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Home My WebLink AboutCertificate of Compliance - 44 CRICKET LANE 5/24/2007 NORTH /64 'I- 0? $ d` 6 Ofn O CONIC HIWKM 1' ��SSAC HUS�� PUBLIC HEALTH DEPARTMENT Community Development Division C0I1"'GCE22I FICArr( O F 1. I. 4NCE As of: May 24, 2007 This is to certify that the individuaCsu6surface dzsposa(system received a SA`ZISFAC`7ORTINSITECYTOYof the: FuffSeptic System Repair By: �lifZe 1�eiffy At: 44 Cricket .cane i North Andover, 91,1A 01845 The Issuance of this certificate shall'not 6e construed as a guarantee that the system wiff function satisfactorily. 1,"Asan If Sawyer, W SAU Pu6fic-Veath Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com ��Orr.ec 4q'N�� PUBLIC HEALTH DEPARTMENT Community Development Division TOWN I�� NOR v I��',�'�I>E VE''T lf,.�o�� P144a kqF�d.�......, TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System(-4'constructed;( )repaired; By: �'°� �- fU I I-L-j 11 (Print Name) Located at: f" G'V� V_ (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated Mr , -0c" and last revised on f 67-'?,4 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; — Engineer Repre tative(Signature) 1.1 ewe And-Print Name Final Construction Inspection Dater '" Engineer Representative(Signature) And-Print Name Installer: / � K. (Signature) Date: —7 � 0 And-Print Name Nz Vtr19A°,� Enginer: 1�r1,`1C ( ` .{Signature) Date: I r(AVH" N� rem ( lit) r/ 1Af:1Si.. 1IL PS,SION And-Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.608.9540 Fax 978.688.0476 Web http://www.townofnorthandover.com AS-BUILT CHECKLIST e. LOT NUMBER, STREET NAME .,. ASSESSORS MAP & PARCEL NUMBER f LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE, °"'mein TIES TO LOT LINES &DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA � LOCATIONS OF DEEP HOLES &PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM ,r TOP OF FDN ELEVATION w' 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 V%OR I-i 0 Z. Fp � L 4 r ten" O sacriiiniw.n aa� A M0 CHU PUBLIC HEALTH DEPARTMENT (ommunity Development Division QNSITE WASTEWATER SYSTEM T TI NOTES LOCATION INFORMATION ADDRESS: MAP: LOT: INSTALLER: 'r� DESIGNER: 9 .M PLAN DATE: m,> - y SOH APPROVAL DATE ON PLAN: , - C INSPECTIONS ❑,❑ t/ TANK INSPECTION: DATE OF BED BOTTOM IN CTION INSPECTION: DATE OF FINAL CONSTRUCTION DATE OF FINAL GRADE INSPECTION: 10, SITE CONDITIONS ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (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 1 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover,com NOR'TFr O�,e41•eD 161 - L O ^ is P oa O COC MI[�WK y', �SSAC HUS�� PUBLIC HEALTH DEPARTMENT Community Development Division ❑ 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 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: DISTRIBUTION-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: 2 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com tkORT14 ¢ totiinatwxn � � ' 044Veo „wy� PUBLIC HEALTH DEPARTMENT Community Development Division SOIL ABSORPTION SYSTE ,,( eneral) ❑' Bottom of SAS excavated down to 6 in into C soil layer, as provided on plan E, Size of SAS excavated as per plan Title 5 sand installed, if specified on plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ❑ Brand and Model of Chamber Infiltrator Quick 4 ❑ Number of chambers per row ❑ Number of rows (trenches) .. ❑ Laterals installed and ends connected to header (and vented if impervious material above) ❑ Elevations of laterals and chambers installed as on approved plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside ❑ Alarm signal located inside Comments: 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www,townofoorthandover.com NORTH qw- O M C, eyy 01, COCAC^A'. N 1\ 2 7 A0RAT/O f"r_ �5 �SSACHusr. PUBLIC HEALTH DEPARTMENT Community Development Division SYSTEM ELEVATIONS INVERT IN FIELD PLAN INVERT ELEV. Benchmark Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 I NV Lateral 1 TOP Lateral 2 I NV Lateral 2 TOP Lateral 3 I NV Lateral 3 TOP Lateral 4 I NV Lateral 4 TOP 4 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com I Q NoRTN !- os,�1LlD �a O O 4~ M 0 Arlo 4y� oa •M T DMA COCM[.t�wK�`,•�' �9SSAC HUS��y PUBLIC HEALTH DEPARTMENT (ommunity Development Division 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 ' 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 5 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com