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Home My WebLink AboutCertificate of Compliance - 517 JOHNSON STREET 11/23/2002 Town of North Andover, Massachusetts Form No.3 BOARD OF HEALTH NORTH Ott« � ee�Yp T �,'•�,,,,o •�"� DISPOSAL WORKS CONSTRUCTION PERMIT �SSACHUS�� Applicant 9AME V ADDRESS TELEPHONE Site Location Permission is hereby granted to Construct ( ) or Repair (1-<an Individual S it Absorption Sewage Disposal System as shown on the Design Approval S.S. No. � CHAIRMAN, BOARD OF HEALTH 17 Fee s° D.W.C. No.� . '�✓ BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: <�7_ lJ ` CURRENT INSTALLER'S LICENSE# LOCATION: LICENSED INST SIGNATURE: c TELEP ONE# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only l� 160.00 Fee Attached. Yes No Project Manager Ob. Yes No Foundation As-Built? Yes No Floor Plans? Yes No Approval Date: /Z INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at 7 C) relative to the application of') /Vdated q for plans by , F and dated Lit— with revisions dated 'J:- �0_ I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must-request the inspection but does not have to be present. b) Final inspection –Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. C) Final Grade-Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work(other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersign icensed Septic taller ® Date: Dispos Works Construct' n Permit �dl Office t�w't Health . tt t"' . 1 Department W ."t1ni trait y I)e'velopment artd Services S 011 77 Charles Street tl'1 5 NCH��r�w, North Andover, Massachusetts 01845 Sandra ' tar!r 1 a:&1ephone( 7' )688-9540 Publia t teidth Director Fax (975)tell 9542 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 11/23102 This is to certify that the individual subsurface disposal system constructed () or repaired (X) by John Soucy at 51.7 Johnson 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. Ole rian . LaGrass.. J e Board of Health Inspector Fed k�4f�'.9:' C.)k l4N"C L9 f 1� •! w N B NNd.D1N"G 6'W(-9.545 CONSFRV TJG"N 688-9530 ��kr�, ➢,TH PrN'0�0540 PLA N%NG 6 -953 r -. ,c � � � o _ � -';•,, ::� ::.. .rid` ,z� ':": - :I '-- y�C' K `-c .��'`._`�' .��~` ::ice ;.. ,} ?;.�..•c,<:' j . r , si ! TOWN OIL NORrfH AiNBOVER SE�V.kGEz DISPOSAI. S). ,-TE1,t I\STAZ. LA-rZON CERTII=ICATION The undersis^ed here_-v certify that the Szewa!2e Disposal System cor.su<<ct:;d-, ( repaired: y by located at 1-7 -_Jv bLL e ------ was installed in conformance with the North Andover Board of Hcrith approved plan; Svstem Deslem Permdt dated: with an aruroved design flow of gallons per day The matenals;usea; were in conformarc•. those specmea on the appirovea plan; the systern was installed in' accordtmu ,bith the provisions of 310 C'NM 15.000, Title 5 and local rei-zalatiors, and the final Qradiri agrees substantially %,6th the approved plan. .ail :Cork- is accurateiv represented or the As-built Nhich has been submitted to the Board c-Health. Beet inspection date: u n;AS.�:,� /0 .(J / 1/ RI ARD Engineer R mi s,=.ative. C. m Final inspect-on /7107- — � G o ngireer Represeniat' e oe5'�rl i. e�/y/J Slp L L:c.T: Date: Date —�. INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initials A. Bottom.of Bed I. Excavation to proper depth 2. With trenches,sides of excavation are beneath B horizon i 3. Edge of excavation specified distance from foundation,etc. Comments: B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed 3. Wall minimum 10'to leaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8"per foot minimum 6. Pipe properly set on compact firm base 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change 10, 10'minimum offset to water line Comments: D. Septic Tank ef 1. Level '. 2. 1,500 gal minimum 3. Gas Gas baffle present on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20"manholes 7. Inlet tee minimum 12"under invert 8. Outlet tee minimum 14"under invert 9. Outlet line cemented 10. Air space 3"above tees 11. 2"—3"drop fi•om inlet to outlet 12. Pipe set 13. Compact base with 6"of 3/4"crushed stone under tank 14. Tank is watertight Comments: E. Pump Chamber Yes NO 1. If separate from tank,compact base with 6"of'14"stone underneath 2. Minimum 2"pipe to d-box if gravity system 3. 20"access manhole 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level 2. Minimum 0.17"(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution 5. Compact base with 6"of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-'/4"- 1 %z" -pea stone ,j Bucket test done? 2. Minimum 2"of pea stone above distribution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not,then swale. - Cam nts: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan-Minimum 2';maximum-4'. 4. Vent present if<50 feet or specified 5. Distance between trenches minimum 4'and maximum of 6' 6. Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". Yes NO 9. Pipes set on stable base. Comments; I. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6"per 100' 3. Separation between pipe 6'maximum. 4. Pipes connected at end 5. Separation between adjacent fields 10'minimum 6. Pipes set on stable base 7. Maximum 4'separation from edge of field to first line j 8. Minimum two distribution lines A 9. Maximum pere rate 20 mpi Comments: I Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12"and 48"wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement i Comments: I K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil _ 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond AS-BUILT CHIECKLIST 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 LOCATION ° S 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 i TANK. & D-BOX w... ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW LOCATION & ELEVATIONS OF BENCHMARK USED