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HomeMy WebLinkAboutCertificate of Compliance - 332 RALEIGH TAVERN LANE 5/9/2012 r nor in,rz�La"e�""M�"�'ao� I PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division LzoilY As of __ - .__ This is to certify,that a SAT SAC` O f INSTEmox Was completed for the: 04 posal e . w (. t s t at: _ 2 _.Tavern Lane r Parcel ID :210/107.A-0130.0000.0 Xortfi,Xwfover. 1 S The issuance of this certificate shad not 6e construed as a guarantee that the On-Site Sewage DisposaCSystem wifrfunction satisfactorily. Susan 1Y SawyeE�fS�1 4u6Czc Y£eartft i.rector 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townofnorthandover.com p fW � r dr�uuo Nm �r„,u„„ � N V 4i 1 • r ..w. ` OWN 01 f A4lRill ANDOVER PUBUC HEALTH DEPAR"�N6E . oHEA1 H!2!E!5t1iAE:N�1 (om[�'iija city DevelOP111011s Divfsiero TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CER TIF'ICATION The undersigned hereby certify that the Sewage Disposal System(" constructed;( )repaired; fi (Print Name) Located at: - -- (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated � ' 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: �ve((Signature) Engineer Repres And—Print Name '"' Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name installer: (Signature) Date: `:IJ And—Print Name Date: a,� "0 y_.12 Engines: 11d(,lml Signature) And—Print Name '1600 Osgood Street North Andover, Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web http://www.townofl,tovtllu:sdovei,,tons AS-BUILT CHECKLIST All changes to the design plan have been reflected on the as-built b..,r Is of suitable scale;(one inch=40 feet or fewer for plot plans and one inch=20 or fewer for details of system components) Lot number, Street'&ame,Assessors Map and Parcel Number Lot Lines and Location of Dwellings served by the system Locations&Dimensions of system,including reserve(if applicable) TOWN( NOR t� Vti Ties to dwelling or Permanent Structure&Wells a.From Septic Tank ., b.From Leach Area Ties to Lot Lines from leach area Locations of Deep Holes&Peres " Elevations of Disposal System p Top of Foundation Elevation - ° Locations of Wells,Drains,Watercourses within 150 feet of system Location of water,gas,electric lines,cable Distances from Corners of House to Center of Tank&D-Box Location of Structures within 6 Inches of Finished Grade Original Stamp&Signature Location and holder of any easements which could impact the system Impervious Areas;Driveways,etc North Arrow "f Location&Elevations of Benchmark used STATEMENT ON PLAN(NA 5.3) "I certify the locations, elevations, ties, coven material; exposed component covers etc. shown on this as-built substantially agree with the approved plan and have determined that the break out elevations, if applicable, have been met." Signature of Designer Date or, if a STUCTURAL WALL IS PRESENT(NA 4,9)Letter or statement on the as-built indicating the wall was, or was not; constructed in accordance with the intended design and any manufacturer's specifications Signature of Designer Date As of:Wednesday,April 27,2011 Grant, Michele Emmum From: Sawyer, Susan Sent: Thursday, April 12, 2012 12:57 PM To: Grant, Michele; DelleChiaie, Pamela Subject: 332 RTL Bill Dufresne called, He was at 332 Raleigh Tavern Lane. W r � missed.The The Ian had an error on the house which resulted in 4 feet less to the field There jog � � � , � p e was a o in the house e, new distance Is 30 feet from the corner. c_ I am sure they will be calling for a Bottom of Bed soon. Susan Susan Sawyer Public Health Director Town of North Andover 1600 Osgood Street Bldg.20,Unit 2-36 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email s4n?y=r. tcuvnra ft— id c]vr cc,n Web ww,:fw tPNcarttiTthrccays r.c. .tm Please note the Massachusetts secretary of State's officcw has determined tk:4 rrrost enl ails°to and frorn marrricipai offices and officials are public records.For more information please refer to:hE:t@,,/lv ww.sc ,t tc.DL,1.ra rrcJtamid x.Patnro. 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I v /p x G v, P Ir> r of } l / I I gm i r r t r r IV„ G / r ! l 1 r � jJ �� � ,�rf J ✓ r u ' 3W1 ��� r r W �r ° f far Ana N J I, uil r / s� / littp://szOO1.4.wc.iiiail.comcast.net/h/'viewiiilages?id=1 1Z XaNITY Connect beilli@comcastmet —--------- .......... ------------ ----------- ----------- -------- photo.JPG RJR -og 9dr-olotid jgu•4se3mo:)@TTTjaq 130UUO:) ,UINX:IX photo.JPG (JPPG Image,320 x 240 pixels) http://sz0014.wc.iiiail.comcast.tict/service/liotiie/•—/photo.JPG?auth=c... r _� , 4/19/2012 7:53 PM North Andover Health Department Community Development Division QNSITE WASTEWATER SYSTEM T 11 TI LOCATION INFORMATION ADDRESS: 332 Raleigh Tavern Lane MAP: 107A LOT: 130 INSTALLER: Todd Bateson DESIGNER: Vladimir Nemchenok PLAN DATE: 12/21/11 BOH APPROVAL DATE ON PLAN: 2/29/12 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: I� f DATE OF FINAL CONSTRUCTION INSPECTION: 4/18/12 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan — bump out in basement not shown on plan ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANG( ❑ Building sewer in continuous grade, on compacted firm base Cleanouts per plan Bottom of tank hole has 6" stone base ❑ W e hole plugged ❑ gallon tank has been installed loading Monolithic tank construction Water tightness of tank has been achieved by testing ❑ Inlet tee installed, centered under access port ❑ Outlet tee installed, centered under access port (gas baffle/effluent filter) ❑ inch cover to within 6" of finish grade installed over one access port Hydraulic cement around inlet & outlet Comments: Not installed, will be installed after backfilling over SAS DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: Need to hydraulic cement around inlet/outlets and add inlet tee. SOIL ABSORPTION SYSTEM (General) ❑ Bottom of SAS excavated down to 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 (concrete) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ® Number of chambers per row: 9 ® Number of rows (trenches): 5 Comments: Total Chambers = 45 BM = 100.00 HR = 4.26 HI = 104.26 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark 4.26 Building Sewer OUT Septic Tank IN Septic Tank OUT Distribution Box IN 15.76 88.15 88.10 Distribution Box OUT 15.93 87.98 87.93 Lateral 1 TOP 16.02 Lateral 1 INVERT 87.89 87.87 Lateral 2 TOP 16.00 Lateral 2 INVERT 87.91 87.87 Lateral 3 TOP 16.04 Lateral 3 INVERT 87.87 87.87 Lateral 4 TOP 16.05 Lateral 4 INVERT 87.86 87.87 Lateral 5 TOP 16.04 Lateral 5 INVERT 87.87 87.87 Top of Chamber 16.04 88.22 88.20 Bottom of Bed/Chamberl 87.22 87.20 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 Bank 75 100(70'as proposed) ® 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