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Home My WebLink AboutCertificate of Compliance - 540 BOXFORD STREET 3/22/2016 • �T'fT:EDl6q . • PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CE TE OF COMPLIANCE As Of: 3/22/16 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Construction of an On-Site Sewage Disposal System By: Jesse Warren Ate@ 540 Boxford St. Street Map 105C Lot North Over, MA 0184 An t�sua ce of this ertf fcate shall not be construed as a guarantee that the system will function satisfactorily. Michele Grant Public Health Agent � 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com k • North Andover Health Department Community and Economic Development Division QNSITE WASTEWATER SY T M CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 540 Boxford St. (aka 602 Boxford lot 1) MAP: 105C LOT: 22 INSTALLER: Jesse Warren DESIGNER: Phil Christiansen PLAN DATE: 3/25/15, rev 7/30/15 BOH APPROVAL DATE ON PLAN: 8/5/15 INSPECTIONS TANK INSPECTION: 11/9/15 DATE OF BED BOTTOM INSPECTION: 11/9/15 DATE OF FINAL CONSTRUCTION INSPECTION: 11/17/15 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑ 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 X Bottom of tank hole has 6" stone base X Weep hole plugged X 1500 gallon tank has been installed H-10 loading X Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port Z 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— Rubber boots so not cement needed Comments: 11/17/-15 - Effleunt filter was installed, informed installer that needed manhole to finished grade if this was retained 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) ® Schedule 40 PVC Pipe Comments: 11/17/15 — Informed installer needed hydraulic cement around pipe penetrations SOIL ABSORPTION SYSTEM (General) X Bottom of SAS excavated down to C soil layer, as provided on plan X Size of SAS excavated as per plan X 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: 40Wx36L with overdig 11/17/15 — Elevations confirmed, however based on a new benchmark not one on the approved plan. Asked installer for letter from engineer or surveyor confirming the benchmark is accurate. SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ❑ Brand and Model of Chamber: High Capacity Quick 4 Infiltrator Chambers ❑ Number of chambers per row: ❑ Number of rows (trenches): 3 Comments: Total Chambers = correct dimensions measured AL GRA6E ❑ med ❑ See d Cover er plan Comments: D CUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer F71" As-Built Plan BM = 126.02 HR = 2.05 HI = 128.07 SYSTEM ELEVATIONS ROD AS-ELT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 2.26 125.48 125.10 Septic Tank IN 2.62 125.12 124.88 Septic Tank OUT Distribution Box IN 2.95 124.79 124.57 Distribution Box OUT Lateral 1 Bottom 4.85 123.22 123.25 Lateral 1 INVERT 3.39 124.35 124.21 Lateral 2 Bottom 5.15 122.92 122.87 Lateral 2 INVERT 3.82 123.92 123.83 Lateral 3 Bottom 5.57 122.50 122.50 Lateral 3 INVERT 4.20 123.54 123.46 11/17/15 -Nail in tree used as benchmark, stake that was on approved plan is not longer present at the site 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 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Bank 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 11/17/15 - Measured distances from SAS to two wells shown on plan and found>100' ' 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 4/19/2016 Town of North Andover Mail-540 Boxford St No Andover OP,'. - ANDOVER Masiachuwlis Michele Grant <mgrant @northandoverma.gov> 540 Boxford St No Andover 1 message Bill Lumbard <gileadme @comcast.net> Tue, Apr 19, 2016 at 8:15 AM To: No Andover B O H Michele Grant <mgrant @townofnorthandover.com> Good morning This letter is to inform the No Andover Board of Health that S&L Homes will be responsible for the final grading at # 540 Boxford St No Andover ma Thank you Bill Lumbard manager S&L Homes 10 Middlesex Ave Wilmington Mass Sent from my Verizon Wireless 4G LTE DROID https://mail.googl e.com/mail/ca/u/0/?ui=2&i k=d4458df3d9&view=pt&search=i nbox&th=1542e72622334c74&si m l=1542e72622334c74 1/1 Town of North Andover — Septic System - AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected and noted on the as-built plan 2) R As-built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans) 3) 7,treet Address,Assessor's Map and Lot Number 4) Lot Lines and Location of Dwellings served by the system 5) Locations Elevate .�..,.,,.. y p S ._ l ons and Dimensrorrs of As-built s steal com oneits mcludin reserve (if a �plicable) 6) - LTies to all tank openings,d-box,and leach area from dwelling or Permanent Structure 7) Setback distances are shown on the as-built plan from system components to: Subsurface,interceptor&foundation drains Catch basins Property lines Dwellings or other structures 77—Frivate water supply or irrigation wells v/Watercourses or wetlands 8) Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) Location of water,gas,electric lines,cable,control panel (if applicable) 10) "' Location of Structures within 6 Inches of Finished Grade 11) ./Original Stamp&Signature 12) location and holder of any easements which could impact the system 13) °' Impervious Areas;Driveways,etc 14) Y North Arrow 15) ` Location &Elevation of Benchmark used r 16) V STATEMENT ON PLAN (NA 5.3) a, "I certify the locations, elevations, ties, cover 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 nict." Signature of Designer Date b. "If a ST UCTUKAL WALL IS FRESENT(NA 4.9)a Letter or statement on the as-built indicating the Wall- way, or was not,constructed in accordance with the intended d sign and any ma17ZlIaCtClrer'S Specification. Signature of Designer Date As of:Thursday,December 10,2015 edge, Lisa From: Dan Ottenheimer <dano @millriverconsulting.com> Sent: Thursday, November 19, 2015 11:28 AM To: Grant, Michele; Hadge, Lisa Cc: 'Isaac Rowe'; Pam Lally Subject: Construction Inspection - 540 Boxford Street (also known as 602 Boxford Street Lot 1) Attachments: S40 Boxford St. (602 Boxford lot 1) Construction Inspection.doc Michele, Construction inspection report form is attached. A f w tems that are in need of attention and were discussed with the installer: ,, ® I D-box needs hydraulic cement around pipe penetrations. Installer was advised and will complete work and show us at final inspection. • Effluent filter was installed in outlet side of septic tank, which is acceptable, however they needed to have a manhole to finished grade if that is going to remain. • The benchmark that was on the approved plan is no longer in the ground, and a new one was set. I asked the installer to acquire a stamped letter from the engineer or surveyor who established the new benchmark confirming they did this field work. Dan M ill River consulting Daniel Ottenheimer, President Mill River Consulting,Inc. 6 Sargent Street Gloucester, MA 01930-2719 978-282-0014 x 802 yr ww €nillriverconsultin m canra@rrillriverconsultir .com Member: Massachusetts Association of Onsite Wastewater Professionals, Massachusetts Environmental Health Association, Cape Ann Chamber of Commerce, New England Water Environment Association PUBLIC HEALTH DEPARTMENT Corriinunity Developnient Oivkioii TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System constructed;( )repaired; By. .. _...� c '. ?gym. (Print Na . ) Located at: l) > � m °��L) '; _ (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan, originally dated ... and last revised ona 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. r Bottom of Bed LYSpection Date: En neer Representative(Signature) / v t4 114-A-) And—Print Name ° ^�� „n Final Construction Inspection Date: ` : . . I✓ sneer Representative(Signature) And—Print Name Installer: / -- ,-....-. (Signature) Date: .. ( f "" g' . .. �� .~� And—Print Name ,( En ineC;, •� Signatcu�e) Date And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.6809540 Fox 978,688.8476 Web bttp://www.townofnortliandovet'.coni