HomeMy WebLinkAboutCertificate of Compliance - 30 STANTON WAY 5/22/2014 e .
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PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
IC A
COMPLIANCE
As 4 5/22/1
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
System Complete Construction of an
On-Site Sewage Disposal
By-, Matthew Manning
At:
Andover,30 Stanton Way '(lot 7)
Map Lot
North MA 01845
The Issuance of 111s,cd ificate shall not be construed as a guarantee that the system will function satisfactorily.
If '
is ele Grant... ;
Public Health Agent
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover,com
Sri •
North Andover Health Department
(ommunity Development Division
QNSITE WASTEWATER SY T M CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 30 Stanton Way MAP: LOT: Lot 7
INSTALLER: Matthew Manning
DESIGNER: Christiansen & Sergi Inc.
PLAN DATE: 6/17/13 (revised)
BOH APPROVAL DATE ON PLAN: 6/18/14
INSPECTIONS
TANK INSPECTION: 5/13/14
DATE OF BED BOTTOM INSPECTION: 5/8/14
DATE OF FINAL CONSTRUCTION INSPECTION: 5/16/14
DATE OF FINAL GRADE INSPECTION: 5/19/14
SITE CONDITIONS
® Contractor reports any changes to design plan
N/A 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
N/A 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
#1 BM = 118.59 #213M = 124.93
HR = 8.66 HR = 3.04
HI = 127.25 Hl = 127.97 (#2)
SYSTEM ELEVATIONS
ROD AS-BLT INVERT DESIGN INVERT
ELEVATION ELEV ELEV
Benchmark
Building Sewer OUT 1.98 (#2) 125.64 125.00
Septic Tank IN 2.74 (#2) 124.88 124.56
Septic Tank OUT 2.32 124.58 124.31
Distribution Box IN 3.92 122.98 122.90
Distribution Box OUT 4.10 122.80 122.73
Lateral 1 TOP 4.19
Lateral 1 INVERT 122.71 122.63
Lateral 2 TOP 4.95
Lateral 2 INVERT 121.95 121.91
Lateral 3 TOP 5.85
Lateral 3 INVERT 121.05 121.16
Top of Chamber
Bottom of Bed/Chamber 555/639/716 121.70/120.86/120. 121.70/120.95/120.2
09 0
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 10 101
® 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
6 M1Ax q ( MAY �'
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(I lE 01[gj i f)t) �fiil lJj if iJ� i�
PUBLIC WEALTH DEPARTMENT
(ommunity Devolopment Division
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System O constructed;( )repaired;
(Print Name)
Located at: C7f 14 - 7 S czj C U ' wa
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
5 L-7 2O /--5 and last revised on 6 Z 7! 2'oz--3 ,with a design flow of
411-10 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,
Bottom of Bed Inspection Date:
Engineer Representative(Signature)
And—Print Name
Final Construction Inspection Date:
Engineer Representative(Signature)
And—Print Name
Installer: �"'(�° V �„�� '° ���
������..-°�.,�-� (Signature) Date: ��� 2 _
And—Print Name
Enginer: Signature) Date: ~— � a� 2 6)
l,'r
And—Print Name
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthanclover.com
Town of North Andover ® Se tic rste AS-BUILT CHECKLIST
1) �/ All changes to the design plan have been reflected on the as-built
2) Vr Is of suitable scale; (one inch = 40 feet or fewer for plot plans and one inch= 20 or fewer for details of systeln
components)
3) Lot number,Street Name,Assessors Map and Parcel Number
4) Lot Liles and Location of Dwellings served by the system
5) Locations,Elevations and Dimensions of system,including reserve (if applicable)
6) ° Ties to dwelling or Permanent Structure &Wells
a. From Septic Tank &Distribution (D) Box
' b. From Leach Area
7) Ties to Lot Lines from leach area
8) Locations of Deep Holes &Peres
9) "Fop of Foundation Elevation
i
10) Locations of Wells,Drains,Watereourses within 150 feet of system
11) Location of water,gas,electric lines,cable
12) 's/ Location of Structures within 6 hlches of Finished Grade
13) 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, covernratezial;exposed component covers etc.,shown ost
this as-built substantially agree 147ith the approvedplan and have determined that the break out
elevations,if applicable,have been met."
Signature of Designer Date
b. "If a STUCTURAL 147ALL IS PRESENT(NA 4.9)a Letter or statement on the as-built indicatigg t1l
wall- was or was not consh-uctedin accordance with the intended design and any manufacturer's
is if cations."
Signature of Designer Date
As of;Tuesday,July 30,2013