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Home My WebLink AboutCertificate of Compliance - 365 BOSTON STREET 9/13/2007 NORTH A� $6 q�0 a AL O F- 70 � I' ey � ° Lt1LMIL I...y1• SSACHUS� PUBLIC HEALTH DEPARTMENT Community Development Division CIF TI FIC�TE O F CO�VI<1'GI.,qjrVCE As of: Septem6er 13, 2007 This is to certify that the individual subsurface disposal system received a SATIS FACTOIRT ITNSITECTION of the: Newly ConstructedSeptic System By: Charlie Todd At: 3 65 Boston Street, aka Got 11 Boston Street Map 107. 10; Parcef 6 North Andover, W q 01845 The Issuance of this certificate shall not 6e construed as a guarantee that the system wifl function satisfactorily. udn 2'. Sawyer Pu6lic Ifealth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com TOWN OF NORTH ANDOVER �� ,�o oTH�N Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT" 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 cwus�a 978.688.9540—Phone Susan Y. Sawyer, REHS/RS 978.688.8476—FAX Public Health Director E-MAIL: healthdept @townofnorthandover.com WEBSITE: http•//www.townoftiorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL, SYSTEM ® INS'TALLAT'ION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( constructed; ( ) repaired; (Print Name) located at 865 Boston Street Lot 11 (Installation Address) r NQ. , r l 04,007R( was installed in conformance with the North Andover Board of Health approved plan, originally dated 9/28/04 and last Devised on 8/20/05 , with a design flow of 550 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: 10/24/07 g p (Signature) ,,Engineer Re resentaty (S E Jams-H. MacDowell Final inspection date: 9/26/07 -- °°- •-.w...... Engineer Representative,($ignature) James H..*. Hm. .Mac"DoN,7,ej1 And-Print Name :,� aq�..•—w'.'t+- ..>:4�' ^{J.Nr. - 'r�'�w r 7d?:cks5r ..,-":5�; ,7!�3t' x=,W2nEfPah55?d Installer: (Signature) Date: And- Print Name 'yt2�p tip ' .��" , Engineer � ,: � � (Signature) Date: 10/28/07 P lo.°3o tot9 n Clayton A. Moirou " And-Print Name may`" �^wa AS-BUILT CBECKILIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER _ LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE_ "µ 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 LOCATION& ELEVATIONS OF BENCHMARK USED q� TOWN OF NORTH ANDOVER Office of COMMUNI'D'Y DEVELOPMENT AND SERVICES a� HEALTH DEPARTMENT ENT 1600 OSGOOD STREE'T; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 ��ncHUS��y Susan Y. Sawyer, REI-IS/RS 978.688.9540—Phone Public health Director 978.688.8476—FAX QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES 1 ; .. LOCATION INFORMATION ADDRESS: ,,-,,,,) ` .�� MAP: LOT: INSTALLER: DESIGNER: . ,. ..�.. �. .. PLAN DATE: BOH APPROVAL DATE ON PLAN: TANK NSPECTION: °° DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECT ON: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer []Topography not appreciably altered Comments: SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading 'Monolithic construction ❑ 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 Wastewater System Documentation—Feb 2006 Page I of 6 TOWN OF NOR'A"H ANDOVER Office of COMM t..JINI"l'Y' 1)1EI,Ol�MENI" AND SERVI('.ES 0 '14EA1,111 DEPARTMENT 1600 OSGOOD STREET; BUilding 236 N0101-1 ANDOVER, MASS, CTIUSETTS 01845 SUS,ffll Y. Sawyer, REFIS/RS 978.6 9 9540 Phone Public Health Director e'l 978,6M8476 F`AX '44 Comments: PUMP CHAMBER Oee'lPottom of tank hole has 6" stone base W V eep hole plugged F-1 Combo Tank installed. Size: F71 1000 gallon Pump Chamber installed H-10 loading Monolithic construction)' Inlet tee-instalted-'centered under access port Pump(s) installed on stable base Alarm float working Pump On/Off floats working Separate on/off floats F I Drain hole in pressure line F-1 24" inch cover to within 6" of final grade installed over j e.. pump access port ❑ ❑ Water tightness of tank has been achieved Visual testing Hydraulic cement around inlet & outlet Comments, �x ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: F-1 Installed per manufacturers requirements F-1 All components working in accordance with manufacturer's requirements Comments: V, Wastewater System Documentation-Feb 2006 Page 2 of 6 TOWN OF NORTH 1kN DOVER Office, of COMMC1NI'f Y DEV :I-,OPME T tk D SERVICES HEALTH DEPARTMENT 1600 OSC GOD STREET; BUILDING 20; SUITE 236 �r�❑ .u,° *� NORTH ANDOVER, MASSACHUSETTS 01845 ��1�sAc"Us, � `USi111 Y. Sawyer, REHS/RS 978.688.95/40--Phone Public Health Director 978.688.8476—PAX 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;, �s'oil layer, as provided on plan Si M Size of SAS excavated as per plan Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ � Retaining wall kboulder/ concrete /timber/ block) Final cover as per plan Comments: " Wastewater System Documentation--Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER iaoRrH Office of CONINIUNI'TV DEVELOPMENT AND SERVICES HEALTH DEPARTMENT � p 1600 OSGOOD ST'REET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 ��IsgCHUSO Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OIL NORTH ANDOVER NORTW Office of COMMUNITY DEVELOPMENT AND SERVICES �204 , ff° HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 9 'I�AOA1nu�PP'4y NORTH ANDOVER, MASSACHUSETTS 01845 9rSgCHUSE� Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX 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 Suction line 222(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 Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT k # 1600 OSGOOD STREET; BUILDING 20; SUI'T'E 2-36 � JY ppO94teu M,y'(h NORTH ANDOVER, MASSACHUSETTS 01845 �SSACHU$ Susan Y. Sawyer, REHS/RS 978.688.9540—Pllone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT 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 Wastewater System Documentation—Feb 2006 Page 6 of 6