HomeMy WebLinkAboutCertificate of Compliance - 855 WINTER STREET 11/12/2010 e
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PUBLIC HEALTH DEPARTMENT
(ommmity Development Division
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( constructed;O repaired;
-T.' „—,,
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(Print Name)
Located at:
(Installation Address)
Was installed in conformance with the North Andover Board ofHealth approved plan,originally dated
_t --�--f ` ------ -------and last revised on cr ( 9 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: �Te)Ga, rr,l
Engineer Representative(Signature)
And Print Name ��
Final Construction Inspection Date:
` Jr ✓tom "
,r Engineer R resentative(Signature)
And Print am
Isttell, Si rarkure Date:'
rra� � ( gr )
w�
And-Print Name
Engin ture) Date: — /a
IB
And--Print Name
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web ht tp://www.townofnortliandover.com
AS-BUILT CHE
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 7 °,TROY SEPTIC T
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
w, LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
pv-, 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
lleChi ie, Pamela
From: Sawyer, Susan
Seat: Tuesday, October 05, 2010 8:40 AM
To: DelleChiaie, Pamela; Grant, Michele
Subject: 855 Winter
Needs tank inspection
855 Winter
Told John one or both of us could go out before the 11 AM insp.
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a#ice 978 688-954e
faux 978 6884476
All email messages and attached content sent from and to this email account are public
records unless qualified as an exemption under the
[
t11p_L/Jwww.sec.state.ma.us p re Pre 4 hurt ]Massachusetts Public Records Law,
PIE:ZIS a WtE tl'W1 Masgich4,setts Secret"my of State's off ce,has detel'ohled Q'I'ICA 1110 M 4,loailS to kll'ld Iroln rY'14.nic'lpal offices and offi Jals are public,iecY7 ds, A-or IYgore
itiforrrraation fale,,ne refer to:httD://www.sec,state.ma.Us/te•
Please consider the environrnenit before lr inting mis r-;maail.
1
elleChiaie, Pamela
From: Randy Burley[rburley @millriverconsulting.cam]
Sent: Monday, October 18, 2010 8:53 AM
To: 'Daniel Ottenheimer'; Grant, Michele; 'Isaac Rowe'; 'Marianne Peters; DelleChiaie, Pamela;
Sawyer, Susan
Subject: Construction Inspection 855 Winter St
Attachments: Construction Inspection Form 855 Winter St.doc
Attached is the report from the final inspection I performed with John Soucy last Friday.
The system was installed per plan with the floats modified as you indicated.
My only comment to John was a suggestion to caulk the electrical conduit leaving the pump chamber. The vent back to
the pc from the d box may allow sewer gas to pass back through the electrical conduit and cause odor issues.
Randy Burley
Project Manager
Mill River Consttltirg?,
6 Sargent Street
Gloucester, MA 01930
Ph 978-282-0014
Fx 978-282-1318
www.nrillrivercorr�g�ltil r� .cg1n
rb irle fit)ti-illriverc:,onsLrlw tt x.coni
Please:note the Vl assarhuseft&ecre;tary of State's office has determined that most cernails to and from municipal offices and officials ato public.records.For more
information falease refer to:http__!www.sec.state.n7a.us/ re%reidxijltrn.
Fleas o consider the environment before parenting this email.
1
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PUBLIC HEALTH DEPARTMENT
Community Development Division
ONSITE WASTEWATER Y T TI NOTES
LOCATION INFORMATION
ADDRESS: 855 Winter St MAP: 104 B LOT: 41
INSTALLER: John Soucy
DESIGNER: Clayton Morin, Engineering and Survey Services Inc.
PLAN DATE: July 7, 2010, rev. August 12, 2010
BOH APPROVAL DATE ON PLAN: August 13, 2010
INSPECTIONS
TANK INSPECTION: l msl lb
DATE OF BED BOTTOM INSPECTION:100 110
DATE OF FINAL CONSTRUCTION INSPECTION: October 15, 2010
DATE OF FINAL GRADE INSPECTION:
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
® 1500 gallon tank has been installed
H-10 loading
® Monolithic tank construction
❑ Water tightness of tank has been achieved by
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fox 978.688.8476 Web www.town0northondover.com
Inspection Form June 2008
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SACHU
PUBLIC HEALTH DEPARTMENT
(ommunity Development Division
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 final grade installed
over one access pork
® Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
❑ Bottom of tank hole has 6" stone base
® Weep hole plugged
® 1000 gallon Pump Chamber installed
® H-10 loading
® Monolithic tank construction
® 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
❑ cover at final grade installed over pump access
port
❑ Water tightness of tank has been achieved by
testing
® Hydraulic cement around inlet & outlet
Comments:
CONT OL PAN L
® Alarm & Pump are on separate circuits
® Alarm sounds when float is tripped
® Location of control panel: garage, house on slab
® Alarm signal located inside: garage
Comments:
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www,townofnorthaiidover.com
Inspection Form June 2008
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PUBLIC HEALTH DEPARTMENT
Community Development Division
DISTRIBUTION-BOX
® Installed on stable stone base
® H-20 ®-Box
® Inlet tee (if pumped or >0.08'/foot)
® Hydraulic cement around inlet & outlets
® Observed even distribution
❑ Speed levelers provided (not required)
Comments:
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 HOPE 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:
OIL ABSORPTION SYSTEM (Gravel-less Chambers)
® Brand and Model of Chamber: Standard Quick 4
Infiltrator Chambers
® Number of chambers per row: 8
® Number of rows (trenches): 4
Comments: Total Chambers = 32
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnortliandover.com
Inspection Form June 2008
61
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PUBLIC HEALTH DEPARTMENT
Community Development Division
SYSTEM ELEVATIONS
AS-BLT INVERT ELEV DESIGN INVERT ELEV
Building Sewer OUT 79.36 13' from ST
Septic Tank IN 79.09 78.50
Septic Tank OUT 78.82 78.25
Pump Chamber IN 78.80 78.20
Pump Chamber OUT 78.61 77.95
Distribution Box IN 79.95 79.94
Distribution Box OUT 79.78 79.77
Chamber 1 TOP 80.02 80.00
Lateral 1 INVERT 79.69 79.67
Chamber 2 TOP 80.02 80.00
Lateral 2 INVERT 79.69 79.67
Chamber 3 TOP 80.02 80.00
Lateral 3 INVERT 79.69 79.67
Chamber 4 TOP 80.02 80.00
Lateral 4 INVERT 79.69 79.67
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.6889540 Fox 978.688.8476 Web www.towiiofiiorthondovei,.com
Inspedion Form June 2008
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PUBLIC HEALTH DEPARTMENT
(ommunity Development Division
CRITICAL SETBACK DISTANCES
Mark those distances checked in the field against the design plan and regulatory
setback
Tarok SAS Sewer
® Property line 1.0 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 Bank3 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,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townolnortha over.com
Inspection Form June 2008
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PUBLIC HEALTH DEPARTMENT
Community Development Division
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SYSTEM ELEVATIONS
ROD ELEVATION AS-BLT INVERT ELEV DESIGN INVERT ELEV
Benchmark
Building Sewer OUT
Septic Tank IN
Septic Tank OUT
Pump Chamber IN
Pump Chamber OUT
Distribution Box IN
Distribution Box OUT
Lateral 1 TOP
Lateral 1 INVERT
Lateral 2 TOP
Lateral 2 INVERT
. Lateral 3 TOP
Lateral 3 INVERT
Lateral 4 TOP
Lateral 4 INVERT
Lateral 5 TOP
Lateral 5 INVERT
Lateral 6 TOP
Lateral 6 INVERT
Top of Chamber
Bottom of Bed/Chamber
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com
Inspedion Form June 2008
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PUBLIC HEALTH DEPARTMENT
Community Development Division
SKETCH PLAN
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
Inspection Form June 2008
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PUBLIC HEALTH DEPARTMENT
(ommunity Development Division
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 Bank3 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,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.lowndnorthandover.com
Inspection Form June 2008