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Home My WebLink AboutCertificate of Compliance - 121 RALEIGH TAVERN LANE 5/13/2005 Town of North Andover ®a"®DT 6�� Office of the Health Department Community Development and Services Division 400 OSGOOD STREET y"°4 <�x.a•�.�4" North Andover,Massachusetts 01845 is US 978.688.9540-Phone Susan Y. Sawyer,REHS/RS 978.688.8476-Fax Public Health Director I As Of may 13, 2005 This is to certify that the individual subsurface disposal system repaired (A) ® (' CfSaystem 6y John Soucy at 121 Raleigh Tavern .bane NorthAndover, -WA 01845 has been installed in accordance with the provisions of Title v of the State Sanitary Code and with the North Andover Board of-Mealth regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. � 5 an T Sawyer Bu6lic Ifealth(Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( )'constructed; K)repaired; by �3nu CIS ewer 5eryiae located at Re l c A k _Giver r1 1 ci4 12 was installed in conformance with the North Andover Board of Health approved plan, System Design Permit.# ,plan dated , 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. Bed inspection date: LOT- Engineer Representative Final inspection date: Engineer Representative Installer: � AAAA o Lic.#: Date: �s Engineer: BENJ A C. Date: S/?/CS- :;e� CIVIL eta No.49999 GIST /C?NAL� V I AS-BUILT 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 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 TOWN OF NORTH ANDOVER Office of COMMUNITV DEVELOPMENTAND SERVICES HEA1,T1-1 DEPARTMEN'r *00 V 2 -JARI-I'S STREET 7 Cl NORT]I ANDOVER, MASSACHL)SETTS 01845 C Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542 FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 121 Raleigh Tavern Lane MAP:107ALOT: 113 INSTALLER: John Soucy DESIGNER: Ben Osgood Jr. PLAN DATE: 1/6/05 BOH APPROVAL DATE ON PLAN: 1/7/05 DATE OF BED BOTTOM INSPECTION: 4/20/05 DATE OF FINAL CONSTRUCTION INSPECTION: 4/27/05 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE ADVANCED TREATMENT X FAST COMPONENT SUMMARY FROM PLAN GALLON TANK = —1500 LOADING OF SEPTIC TANK = H-10 GALLON PUMP CHAMBER = - 1000 LOADING OF PUMP CHAMBER = H-10 TYPE OF SAS = Infiltrator DIMENSIONS AND DETAILS OF SAS: 32.83 X 32.25 SITE CONDITIONS IE Existing septic tank properly abandoned 1E Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Sewer from house has 2-bends to tank. Page 1 of 4 TOWN OF NORTH ANDOVER Office of COMMLJN[TV DEVELOPMENT AND SEE VICE,S HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHIJSETTS 01845 CH S Susan Y. Sawyer, REIIS/RS 978.688.9540- Phone Public Health Director 978.688.9542- FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged El 1500 gallon tank has been installed (H-10) (2 piece) ❑ Water tightness of tank has been achieved (Visual) Inlet tee installed, under access port ❑ Outlet tee (gas baffle) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present El Hydraulic cement around inlet & outlet (note) Comments: Could not see hydraulic cement around inlet to S.T. FAST unit installed — no outlet tee. PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1000 gallon Pump Chamber installed (H-1) (monolithic) ❑ Inlet tee installed, under access port 1E Pump(s) installed on stable base El Alarm float working 0 Pump On/Off float working El Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Comments: Page 2 of 4 TOWN OF NORTH ANDOVER Office of COMMUNITV DEVEI-d OPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MAS SAC HUSE-l"I'S 01845 Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 9M6M9542 FAX SOIL ABSORPTION SYSTEM 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 Gravelless 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: Retaining wall to be checked at Final Grade Inspection—need Top of Wall Elevations. PRESSURE DISTRIBUTION rx-1 4 inch manifold laterals installed with end sweeps size: 1.5" material: PVC EK Squirt test 3 ft in height ED Equal distribution to all laterals 71 orifice size 1/4 inch as per plan Comments: CONTROLPANEL Alarm & Pump are on separate circuits Alarm sounds when float is tripped Location of control panel: Basement ❑ Rated for exterior if placed outside Comments: Page 3 of 4 TOWN OF NORTH ANDOVER Office of COMM 1JNrrV DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARI-ES STREET NORTH ANDOVER, MASSACHUSETTS 01845 CHUS Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542 FAX SYSTEM ELEVATIONS Benchmark:100.0 Rod at Benchmark: 2.12 Height of Instrument: 102.12 INVERT ON DESIGN PLAN INVERT ELEVATION Building Sewer OUT 97.39 Septic Tank IN 96.00 96.88 Septic Tank OUT 95.75 96.36 Pump Chamber IN 95.70 96.27 Pump Chamber OUT 95.45 95.67 Top of Chamber HIGH 98.17 98.23/ 98.20 Top of Chamber LOW 98.17 98.20/98.18 Lateral Invert HIGH 9790 97.91 Lateral Invert LOW 97.90 97.85 Chamber elevations are based on top of chambers at start and end of each row. Highest and lowest elevations are provided. Page 4 of 4