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Home My WebLink AboutCertificate of Compliance - 99 RALEIGH TAVERN LANE 12/9/2004 Town of North Andover Q NORTN , Office of the Health Department Community Development and Services Division v ; a 400 OSGOOD STREET North Andover, Massachusetts 01845 s"""° �g 1 SACHU S� Susan Y. Sawyer, REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax cIFRTIFIC TE OF CO�V1'1'.GJ--/ IL As of: (December 9, 2004 This is to certify that the individuafsu6surface disposafsystem repaired FuffSystem by James Xellett at 99 Raleigh Tavern .cane North Andover, W,4 01845 has been instaffed in accordance with the provisions of Title V of the State Sanitary Code and with the,North Andover 0oard of I feafth regulations. 7(ie Issuance of this certificate shaff not be construed as a guarantee that the system wiff function satisfactori(y. Susan T Sawyer Tu6fic Yfeafth Director 130ARD OF APPEALS 688-9541 BUILDIN6 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 689-9535 TO F NORTH ANDOVE It.SEWAGE' DISPOSAL SYSTEM INSTALLATION CI•;T,tTII''ICATION The undersigned hereby certify that the Sewage Disposal System( )constructed; (�repaired; by .located at was installed in conformance with the North Andover Board of Health approved plan, System Design Permit.# ,plan dated with a design flow of gallons per day. The materials used were in conformance with those specified crri the approved plan;the system was-'installed in accordance with.tlie provisions of 310 :CI IR.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 inspecttion date: Engineer Representative Final inspection date: Engineer Representative Installer: Date: ,,. Engineer: g ppg ~� Date: 0.� qq yPY77PH¢ 7,PM pI d, . """ .....o _............... ....... —.... ,__..— ............ ... . ......_ �.� ..�o..._� ................... �_ f> NEW ENGLAND ENGINEEF'�ING SERVICES ,_... ....... INC ... . .... . -d.. . - October 15, 2004 �� t.. Susan Sawyer North Andover Board of Health 27 Charles Street OU. 2 0 ?(,)o4 North Andover, MA 01845ra�w Re; 99 Raleigh Tavern Lane,North Andover Septic System As-Built Dear Susan, The following Septic As-Built plans for the above referenced property are being submitted for approval and issuance of Certificate of Compliance. Enclosed are the following: 1. (3) Copies of the Septic System As-Built Plan. 2. (1) Form 3A—Certificate of Compliance Form. If you have any comments or questions please do not hesitate to contact this office. Sincerely, ";r,4�/"_* Steven E. Pouliot Project Manager 60 BEECHWWOOD DRIVE-NORTH ANDOVER, MA 01845,-(976)686-1766-(888):359-7645- FAX(976)685-1099 TOWN OF NORTH ANDOVER Office of COMMUNrrV DFVE1,0PM,EN[' AND SERVICES HEALM11 DEPAR rrMENT 27 CTIARLES STREE'r 41 NORT11 ANDOVER, MASSACHUSETTS 01845 cmu ccsan Y. Sawyer, IZE14S/RS 978,688,9540.....Phone PUb is Health Director 9M688.9542 FAX SEPTIC I NOTES ADDRESS: 99 Raleigh Tavern Lane MAP: 107.A LOT: 115 INSTALLER: James Kellett DESIGNER: NEES PLAN DATE: August 20, 2004 BOH APPROVAL DATE ON PLAN: September 28, 2004 DATE OF BED BOTTOM INSPECTION: September 29, 2004 DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = LOADING OF SEPTIC TANK GALLON PUMP CHAMBER = LOADING OF PUMP CHAMBER = TYPE OF SAS DIMENSIONS AND DETAILS OF SAS: SITE CONDITIONS ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer El Topography not appreciably altered Comments: Page 1 of 1 TOWN OF NORTH ANDOVER PVT I Office of COMMUNITY DEVELOPMEN"I"' AND SERVICES FlEA1,111 DEPARI'MFIN'T 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REIIS/RS 978.688.9540 Phone Public I lealth Director 97&6W9542 -FAX SEPTIC TANK ❑ Bottom of tank hole has 6" stone base El Weep hole plugged El 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, under access port El Outlet tee (gas baffle or effluent filter) installed, under access port El 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: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base El Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs Hydraulic cement around inlet & outlet Comments: Page 2 of 2 TOWN OF'NORT11 ANDOVER Offic( of COMMUNITV DEVELOPMEN'r AND SERVIC'ES 1-WAIJ11 DEPAR,rME'N'T' 27 Cf IARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 SLIsan Y. Sawyer, REIIS/RS 97&688.9540 Phone Public Health Director 978.688.9542 FAX D- OX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) 1:1 Hydraulic cement around inlet & outlets El 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 El Title 5 sand installed, if specified on plan El 3/4-1 Y2" 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) El Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan El Elevations of laterals installed as on approved plan El 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: 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: Page 3 of 3 TOWN OF NOR'm ANDOVER 00NI,#1 'r, 7. Office of COMMUNITY DEVEI,OPMEN,r AND SERVICES HE.AIJH DEPAR'rMENT' 27 Cl IAR[XiS STR EIET 14 NORTH ANDOVI-,"R, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978k88.9540 Phone Public Health Director 978.688,9542 FAX CONTROLPANEL 13 Alarm & Pump are on separate circuits El Alarm sounds when float is tripped El Location of control panel: Rated for exterior if placed outside 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 D-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 Page 4 of 4 TOWN OFN(fffll A114DOVEIZ Office o1'C0MMt.JN#TY DfiI/ELOIINIEINTAND 811RV'K1,S 0 14EAi-,,rH DEPAR'TMENT' 27 CHARLF'S STREET NORTH ANDOVER, MASSA011.3SETTS 01845 Ss Susan Y. Sawyer, REJ IS/RS 978,688.95,10 Phone Public Health Director ❑D-BOX Installed on stable El Inlet tee (if pumpe, .............. C/o-q ❑ Hydraulic cement ; ❑ Observed even di<1 El Speed levelers pr( 1!3 <' o Comments: SOIL ABSORPTION SYSTEM, N Bottom of SAS ex provided on plan 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 El 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: PRESSURE DISTRIBUTION ❑ inch manifold El laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan , Comments: Page 3 of 4