVER a NoRrw � Office of COMMUNITY DEVELOPMENT AND SERVICES � �� HEALTH DEPARTMENT 400 OSGOOD STREET NORTI-1 ANDOVER, MASSACHUSETTS 01845 978.688.9540—Phone Susan Y. Sawyer,REHS/RS 978.688.8476—FAX Public Health Director E-MAIL: healthdept( townofnorthandover.com WEBSITE: http://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System O construe red,( efpc � by (Print Name) ( (17 located at -me J/. A4. A od � "r l (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated /1,Z601n and last Revised on , with a design flow of 4 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. Red inspection date: ZS .m 4 Engineer Representative(Signature) Vl� And-Print Name Final inspection date: ( "') Engin r Representative(Signature) And- rint Name _ Q� �' . ... Installer: �" � � (Signature) Date: And-Print Name Engineer._g �— — ( --- (Signature) Date: — And-Print Name ty Z. C PUBLIC HEALTH DEPARTMENT (ommunity Development Division QNSITE WASTEWATER SYSTEM CONSTRUCTION NO LOCATION INFORMATION ADDRESS: 445 Forest Street MAP: 106A LOT: 131 INSTALLER: John Soucy DESIGNER: New England Engineering Services PLAN DATE:October 18, 2006 BOH APPROVAL DATE ON PLAN: February 26, 2007 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 5/29/07 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 port 1600 Osgood Street,North Andover,Mossorhusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www,townohorthnndoverarn 4.d R' w 6`I 0 45 SSA U PUBLIC HEALTH DEPARTMENT (ommunity 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: Combination tank 1500/500 gal. septic tank/pump chamber was not full so water tightness could not be verified on 5/29/07. PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ® Combo Tank installed. Size: 2000 gal. (1500/500) ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic 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" 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: Pump chamber had enough liquid (water from a hose) to verify pump operation but not water tightness. 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: 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 418,688.9540 Fax 978.688.8476 Web www,town ofnorthandover.corn %,% °M r C4 oar mlrtaraKKiaoca,w' 6�t9 PUBLIC HEALTH DEPARTMENT (otnmunity Development Division 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 Quick 4 ® Number of chambers per row 8 ® Number of rows (trenches) 3 ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan Comments: CONTROLPAN L ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: In basement ❑ Rated for exterior if placed outside ® Alarm signal located inside Comments: 1600 Osgood Street,North Andover,Mossochosetts 01645 Phone 976.666.9540 Fox 976.666.6476 Web www.townoMorthondover.rorn oOR �t r,. to,l.c K , °4A , f. SA US PUBLIC HEALTH DEPARTMENT Community Development Division SYSTEM ELEVATIONS INVERT IN FIELD PLAN INVERT ELEV. Building Sewer OUT 98.24 Existing Septic Tank IN 97.77 97.40 Septic Tank OUT ________ ____________ Pump Chamber IN ________ ____________ Pump Chamber OUT 97.51 97.15 Distribution Box IN 99.43 99.37 Distribution Box OUT 99.25 99.20 Lateral 1 INV 99.16 99.10 Lateral 1 TOP 99.49 99.43 Lateral 2 INV 99.15 99.10 Lateral 2 TOP 99.48 99.43 Lateral 3 INV 99.16 99.10 Lateral 3 TOP 99.49 99.43 1600 Osgood Street,North Andover,Mosso(husetts 01845 Phone 978,688.9540 Fox 978.688.8476 Wei) www.town0northnndover.tom tAORTH 4"%o, `° � SAC PUBLIC HEALTH AM (ornmunity Development Division CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 1.0 10 -- ® Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 ❑ Deck, on footings, etc 5 10 -- F-1 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 Bank 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)Foun(lation 10(5) 20(10) ❑ Drywells 20 25 1 Suction line 222(2) 2 10 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 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 1600 Osgood Street,North Andover,Mossorhusetts 01645 Phone 976,666.9540 Fox 976,666,6476 Web www.townofnorthondover.rorn %AORT I 4'�' _ •• 0 00 $4 COLNICK� KII�A 0N'AYB0 APB` PUBLIC HEALTH DEPARTMENT Community Development Division QNSITE WASTEWATER SYSTEM T 11 TI NOTES ADDRE LOCATION INFORMATION tL �,T: �� .. 15 I ,. .. INSTALLER: DESIGNER; PLAN DATE: � { > SOH APPROVAL DATE INSPECTIONS ' INSPECTION:TANK DATE OF BED BOTTOM�INSPECTION DATE OF FINAL CONSTRUCTION INSPECTION: 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 `" a, µ' ❑ 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 as baffle or effluent filter installed, centered under access port 1 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688,8476 Web www.townofnorthandover.com NORTI� w- ® g46lD 6. 'IO �"? 4- 11 " 6 O- ®yy w_O�A COCNI[�WK11`y7' ry TID^pP Qy �SSACHU5�� PUBLIC HEALTH DEPARTMENT (ommunity 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: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic 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" 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: 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: 2 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.town0northandoverarn tkoRTH 0 co—K.l WIC.Vq4 & rao 11 aaus�� PUBLIC HEALTH DEPARTMENT Community Development Division SOIL ABSORPTION SYSTEM (General) "" , ❑, Bottom of SAS excavated down to 5 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 II SOIL ABSORPTION SYSTEM (Gravel-leas Chambers) ❑ Brand and Model of Chamber Infiltrator Quick 4 ❑ Number of chambers per row ,w9,. ❑ Number of rows (trenches) ❑ Laterals installed and ends connected to header (and vented if impervious material above) ❑ Elevations of laterals and chambers installed as on approved plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel ❑ Rated for exterior if placed outside ❑ Alarm signal located inside Comments: 3 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978,688.9540 Fax 978.688.8476 Web www.lownofoorthandover.com ttORTH q N y C, ®yh T O COCNIC nIwKM 2 9 4�RATm D 0p��'(y SSACHUS�� PUBLIC HEALTH DEPARTMENT Community Development Division SYSTEM ELEVATIONS INVERT IN FIELD PLAN INVERT ELEV. Benchmark Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 I NV Lateral 1 TOP Lateral 2 I NV Lateral 2 TOP Lateral 3 I NV Lateral 3 TOP Lateral 4 INV Lateral 4 TOP 4 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com FORTH t q61 6 oL O 1� h 70 �yOgA COf MAIN WKw`y^` 7 �RATID PrP �fi> �SSACHUS�� PUBLIC HEALTH DEPARTMENT (ommunity Development Division 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 Bank3 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 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 5 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com AS-BUILT CBECKLIST b a® LOT NUMBER, STREET NAME 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 r LOCATION & ELEVATIONS OF BENCHMARK USED