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Home My WebLink AboutCertificate of Compliance - 275 HAY MEADOW ROAD 9/30/2008 %AORTH ,%_f D I6a - t ®y O C.C.,LAKV � ° as V1' ��A RaveD PPp ��9 Cb0U5�� PUBLIC HEALTH DEPARTMENT Community Development Division C C.A E September 30, 2008 ,This is to certify that the individual subsurface disposal system received a SA7IST-ACT0RT1XS(EC`Z70Xof the: Eud System Repair ®f the Subsurface Sewage 1Disp®safSystem By: ik e Reiffy At: North Andover, MA 01845 The issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. r c� .S'usan Sa er (Puffic Yfealth(Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com rsw„. it i PUBLIC HEALTH DEPARTMENT Community Development Divisipa TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System(0/constructed;( )repaired; By: �'I -1' 1 L/L- I (Print Name) Located at: 7,15 144)(I-_ A M O IJ (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated ” 16, O and last revised on t5- 2_9 -o ,with a design flow of -4"[o 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: ''5-ye) Engineer Representative(Signature) iRL,L, And-Print Name Final Construction Inspection Date: fi Engineer Represe tative(Signature) ii And-Print Name Installer: + � _11 if A (Signature) Date: Cl 0'�- rj +JLf1i)tMlf't.. , `r And-Print Name NEW :tiC:ttilC)t m� Enginer: /A mt. ((Signature) Date: OY-If 2002 4tcr,:3�3Eitp ' ,' 4f� ` 6/0NM. -; And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.eom AS-BUILT CBECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LILIES & 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 m...�" DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK &D-BOX ORIGINAL STAMP & SIGNATURE i.... IMPERVIOUS AREAS -DRIVEWAYS, ETC. ' NORTH ARROW (. °' LOCATION &ELEVATIONS OF BENCHMARK USED I� kq0R NV SAC HU5 PUBLIC HEALTH DEPARTMENT Community Development Division QNSITE WASTEWATER SYSTEM T TI LOCATION INFORMATION ADDRESS: 275 Haymeadow Road MAP: 1048 LOT: 84 INSTALLER: F.P. Reiley DESIGNER: Merrimac PLAN DATE: 5/16/08 rev. 5/29/08 BOH APPROVAL DATE ON PLAN: June 14, 2008 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 9/11/08 DATE OF FINAL GRADE INSPECTION: 9111107 SITE CONDITION ❑ 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 ❑ Clean Solutions tank has been installed ❑ Water tightness of tank has been achieved by testing ® Inlet tee installed, centered under access port 1600 Osgood Street,North Andover,Mossochusetts 01845 Phone 978.688,9540 Fox 978.688.8476 Web "WW wr: ORB H ' 0 s� ` °rovc m 'SA t tit PUBLIC HEALTH DEPARTMENT (ommunity Development Division ® Outlet tee installed, centered under access port; gas baffle installed ® 24 inch 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: PUMPCHAMBER ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ❑ Combo Tank installed, Size: ® 1000-gallon Pump Chamber ® 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 at final grade installed over pump access port ❑ Water tightness of tank has been achieved by 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 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web ww,vwnot0orthqndover.(oPi Inspection form June 2008 R 41 PUBLIC HEALTH DEPARTMENT Community Development Division ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION YSTEM (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 ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYST M (Gravel-less Chambers) ® Brand and Model of Chamber: Quick 4 ® Number of chambers per row: 15 ® Number of rows (trenches): 2 Comments: CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement 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 wvww."Io,wrnfrnorthontlaverum Inspection Form June 2008 ". a6, " C r AYID w CHUS PUBLIC HEALTH DEPARTMENT Community Development Division SYSTEM ELEVATIONS INVERT" IN FIELD PLAN INVERT ELEV. Building Sewer OUT 97.81 98.1 Septic Tank IN 97.55 97.80 Septic Tank OUT 97.25 97.55 Pump Chamber IN 97.16 97.50 Pump Chamber OUT 96.88 Distribution Box IN 101.50 100.37 Distribution Box OUT 101.27 Lateral 1 TOP Lateral 1 INVERT 101.22 1 01.17 Lateral 2 TOP Lateral 2 INVERT 100.49 100.47 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofoorthandover.com Inspection Form Jane 2008 _.__ o g .oNt, tlw•�'g 0 �'v, PUBLIC HEALTH DEPARTMENT Community Development Division CRITICAL SETBACK DISTA S 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 Bank 3 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 1600 Osgood Street,North Andover,Mossarhuseits 01845 Phone 978,688.9540 Fax 978.688.8476 Web wsww.townafngrlhanda,ver to111 Inspedion Form June 2008