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Home My WebLink AboutCertificate of Compliance - 45 CRICKET LANE 4/15/2009 NORTH '9 O M ,L y� * C, O COCMIc"awKK V^ ��SSAC HU,-,, PUBLIC HEALTH DEPARTMENT Community Development Division ,CCFR TFIC.ArIE OF CogVj, '.GI. gXCE As of: Aprif 15, 2009 This is to certify that the individual subsurface disposal system received a SATISTACTORTI-AVS(EC7IOJV of the: Tuff System repair of the Subsurface Sewage 1Disposa(System �y� James Kellett At: 45 Cricket .cane Wap 107.,X; ('arcel219 North Andover, CIA 01845 The Issuance of this ceni cate shall not 6e construed as a guarantee that the system will function satisfactorily. .e. "Su�n T SawyerZ 1Pu6fic Yfealth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com TOWN OF NORTH ANDOVER Office of COMMUNITY DGVCL OPMENT AND SERVICES HEALTH DEPARTMENT c OSGOOD STREET NORTH ,ANDOVER, MASSACHUSETTS 01845 SACHUS�a 97088.9540—Phone Susan V.Sawyer, REHS/RS 978.688.8176—FAX Public Health Director E-NIA1L: heaIdidept,a,tow nofnorthandover.com W EBSITE: http:.',w�vw.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM ® INSTALLATION CERTIF'ICATI®N The undersigned hereby certify that the Sewage Disposal System ( ) constructed; ( ) repaired; by i v -e-�l Ck- (Print Name/) located at h/5 - 1 l c �,6:7tv,ZEE (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally M-le dated / M 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 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. ' , r Bed inspection date:_ r �2— L Engine Representative( atur ) And- Print Name Final inspection date: 12—) �� _ 0 `- ngineerApresentative( ature) And- Print Na Installer: (Signature) Date: �...� ,krill Print Name Engineer. (Signature) Date: And-Print Name elleChiaie, Pamela Subject: Septic-45 Cricket Lane Start Date: Wednesday, April 01, 2009 Due Date: Thursday, April 02, 2009 Status: Waiting on someone else Percent Complete: 50% Total Work: 0 hours Actual Work: 0 hours Owner: Ben Osgood 4/17/09 Hi Ben, If you are talking to Jim, please remind him of this. Thanks.--Pam ------------ 4/l/09—Ben.Osgood signed installation certification form today. Jim Kellett will be in tomorrow to sign. Left h/o—Mel Robbins a voice mail—978.535.3420 to let him knew once I have that signature,I can issue a COC:p.d. i Commonwealth of Massachusetts i City/`town of Q0, � � Certificate Compliance Form 3 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. This is to Certify that the following work on an On-Site Sewage Disposal System Important: When filling out ❑ Construction of a new system forms on the ® Repair or replacement of an existing system computer,use ® Repair or replacement of an existing system component only the tab key to move your cursor-do not Has been done in accordance with Title 5 and the Disposal System Construction Permit (DSCP): use the return key. DSCP Number DSCP Date Q Facility Owne H S_ yjj ka Street ddres Lot# 1 .. A 6121 City/Town State Zip Code Designer Information: Benjamin C. Osgood Jr., P.E. New England Engineering Services, Inc. Nam Name f Com any 1® 4 Si re T 7 Date Installer Information: Name Name of Company Signature Date Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc•06/03 Certificate of Compliance•Page 1 of 1 Y I A S-BU-IL I' 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 LOCATIONS OF DEEP HOLES &PERC TESTS _ ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 1 SO' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX ORIGINAL STAMP & SIGNATURE t' IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW � ` LOCATION & ELEVATIONS OF BENCHMARK USED elleChiaie, Pamela From: Marianne Peters [mpeters @millriverconsulting.cam] Sent: Wednesday, November 05, 2008 10:41 AM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Grant, Michele; DelleChiaie, Pamela; 'Randy Burley'; Sawyer, Susan Subject: Construction Inspection Report-45 Cricket Lane Attachments: Construction Inspection Rpt-45 Cricket Lane.doc Attached please find the construction inspection report for 45 Cricket Lane. Please call if questions. 19., Marianne Peters Office Manager ph 800-377-3044 ph 978-282-0014 fx 978-282-0012 web: www..mitl.rivei:ccatisutt.itig.coiii. 1 off` 't'�-60 ,,,a std 0 6 o r a cotmteewamK. +• � Ira PUBLIC HEALTH DEPARTMENT Community Development Division ONSITE WASTEWATER SYSTEM T U TI LOCATION INFORMATION ADDRESS: 45 Cricket Lane MAP: 107A LOT: 167 INSTALLER: Jim Kellet DESIGNER: Ben Osgood PLAN DATE: 10/12/07 BOH APPROVAL DATE ON PLAN: 11/15/07 INSPECTIONS TANK INSPECTION: )01 C I DATE OF BED BOTTOM INSPECTION: l a-14 DATE OF FINAL CONSTRUCTION INSPECTION: 10/17/08 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan ® 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 ® Cleanouts per plan ® Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading mono construction ❑ Water tightness of tank has been achieved by testing 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www.town0northondovera n Inspection Form June 2008 ORT 0 'P � CdC i4LadkwKU �' PUBLIC HEALTH DEPARTMENT Community Development Division ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (circle one: gas baffle) ® 24" cover to within 6" of final grade installed over one access port, must be to grade and over outlet of tank if effluent filter is present ® Hydraulic cement around inlet & outlet Comments: DISTRIBUTION-BOX ® Installed on stable stone base ❑n/a 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 (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 ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townoMorthandover.com Inspection Form June 2008 tkORT01 6 tOC IC nRMMKN 4 Avg�r �° Al `'"SAC MtUS PUBLIC WEALTH DEPARTMENT (ommunity Development Division ® Brand and Model of Chamber: Infiltrator Chamber ® Number of chambers per raw: 8 ® Number of rows (trenches): 5 Comments: 40 chambers total SYSTEM ELEVATIONS INVERT IN FIELD AS-BUILT INVERT DESIGN INVERT ELEV. ELEV. Benchmark 103.96 Building Sewer OUT 2.18 102.80 103.64 Septic Tank IN 245 102.53 102.30 Septic Tank OUT 273 102.25 102.05 Distribution Box IN 319 101.79 101.69 Distribution Box OUT 336 101.62 101.52 Lateral 1 TOP 358 Lateral 1 INVERT 101.40 101.42 Lateral 2 TOP 357 Lateral 2 INVERT 101.41 Lateral 3 TOP 356 Lateral 3 INVERT 101.42 Lateral 4 TOP 357 Lateral 4 INVERT 101.41 Lateral 5 TOP 358 Lateral 5 INVERT 101.40 BED BOTTOM ELEV 452 100.81 100.75 CRITICAL SETBACK DISTANCES 1600 Osgood Street,North Andover,Mossochusetts 01045 Phone 910.688"9540 Fax 978.688.8476 Web wrwwr.ttownofnorthundoverram Inspection Form June 2008 ORI'l ° ,swxr> c 6 s S FdV b PUBLIC HEALTH DEPARTMENT Community Development Division 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 ❑n/a Inground pool 10 20 ❑n/a Slab foundation 10 1.0 ® Deck, on footings, etc 5 10 -- ® Waterline 10 10 101 ® Private drinking well 75 1002 50 ❑n/a 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 r 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 31.0 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,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www,townotnorthondover,com. Inspection Form June 2008 elleChiaie, Pamela From: Ben Osgood Jr. [bosgood @neengineeringinc.com] Sent: Tuesday, October 14, 2008 4:35 PM To: DelleChiaie, Pamela Subject: 45 Cricket Lane Pam, We inspected 45 cricket lane and it is fine for your file. Ben Benjamin C Osgood Jr. PX. President New England Engineering Services, Inc. 1600 Osgood `street Suite 2-64 North Andover, MA 01.845 978-686-1.768 www.neen ineerin ginc� 1