HomeMy WebLinkAboutCertificate of Compliance - 42 OLYMPIC LANE 3/24/2006 Town of North Andover pf "p RT#1
Office of the Health Department " °° 0 AL
Community Development and Services Division
400 OSGOOD STREET
North Andover, Massachusetts 01845 ��SSaCHUSE��y
Susan Y. Sawver,REHS/RS 978.688.9540-Phone
Public Health Director 978.688.8476-Fax
r(77XV 7ICA(7tTv OT C05 (I)rT O CE
As of:
March 24, 2006
This is to certify that
the individual subsurface disposal system was a
Full System Repair
Completed by:
,john Soucy
At:
42 Olympic Lane
,North Andover, W,4 01845
Yfas been installed in accordance with the provisions of Title V of the State Sanitary Code and
with the North Andover Ooard of Yfealth regulations.
The Issuance of this certificate shall not 6e construed as a guarantee that the system wdl
function satisfactorily.
r
Susan 7 Sawyer, 1RE7fSIQU
Eu6lic Yfealth Director
RO��RD OI ,1PPIIAI,S 638�)5l l BUILDING 683-9515 CON,St RVA"['ION 688-9530 11F ALT11 688-95-40 PLANNING 638-9535
TOWN OF NORTH ANDOVER ,, NORTH
Office of COMMUNITY DEVELOPMENT AND S_RVICES 3?•`�° -
HEALTH DEPARTMENT ~ 1 0 p
400 OSGOOD STREET "° • ,r*
NORTH ANDOVER, MASSACHUSETTS 01845 "S8 CHUS
978.688.9540—Phone
Susan Y.Sawyer,REHS/RS 978.688.8476—FAX
Public Health Director E-MAIL: healthdept@townoffiortilandovei-.com
WEBSITE: http://www.townofilorthandover.com
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System ( ) constructed; (>/) repaired;
by 3-61,j v Gy
(Pant Name)
located at .1
(Inst lation Address)
was installed in conformance with the North Andover Board of Health approved plan, originally
dated 9'11g le-jr 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.
Bed inspection date:
Engineer Representative(Signature)
,t) 165
And-Print Name
Final inspection date: F,.. 4—
Engi eer Representative(Signature)
.., C C9-
And- rint Name
f
Installet (Signature) Date:
J
And-Print Name
Engineer: D (Signature) Date:X10;
And-Pri t Name
AS-BUILT CBE CKILIST
LOT NUMBER STREET NAME
ASSESSORS MAP & PARCEL NUMBER
_ LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
INCLUDING RESERVE,.m::
TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PE
RC
TESTS
ELEVATIONS ATIONS OF DISPOSAL SYSTEM
/ TOP OF FDN ELEVATION
LOCATION
� S OF WELLS, DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM
LOCATION OF W ,Tiµ ,.-.:
R, GAS.,ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER. OF
TANK, &D-BOX
� ORIGINAL 5..._. .....
TAMP & SIGNATURE
IMPERVIOUS AREAS ®DRIVEWAYS, ETC.
F ' NORTH ARROW
LOCATION & ELEVATIONS OF BENCHMARK USED �
'Afp,
NE\/\/ ENGLAND EN(,')'1NEER1NG SERVICES
..00 .. ... ..... mow.
November 30, 2005
Mrs. Susan Sawyer
North Andover Board of Health
400 Osgood Street
North Andover, MA 01845 RECEIVED'
Re: 42 Olympic Lane,North Andover, MA DEC 0 1 Z005
As-Built Septic System Design
COWN AVER
Dear Mrs. Sawyer,
The following As-Built Plans for the above referenced property are being submitted for
approval.
1. Three (3) Copies of the As-Built Septic System Design Plans.
If you have any comments or questions please do not hesitate to contact this office,
Sincerely,
Steven E. Pouliot
Project Manager
cc: Homeowner
60 k1F.ECFIWO01.) DI''ME- Noti-r1l ANDOVER,, MA 01845-(978)686-1768., (888)3597645 a- FM(978)685.1099
"YOWN OF NORTH ANDOVER
Office of COMAII,JNII'N' I)EVEI,()['Ml ]' AND SERVR-J�,,`S 7
HEAI.,'111 DEPAR'YMENT
P
400 OSGOOD STR E'FT
.4
NORTJ I ANDOVFR, MASSACI 1USE'l-I'S 01845
Susan Y, Sawyer, RE11YRS 978.688,9540 Phone
Public Health Director 978,688.9542 FAX
ADDRESS: 42 Olympic Lane MAP:1 06B LOT: 110
INSTALLER: Mr. John Soucy
DESIGNER: Mr. Benjamin Osgood, P.E.
PLAN DATE: 9/13/05 Rev:
BOH APPROVAL DATE ON PLAN: 11/07/05
DATE OF BED BOTTOM INSPECTION: 11/17/05@11:00- MG
DATE OF FINAL CONSTRUCTION INSPECTION: 11/22/05
DATE OF FINAL GRADE INSPECTION: *q
SITE CONDITIONS
EExisting septic tank properly abandoned
EInternal plumbing all to one building sewer
ZTopography not appreciably altered
Comments:
Information above was completed at thel 1/17/05 inspection by the North Andover
Health Department.
SEPTIC TANK
Bottom of tank hole has 6" stone base
Weep hole plugged
1500 gallon tank has been installed
H-10 loading Monolithic construction
F-1 Water tightness of tank has been achieved
(Visual or Vacuum Test or Water held for 24hrs)
Inlet tee installed, centered under access port
Outlet tee (gas baffle or effluent filter) installed,
centered under access port
24" 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:
The first three items above were completed at the 11/17/05 inspection by the North
Andover Health Department. Mill River Consulting inspected the next four items on
11/22/05
Page 1 of 3
D-BOX
® Installed on stable stone base
• 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
❑ Bottom of SAS excavated down to soil layer, as
provided on plan
® Size of SAS excavated as per plan
® Title 5 sand installed, if specified on plan
❑ 3/4-1 '/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
® Gravelless disposal systems: type, number and
location as per plan
® Elevations of laterals installed as on approved plan
❑ 40 Mil HDPE barrier installed
❑ Retaining wall (boulder/ concrete /timber/ block)
❑ Final cover as per plan
Comments:
Page 2 of 3
SYSTEM ELEVATIONS
Benchmark: 100.00
Rod at Benchmark: 0.80
Height of Instrument: 100.80
INVERT ON DESIGN INVERT ELEVATION
PLAN
Building Sewer OUT N/A 96.21
Septic Tank IN 95.75 95.77
Septic Tank OUT 95.50 95.50
Distribution Box IN 95.15 95.15
Distribution Box OUT 9498 94.97
Chamber 1—Inv. 94.88 94.89
Chamber1_Top 95.34 95.33
Chamber 2_Inv. 94.88 94.89
Chamber 2—Top 95.34 95.33
Chamber 3 _Inv. 94.88 94.89
Chamber 3—Top 95.34 95.33
Chamber 4—Inv. 94.88 94.89
Chamber 4—Top 95.34 95.33
Page 3 of 3