HomeMy WebLinkAboutCertificate of Compliance - 15 NORTH CROSS ROAD 12/24/2003 Town of North Andover F p1ORTH
Office of the Health Department
Community Development and Services Division -
27 Charles Street'"AAt[n °q5*
North Andover,Massachusetts 01845 "SSACNUSE`
Heidi Griffin Telephone (978)688-9540
Acting Pcrhlic Health Director Fax(978)688-9542
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
December 24, 2003
This is to certify that
the individual subsurface disposal system
constructed ( ) repaired (X)
by
Peter Breen
at
15 North Cross Road
North Andover, MA 01845
as 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.
Jonathan arkey
Chairm ,North Andover Board of Health
BOARD OF APPEALS 685-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLAINNVING 688-9535
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The 4ndersigned hereby certify that the Sewage Disposal System constructed;
(repaired:
by
located at KWV-1-0 K-' PZ
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: u-/ ujt
Engineer Representative
Final inspection date: i
Engineer Represe tative
Installer: Lic.ff: Date:
Design Engineer: Date: --e"
.........
01"-I ,
AS-BUILT ClIE, CKLIST
LOT NUMBER, STREET NAME 2 <<
ul
ASSESSORS MAP& PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
TIES x0 LOT LINES &DWELLING, WELLS
a. FROM SEPTIC TANK..
b. FROM LEACH AREA
V LOCATIONS OF DEEP HOLES& PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
'r LOCATIONS OF WELLS,DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM �,tq
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
i
y
Page I of I
DelleChiaie, Pamela
From Can Oftenheimer[info@millriverconsulting.com]
Sent: Monday, December 08, 2003 1:15 PM
To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie
Subject: 15 North Cross Construction Inspection
1--Ieldi, Brk'ii-i and Parn,
Attac.hed please find fhe consirud-ion insp&z,"Hon form for the botiorn of bed
inspection at 15 Notfh Crc)ss l"'bad. All was fir"ie.
Dar.)
Daniel Offenhelmer, President
Mill River Consulting
Septic Systern Mcinagement Services
5 Blackburri Cl'er'Jer
(-Iotx".esler, MA 01930-2259
978-282-0014 or 1-800-377-3044
fax: 978-282-00,12
12/8/2003
MILL RIVER CONSULTING
Septic System Management Services
TOWN OF NORTH ANDOVER
SEPTIC SYSTEM CONSTRUCTION NOTES
ADDRESS: 15 North Cross Road MAP: 38 LOT: 188
INSTALLER: Peter Breen
DESIGNER: Merrimack Engineering
PLAN DATE: 11/25/03
BOH APPROVAL DATE ON PLAN:
DATE OF BED BOTTOM INSPECTION: December 4, 2003
DATE OF FINAL CONSTRUCTION INSPECTION:
DATE OF FINAL GRADE INSPECTION:
ELECT SYSTEM TYPE
X GRAVITY DISTRIBUTION
PRESSURE DISTRIBUTION
PRESSURE DOSING
HOLDING TANK
ADVANCED TREATMENT
OTHER
COMPONENT SUMMARY FROM PLAN
GALLON TANK = 1,500
LOADING OF SEPTIC TANK = H-10
GALLON PUMP CHAMBER =
LOADING OF PUMP CHAMBER =
TYPE OF SAS = Field
DIMENSIONS AND DETAILS OF SAS: 38' x 20'
SITE CONDITIONS
Inspections
Existing septic tank properly abandoned
El Internal plumbing all to one building sewer
® Topography not appreciably altered
Comments:
5 Blackburn Center, Gloucester, Massachusetts 01930-2259
toll free 1.800.377.3044 978.282. 0014 in f(-Ald L I c~c:m
Page 1 of 3
MILL RIVER CONSULTING
Septic System Management Services
SEPTIC TANK
❑ Bottom of tank hole has 6" stone base
D Weep hole plugged
gallon tank has been installed
(H-10 or H-20) (monolithic or 2 piece)
❑ Water tightness of tank has been achieved
(Visual or Vacuum Test or Water held for 24hrs)
Inlet tee installed, over access port
El Outlet tee (gas baffle or effluent filter) installed, over
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
Hydraulic cement around inlet & outlet
Comments:
D-BOX
Installed on stable stone base
❑ Inlet tee (if pumped or >0.08'/foot)
❑ Hydraulic cement around inlet & outlets
❑ Observed even distribution
El Speed levelers provided (not required)
Comments:
SOIL ABSORPTION SYSTEM
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
❑ 3/4-1 1/2" double washed stone installed
1/8-1/2" (peastone) double washed stone installed
laterals installed and ends connected to header (and
vented if impervious material above)
❑ Orifices @ 5 & 7 o'clock positions
5 Blackburn Center, Gloucester, Massachusetts 01930-2259
toll free 1.800.377.3044 978.282. 0014 tin(, 'co
-- m
7
.......... --.............. ............
Page 2 of 3
MILL RIVER CONSULTING
Septic System Management Services
El Gravelless disposal systems: type, number and
location as per plan
El Elevations of laterals installed as on approved plan
40 Mil HDPE barrier installed
Retaining wall (boulder/ concrete / timber/ block)
El Final cover as per plan
Comments:
SYSTEM ELEVATIONS
Benchmark:
Rod at Benchmark:
Height of Instrument:
INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION
Building Sewer OUT
Septic Tank IN
Septic Tank OUT
Pump Chamber IN
Pump Chamber OUT
Distribution Box IN
Distribution Box OUT
Manifold
Lateral 1 HIGH
Lateral 1 LOW
Lateral 2 HIGH
Lateral 2 LOW
Lateral 3 HIGH
Lateral 3 LOW
Lateral 4 HIGH
Lateral 4 LOW
Lateral 5 HIGH
Lateral 5 LOW
5 Blackburn Center, Gloucester, Massachusetts 01930-2259
toll free 1.800.377.3044 978.282. 0014 ij.-vfo0m ].Z I ti rig com
Page 3 of 3
MILL RIVER CONSULTING
Septic System Management Services
Elevations of laterals installed as on approved plan
Final cover as per plan
Comments: Potable water supply line from street to house was not as shown on design
plan. Pipe was rerouted around soil absorption system with slight modification in
location of soil absorption system. Waterline location to be depicted on as-built plan.
SYSTEM ELEVATIONS
Benchmark: 100.00
Rod at Benchmark: 3.36
Height of Instrument: 103.36
INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION
Septic Tank IN 97.39 97.84 97.51
Septic Tank OUT 97.14 97.44 97.11
Distribution Box IN 96.92 97.36 97.03
Distribution Box OUT 96.75 97.16 96.83
Lateral HIGH 96.70 97.08 96.75
Lateral LOW 96.47 96.86 96.53
5 Blackburn Center, Gloucester, Massachusetts 01930-2259
toll free 1.800.377.3044 978.282. 0014 info(dulij I H.Ver'("Ons'ul i i r1q.com
Page 3 of 3
Clear Day Page 1 of 1
elleChiaie, Pamela
.........
From: Dan Ottenheimer[info@millriverconsulting.com]
Bent: Thursday, December 04,2003 9:30 AM
To: pdellechiaie @townofnorthandover.com
Subject: RE: 15 North Cross Road -Bottom of Bed Inspection
All set for 3:00 today (12/4)
Daniel Ottenheimer,President
Mill River Consulting
Septic System Management Services
5 Blackburn Center
Gloucester, MA 01930-2259
978-282-0014 or 1-800-377-3044
fax: 978-282-0012
wvr ,trrillrivera;onsultirig.cotn
irrt��P�a�rrrill ri�� re°,rmrt�ul I.irrt,.�rangy
-----Original Message-----
From: Pamela DelleChiaie [mailto:pdellechiaie @townofnorthandover.com]
Sent: Wednesday, December 03, 2003 1:58 PM
To: Daniel Ottenheimer(E-mail)
Subject: 15 North Cross Road - Bottom of Bed Inspection
Irmportance: High
P ease sraGmr:rtstir ra Bottom of Bed InQ.:l.ection for UM above with Peter 131 een ...978.2651580 I..le ik bE°
ready tornor row morning,
Thanks,
ks,
rare
Pamela DelleCffiaie, Health Dept Assistant
7"dwn of North An(Jover
Community Development& services
7 Charles ,street
North Andover, MA 01845
pdelleerhiaie towiiotrrortharrdovet-,cxonn
7`el, 978-588-9540
r-ax 978-688-9542
12/4/2003
Page 1 of 2
elleChieie, Pamela
From: Dan Ottenheimer[info @miliriverconsulting.com]
Sent: Wednesday, November 12, 2003 10:27 AM
To: pdellechiaie @townofnorthandover.cam
Subject: RE: 15 North Cross Road-Urgent Plan Review Request
We will make this a priority. Regarding construction, if the contractors can get clean stone and the frost
is not too thick I do not have a problem with continuing construction beyond December 1.
Dan
Mill Diver Consulting
Septic System 1 anagement Services
5 Blackburn Center
Gloucester,MA 01930-2259
978-282-0014 or 1-800-377-3044
fax: 978-282-0012
info@milltiverconsulting.com
-----Original Message-----
From: Pamela DelleChiaie [mailto:pdellechiaie @townofnorthandover.com]
Sent: Wednesday, November 12, 2003 10:06 AM
To: Daniel Ottenheimer(E-mail)
Cc: Lagrasse, Brian
Subject: 15 North Cross Road - urgent Plan Review Request
Importance: High
Hi Dan,
The homeowner of 15 North Cross Road, Jan Rooney, came in this morning concerned about her plans
getting reviewed in time for septic construction. These are revised plans submitted by the engineer last
week. Here is her situation:
Mrs. Rooney and her husband are being transferred to St. Louis, and are moving the first week of
December. The closing on the house is Dec. 9th. Her main concern is that they have buyers for
their house, and as this is a revised set of plans, if it does not pass,they will lose the sale, and be
out of state, and can't do anything about it. She states that she knows that Nov. 30th is the cutoff
for construction.
November 30th is the formal cutoff construction date in the regulations, but my understanding is that,
based on the weather conditions, and working within reason, a system could be potentially
be repaired(constructed after that date if there is a hardship, or a situation warrants it being so.
Therefore, can you make this revised plan review a priority due to the above situation? I know that you
have lots of other things going on, but I did tell Ms. Rooney that I would forward her concerns to you. If
you want to call her at all, her number is: 978.682.4741.
Thank you.
Pamela tDelleChiaie, hk.balth Dept. Assistant
1.1/12/2003