HomeMy WebLinkAboutCertificate of Compliance - 295 FOREST STREET 7/19/2001 TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
7/19/01
This is to certify that
the individual subsurface disposal system
constructed (X) or repaired ( )
by
William Sawyer
at
295 (Lot B) Forest Street
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
Board of Health Inspector
6 q
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INS'T'ALLATION CERT'IFICAT'ION
The undersigned hereby certify that the Sewage Disposal System(tconstructed;
( ) repaired;
by
located ata ,) eh
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit # , , dated Kn , with an approved 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.
Bed inspection date:
nginee Representative
r
Final inspection date: ,.,��' e e'/ ," .1
�. Engineer kepre fif ative u
µr
.,,
Installer: A,41 �� ����� Lic.#:, " ° Date: ,-/) �
r .� � .� ,
Design Engineer: r,� .�°'� �' � �, � �` .�� Date. ��
1 3
o
AS-BUILT CHECKLIST
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
i
LOCATIONS OF DEEP HOLES &PERC
TESTS
J, 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
Goo 68B '�"".A'u 2
-a,eef-wy ( 'T'FOR S rric yS 5
Yes NU
A pcAwm of Bed
APB he "
Wig, 'B 1 ml C r
'Tom f()Undati .
w
wa41 lNeight and width as specified
3, wall ry d�r l wve
4. wall 1'" $ ,Aj%,Mk.,..�.w.I-.
Sewer
e-»
C. }�aticltra _
,w
g
4
. r
A. 6 T'9 I Y 6+tank
sl minimum d 11 of
y _�. .
7. PIS l"ca czrc u» ,<r �°W__ _ _ � .. _
aI1 a L9tl1 wP °_
H. " a _ ;
7. water I, 1 n, ril eC to liras �.
U. awpkm
' _ I.�� It _.._..°w_ .. n°,•.,...-...,
b&ME Presmo t cta fill
4. MMIJI0W tO Vww _ -
awh We
r 1 #c %yaisrl I2"' invert
m —°
9, outlet Ii to -
ai, exr raaWlt ✓ _
1�. r;etk is c
_ .r
NIPrth Andover Coo. Dev .. 508 688 9542 P .03
0 — _1fi. ► r.�
V 1 v `--F1`U c-j V 4
Yes NU
E. { fr is paw wide 6'°of'r�"stone Il[ad a
2. Mubmuln 2"pipe to d4m if gwity Nyawn
4. Tank Wt
g- Check valve and b hole PFOMU '�-
9. AJAM in butildinS on seqmraW c► it
10. Alum functions � a
►t. man t ea
t
1. level s _
2_ Minimum 0.1r(r)drop from Intel to AulacE —
3. MinlInunk 6..MnP
4. (hat»pt �1vaa cya�fta.., w......
6e`'nr }taalenth box
All ?illy emented with hydraulic CeMeOt
S. Schedule 40 pipe t
Comments:
FA_ Soi!Abeorodcft SYsdefn
1. Ali ® lo- h9d •,- - s fa'
s.��..�
nfnon ems above diwibution.lines
RRin;rntim 6°°"a beneath pipe
4. DisbibutiM Unft ORPOM or COMWded tog 'lam
3:1 skspe A
6. AftgMtjM of V- nc lua W ....°-
�._. :<a:xan�Sa Crfam Mae of . if nca,theft lc•
Ue v
hL tech Tratches -
t, iviinimtmu
th of . ( lAaa t04') -
3. W7,aq!of trenches a m with plan–Minittlton 2';maximum—4`•
4, Vent PFCWM if<50 Or$ fked --
5. Distance bCONOM Omches m ntmum Y UL4 aaaa;�..n....nP
--- s
A— 10,
6. MinIMUM dilg=ce
® a a s n6A ,rh�c
below QAatleg i"VM Minilnwn of6", —
Jun-14-00 10:02 Nov-It r Andover Com. Dev.. boa Gag 9542
Pe04
Yes NO
9, pipes se an stable
T�A.. —..— lanoth of field 100'
I- vip-A sl T minimum 0.005 or 6"per 100'
4. pipes Dounected at end o--
5. Sepgr&fton bCC4AM UQJ"VUt AlCk s 10, uaiaaea:. ;
.:>
a_ ripim JB88 Vet
matron frnm edge of Reid to rxrst Line
2 rV m;mum two distribution lines -
9_ MwdMUM OM WC 20 MO �
Comments:
i 6--,Alin®P15
t_ Min Mum inlet pipe 4-
2. Pim of co=etc
3. SideWall tftweM 14 ate -*a sec --
4. ACC OW MAFUVai6a
K. r t"I%A
miP11Slurn 0.02 \ ...
y a it by at least.9"soil
3, cover soil of stOnes lzrgGr thmn b"
4. GnMjWS slopes swRy dwetift / —�--