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Home My WebLink AboutCertificate of Compliance - 66 CEDAR LANE 6/18/2009 t1ORTH q O <t%�E o , + g646 OL o ~ 0 ? 1b M ��AORtiTED �`PP`y�� .9SSAC HUSH" PUBLIC HEALTH DEPARTMENT Community Development Division CEX2JI FIC.AT2 OE C05WI"'r IA.�VCE As of: ,dune 18, 2009 This is to certify that the individual subsurface disposal system received a SA7IS,AC7oRTINS1nE071-0- rof the: Fuf( epair of the Subsurface Sewage (Disposaf�Svstem B 2odd Bateson 66 Cedar Lane 911ap — 106..,0; Parcel— 143 Worth Andover, 914A 01845 The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. us n 7 Sawyer Tu6licWealth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com Na r"i1 S. �c PUBLIC HEALTH DEPARTMENT fommunity Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION ..w� .,..VED The undersigned hereby certify that the Sewage Disposal System( )constructed;(O"'repair ; (Print Name) a b "'� 'J; � � l 4� Installation Address � ��Q C�i�� i" �� ttuti aD Located at: �•r � u..t��u � ( ) Was installed in conformance with the North Andover Board of Health approved plan,originally dated 2 G ) 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. Bottom of Bed Inspection Date: �� r Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name .w.."'""..� / Installer: Y °' (Signature) Date; L V1 of f4f wIN,:�`4tm9* � . � .Ii'" � `� .�(Signature) Date: —Print Name � �°r� � n 1 1 �� Enginer � r i" � d41414 4TV e r � And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.towtioftiorthandover.com elleC iaie, Pamela From: brdufresne @comcast.net Sent: Tuesday, June 23, 2009 2:48 PM To: DelleChiaie, Pamela Subject: Re: 66 Cedar Lane Pam, They are both in the works, the as-built plan will be completed in the next day or so and then I will get you a copy along with a completed certification form. Thx, Bill ----- Original Message ----- From: "Pamela DelleChiaie" <pdellech @townofnorthand over.com> To: "Bill Dufresne (brdufresne @com cast.net)" <brdufresne @comcast.net> Cc: "Susan Sawyer" <ssawyer @townofnorthandover.com> Sent: Tuesday, June 23, 2009 2:14:10 PM GMT -05:00 US/Canada Eastern Subject: 66 Cedar Lane Hi Bill, need a completed certification form for 66 Cedar Lane before I can issue a COC. Can you get that form over to me? Todd will then need to sign it as well. Also will need a final as built and schedule a final grade inspection. I left you a voice mail as well. Thanks, P. A7inela DelleChh e Health De artinentAwsistant TOWN OF NORTH ANDOVER Health D l:)artmetit 1600 Osgood Stt•eet Building 20;SLI te:236 North t4 iidove.t•,MA 01£345 978.688,9540- Phone 978.688.8476- fax lick a a lsa Luc + carn u a 8a br } call �r. c d�c�c E-mail 6tttl /fWWW.toW11ofi1ruq_h.midove corn Websit.e Notes. If copied to BOH Members-Reference Copy Only-no response requested at this time 1 AS-BUILT CHECKLIST ce 'V LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDINNG 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 , LOCATION& ELEVATIONS OF BENCHMARK USED f TOWN OF NORTWANDOVER �at�Rrrr Office of COMMUNITY I)1!.VELOI'li![IEN 1'AND SERVICES o I-1EALTH DEPARTMENT 1600 OSGOOD SIRE E'f; Building 2-36 d N .jY� unAE� ,�„v�� OI�TH ANDOVER,MASSACHUSETT'S 01845 �� c�-°u? Susan Y. Sawyer, REI-IS/RS 978.688.9540 -Phone Public health Director 978.688.8476 FAX ®NSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION IINFORMATION ADDRE AP °�� LOT: " INSTALLER: DESIGNER: r PLAN DATE: Al_. „„w.a N ..., BOH APPROVAL DATE ON PLAN: ~` INSPECTIONS .;' i f TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITION Existing septic tank properly abandoned Internal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANK ,.r Bottom of tank hole has 6” stone base Weep hole plugged x >°)❑: 1500 gallon tank has been installed / H-10 loading (M`6nolithic constructlori ❑ Water tightness"of tank has,been achievdd (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 ❑ 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 Wastewater System Documentation—Feb 2006 Page 1 of 6 TOWN Or NO-11TH ANDOVER F %A RTk Office of COMMUNITY DEVELOPMENT AND SERVICES Sao`; .a° - , HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 �9 °N4rta nPP`y 5 NORTH ANDOVER,MASSACHUSETTS 01845 �SSgc"tj Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX 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: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 TOWN OF NORTH ANDOVER t60RTH q Office of COMMUNITY DEVELOPMENT AND SERVICES HEAL'T'H DEPARTMENT � A 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 �'�tSA U5�� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX D-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: SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to soil layer, as provided on plan Size of SAS excavated as per plan d Title 5 sand installed, if specified on plan 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete / timber/ block) ❑ Final cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER °F �io�arH q Office of COMMUNITY DEVELOPMENT AND SERVICES ,0 32 HEALTH DEPARTMENT 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 Y��cSAC HU5E4R5* Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROLPANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OF NORTH ANDOVER ,aoRTH q Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 � NCHl1`'E� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX 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 -- F-1 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 Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER 4 ,FORTH A Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 0 � - 1600 OSGOOD STREET; Building 2-36 .rt;,... NORTH ANDOVER,MASSACHUSETTS 01845 1'�SSq�E{RSE�iy Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6