The URL can be used to link to this page

Home My WebLink AboutCertificate of Compliance - 325 BOSTON STREET 12/12/2013 PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFRC-ATE OF COMPLIANCE As of: 12/12/1 This is to certify that the individual subsurface disposal system received a COM SATISFACTORY INSPECTION of the: plete Repair and Construction of an On-Site Bill Hall At: 325 Boston Street Map 107D Lot 136 North Andover, MA 01845 The/� suanee of"this cart f cafe shall not be construed as a guarantee that the system will Function satisfactorily. r MichVle 'Grant � i Public Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.8416 Web www.iownofnorthandover.com matiw�Yoo�""�^ h CHO PUBLIC HEALTH DEPARTMENT Coirrmunity Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certif that the Sewage Disposal System"constructed;( )repaired; By:_ -- — (Print Name) Located at )_,:, .,x� .. (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated 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. Bottom of Bed Inspection Date: Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: _ Engineer Representative(Signature) And—Print Name Installer:— (Signature) Date: And—Print Name Fnginer:` r„ (� ) ,..,.. ��° ,r,, 'n S° ''('Signature) Date: And—Print Name 1600 Osgood Street, Furth Andover, Massachusetts 01845 Phone 970.688.9540 Fax 97 .688.8476 Web http://www.townofnorthandover.corti No, THE COMMONWEALTH OFMASSACHUSETTS FEE BOARD OF I-1EALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) Complete System The Undersigned hereby certify that the Sewage Disposal System;Constructed Repaired Upgraded Abandoned by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow I I I I I 62 (gpd) Installer T,0, Designe Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 ,1— 411 North .Andover Health Department Corn nunity Development Division QNSITE WASTEWATER Sif T M CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 325 Boston Rd. MAP: 107D LOT: 136 INSTALLER: Bill Hall DESIGNER: Christiansen & Sergi PLAN DATE: 9/9/13 (rev. 10/4/13) BOH APPROVAL DATE ON PLAN: 10/8/13 INSPECTIONS TANK INSPECTION: 11/12/13 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11/21/13 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan N/A Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: Tank was moved in order to provide straight building sewer line. SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base N/A Cleanouts per plan ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged X 1500 gallon tank has been installed H-10 loading X Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (gas baffle) ® 24" inch cover to within 6" of finish grade installed over outlet access port N/A Hydraulic cement around inlet & outlet Comments: Neoprene boots DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box N/A 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 N/A 40 Mil HDPE 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 N/A Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: internal 29'x48 5'overdig 38' 58' SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers High Capacity ® Number of chambers per row: 12 ® Number of rows (trenches): 3 Comments: Total Chambers = 36 FINAL GRADE ❑ Loamed ❑ Seeded ❑ Cover per plan Comments `t. o." :,; l, r � �- C D®CU ENTS NEEDED �, �.... � 6(A .., Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer As-Built Plan BM = 105.13 HR = 6.70 HI = 111.83 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 1.30 110.18 110.09 Septic Tank IN 1.63 109.85 109.76 Septic Tank OUT 1.93 109.55 109.51 Distribution Box IN 2.02 109.46 109.43 Distribution Box OUT 2.18 109.30 109.26 Lateral 1 TOP 2.30 Lateral 1 INVERT 109.18 109.16 Lateral 2 TOP 2.93 Lateral 2 INVERT 108.55 108.46 Lateral 3 TOP 3.58 Lateral 3 INVERT 107.90 107.86 Bottom of Bed/Chamber 3.65 4.28 4.81 108.18 107.55 108.20 107.55 107.02 106.90 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 i i °ROf'�RrY LINES Sh'G`v'iN sN ER� iAKc ''d r{s�j� �.YiC;,'��v P� �I:� A.RD PEC:ORG�. i FOR NORTH Af\,'' w'L BOARF' _N'S °_A f4 i E GEL 1� 71.i1s 1 i U;N�L v � 1 JI e, G': wZ`o; Prze-� �j r � �� OJ"i 1 t y e oz ja Y i .� 4 Town of over — Septic System a AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected on the as--built 2) ' J's of suitable scale; (one inch = 40 feet or fewer for plot plans and one inch = 20 or fewer for details of system components) 3) V Lot number,Street Name,Assessors Map and Parcel Number 4) Lot Lines and Location of Dwellings served by the system 5) c/Locations,Elevations and Dimensions of system,including reserve (if applicable) 6) i,/Ties to dwelling or Permanent Structure &Wells a. From Septic Tank&Distribution (D) Box b. From Leach Area 7) k°'Ties to Lot Lines from leach area 8) Locations of Deep Holes &Peres 9) _;�Top of Foundation Elevation 'j 10) ` Locations of Wells,Drains,Watercourses within 150 feet of system 11 0 of water,gas,electric lines,cable 12) _- ,"location of Structures within 6 Inches of Finished Grade 13) Original Stamp &Signature 14)`� 1, Location and holder of any easements which could impact the system 1 Impervious Areas;Driveways,etc 1.6) _North Arrow 17) __,�"_,tocation&Elevations of Benchmark used 18) _ STATEMENT ON PLAN (NA 5.3) a. "1 certify the locations, elevations, ties, cover material;exposed component covers etc.,shown on this as-built substan tiallyagree with the approved plan and have determined that the break out elevations,ifapph'oable,have been met." Signature of Designer Date b. "If a STUCTURAL WALL IS PR15SENI'(NA 4.9I a Letter or statement on the as-built indicatin&the wall- was, or was not; constructed in accordance with the intended design and an v manufacturer's specificfltiorrs." Signature of Designer Date As of:Monday,December 02,2013 Blackburn, Lisa From: Sawyer, Susan Sent: Thursday, December 05, 2013 3:24 PM To: phil @csi-engr.com Cc: Blackburn, Lisa Subject: lot 13 Boston Road Phil, I reviewed the As-built. I understand the driveway is not in yet, which is ok, but I do not see where the water line ended up going in or any other utilities. I hate to waste trees, but this is a detail that future owners ask about. Could you put in on and send a signed and stamped copy please? All else looks great. Thank you Susan Susan Sawyer Public Health Director Town of North Andover 1600 Osgood Street Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mailto:ssaw re townofnorthandover.com Web www.TownoMorthAnclover.corn 10 . , w4 m .,,,, .. Please note the MaSSachusetts Secretary of State's office has determined that most ernails to and fMm nuuiicipal offices and officials are public records,For more information please refer to:htt :/P m /www.sec,state. a.us/L)e/ rreidx.htni. Please consider the environment before printing this email. 1