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Home My WebLink AboutCertificate of Compliance - 27 BRADFORD STREET 5/17/2002 Town of North Andover NoRrH Office of the Health Department !A- A Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 ° SacHUSti Sandra Starr Telephone(978)688-9540 Public Health Director Fax(978)688-9542 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE 05/17/02 This is to certify that the individual subsurface disposal system constructed () or repaired (X) by Jon Whyman at 27 Bradford Street has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. rian J. LaGrasse North Andover Health Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 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 a ° LOCATION & ELEVATIONS OF BENCHMARK USED TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( ) constructed; krepaired; by 1 '` a �e vim. located at 1 ,& °A was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # , dated , with an approved 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: Engineer Representative Final inspection date: Engineer Representative installer: Lic # Date: ........ .-- Design Engineer: Date: I u �eu Y , s TOWN OF ` 0R'fjJ ANDOVER SEWAGE,'', D[SPOSAI. S),q TEIm I_N,STALLA-LION CLRTflFI(.ATI0I Ttte undersiizned herei_,v ceriiv that the SC,.uaL)e Disposal System I ( ! co::sI C d ( ; ) rec aired: - ✓ by— lla VVN A located at was installed in conformance with the North Andover Board of He-aith a-fproved plan. Svstem Design Pe;:rit = dated with an approved desion flow or ryallons per day The mate ais uses were in contormarc vit`r those y speciiied on the appiroN�ec' plan, the system % as installed in accordarcti v.-ith thv provisions of 3 10 C.vM 15.000, Title 5 and local rei-zalauons, and the final Qradir.2 agrees substantially with the approved plan. Vil-work- is acct^rateiy represented ;)c the As-built wtuch has been submitted to the Board e Health. Bed inspection date: .i Eneineer R; �r4se .ative Final inspection sate =� 61 y ° L-ncireer 1Represe::mi::e Lnsta!:er: _ L Date: LesiLyr, Engineer: Date / — - RICHARD C. , ti7 "Po ° i TOWN OF NORTH ANDOVER SEWAGE DISPOSAL, SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( ) constructed; ( )repaired; _T by located at .. was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # , dated with an approved 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 CNM 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: In Engineer Representative Final inspection date: Engineer Representative Installer: ,( LicA Date: Design En eer: Date: � i ......................... I 71 N&M Job number 1770/ '") TOWN OF NORTH ANDOVER INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Site: Final Date: Installer• Tel: Date Yes No Initials A. Bottom of Bed 1. Excavation to proper depth 2. With trenches, sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation, etc. Comments: (Use back of sheet for diagrams.) T L 7/1 > B. Retaining Wall 1. Wall height and width as specified 2. Waterproofed, -- -------- 3. Wall minimum 10' taleaching facility 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" 2. Schedule 40 pipe 3. Inlet to tank cemented 4. Slope minimum 0.01 or 1/8"per foot minimum 5. Pipe properly set on compact firm base 6. Pipe laid on continuous grade in straight line 7. Cleanouts precede all change in alignment and grade 8. Manholes at any 90'change 9. 10' minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet 4. Manhole to w/in 6"of grade .........— W 5, Manholes over center and each tee 6. 3-20"manholes 7. Outlet line cemented 8. 2"—3"drop from inlet to outlet 9. Pipe set 10. Compact base with 6"of 1/4"crushed stone under tank 11. Tank is watertight 12. Tees 12"off side of tank N&M Job number 1770/ j 7 Comments: Date Yes No Initials E. Pump Chamber I. If separate from tank, compact base wit of'/4"stone underneath 2. Minimum 2"pipe to d-box if gravi stem 3. 20"access manhole 4. Tank Ievel 5. Watertight r 6. Tank size agrees w'K Ian specification ,. 7. Manhole to grade` 8. Check valve,and bleeder hole present wT 9. Alarm�'na uilding on separa�ciirc i 1 0. AlarrpIfunctions 11. Mailual operating switch 12. Pump delivers liquid -box Comments: F. Distribution Box 1. D-box level " 2. Minimum 0.1T'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution Z�_ 5. Compact base with 6"of stone beneath box rs 6. Box is watertight — 7. All lines cemented with hydraulic cement �- 8. Schedule 40 pipe 9. First 2' from box laid level Comments: G. Soil Absorption system f �� 7 A�' 1. All stone double-washed-3/a"- -pea stone Bucket test done? 2. Minimum 2" of pea stone above distribution lines _. 3. Minimum 6"stone beneath pipe - - 4. Distribution lines capped or connected together 5. Toe of slope stops minimum 5' from edge of property; a� 5a. if not, then Swale. Comments: N&M Job number 1770/ C 7–R Date Yes No Initials H. Leach Trenches 1. Minimum 2 trenches m 2. Length of trenches agrees with plpn:- (Max. length 100') 3. Width of trenches agrees with plan–Minimum 2';max' 4. Vent present if>50 feet.•or'specified 5. Minimum distance.between trenches 10' 6. Pipe slope m)nitnum 0.005 or 6"per 100 7. Depth ofd riches below outlet irkvert,nfmimum of 6". 8. Pipes set on stable base. / �---- Comments: r. I. Leach Field 1. A , Z Maximum length of field 100' - ' %,/ 2. Pipe slope minimum 0.005 or 6"per 100' — - 3. Separation between pipes 6'maximum 4. Pipes connected at end&vent end raised 5. Separation between adjacent fields 10'minimum �- 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines Comments: J. Leaching Pits 1. Minimum inlet pipe 4" ' 2. Pits of concrete 3. Sidewall b een 12"and 48"w' e' 4. Acces anholes on each p' 5. Pipes cemented with by aulic cement 6. Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond 6. Grading meets 3:1 slope 7. Minimum of 9" of fill graded over system CD o I J � SWALE s , VENT � 5 _ / 73 0 0 98*/0 {I 1( II its EA All 11 11 98*90 0 N / ir Nc* o ® �� LIMIT OF SAND (see constructior TP 2 T P 1 �, of 11 PT 1 DISTRIBUTION BOX i- L--------� --- 4 APPROXIMATE LO- 000 EXISTING LEACH r � \ PORCH \ 1500 GALLON SE r *75 99!t75 99't75 APPROXIMATE LO I I - i OF EXISTING SEF EXISTING THREE BEDROOM HOUSE SILL ELEV 100.20 W BENCHMARK: TOF x / FRONT STEP. ELI m Z / i PRESSURE WATER SERVICE W O Project Request Record Town of North Andover Date: ... .... Client Id:ToNA Card Id: ToNA Client/Company Name:Board of Health Card TvDe-Client Contact Name: Ms.Sandra Starr Phone: 978-688-9540 Title:Director Fax: 978-688-9542 Address: 27 Charles Street Email: sstar•r @townofnorthandover--.cam Notes: Town: North Andover State: MA Zip Code: 01845 Other contacts if applicable: ie En ineer IxtAIaller Name: t~, _r Phone: Z Title: Fax: Address: Email: Notes: Town: State Zip Code: Project: Project Id: 1770 Project Title: Town of North Andover Board of Health (JOB NO) (PROJECT NAME&STREET ADDRESS) Manager: NOW Billing Group: Cl Billing Cod :Fixed Fee, Contract Info.Project Description for each billing group BG/ Applicant 7-4,,,, ez 7- Assessors Map 4m•„ / Lot -3 5 ,m. Street Z ...�, „��.. ,��",��d`"""��.�.z' r.:)p Type of serv'iCe a s, „ 'yr n .r �...� ., ✓ m" ^' s C. office/forms/jbrqutoua