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Home My WebLink About1055 SALEM (formerly 1053) CERTIFICATE OF COMPLIANCE o ° • PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATEON As of 4/18/14 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: New Construction On-Site ys By: Robert Daigle At: 1053 Salem Street Map 104D Lot 69 North Andover, MA 01845 The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Michele Grant Public Health Agent 1600 Os0ood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthondover.com 4 North Andover Health Department Contniunity Development Division QNSITE WASTEWATER SYSTEM T UCTI N NOTES LOCATION INFORMATION ADDRESS: 1053 Salem St. MAP: 104D LOT: 69 INSTALLER: Robert Daigle DESIGNER: Merrimack Engineering PLAN DATE: 3/27/13 BON APPROVAL DATE ON PLAN: 11/13/13 INSPECTIONS TANK INSPECTION: 11/13/13 then closed for winter; re issued permit in spring DATE OF BED BOTTOM INSPECTION:4/10/14 DATE OF FINAL CONSTRUCTION INSPECTION: 4/13/14 DATE OF FINAL GRADE INSPECTION: CCU SITE CONDITIONS NA Contractor reports any changes to design plan NA Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base NA Cleanouts per plan X Bottom of tank hole has 6" stone base X Weep hole plugged X 1500 gallon tank has been installed H-10 loading X Monolithic tank construction ® Watertightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (effluent filter) ® 24" inch cover to finish grade installed over outlet access port ® Hydraulic cement around inlet & outlet Comments: - 24" cast iron cover to within 6" finish grade over inlet..........IMR Pipe has not been bedded properly and went through the winter without being bedded. Told them that they need to bed properly with sand or stone DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box NA 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) X Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan X Title 5 sand installed, if specified on plan ® 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 ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: 1. Looking at the house closest side to house right hand side 2' short, 2. street side 1' short, 3. told Daigle to excavate to plan and will be reinspected, 4. Water in hole indicated pump water out until ready to put in sand, 5. First load of sand was ok, 6. Tank is exposed from the top to the bottom, recommended to sure up the tank for fear it could shift, 7. Reinspected SAS was sized to the plan, 8. Again, told Daigle to bed the tank pipes properly. FINAL GRADE [ Loamed [� Seeded Cover per plan Comments: DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by ngineer and installer As-Built Plan BM = 154.00 HR = 6.16 HI = 160.16 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 2.67 157.14 156.72 Septic Tank IN 3.14 156.67 156.52 Septic Tank OUT 3.49 156.32 156.27 Distribution Box IN 3.74 156.07 156.02 Distribution Box OUT 3.92 155.89 155.85 Lateral 1 TOP 3.96 /4.31 Lateral 1 INVERT 155.85 / 155.50 155.81 / 155.50 Lateral 2 TOP 3.96 /4.31 Lateral 2 INVERT 155.85 / 155.50 155.81 / 155.50 Bottom of Bed 6.09 154.07 154.0 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) 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 Z' -�' � u� �� _�> � ap � ~� �~ � ��_-�_ | l) _1 . All changes tn the design plan have been reflected on the as-built 2) _��_{xof suitable scale; (one inch = 40 feet or fewer for plot plans and one inch 20 or fewer for details of system oompmnomm) 3) �� otonnxb�r 8tz��i�uzn� �xu�xuorx&4ayandPurocl�nudocr � ' __ � ' ' � ~~ 4) Lot Lines and Location mf Dwellings served bvthe Locations,Elevations and Dinuuusiomaof ncluding applicable) \~/ ' systern,\` ) ~� N VIIII Ties Lo dwelling oc Permanent Structure/6Wells ----------- - - - ----- . From Septic Tank 8 Distribution ([) Box b. From Leach Area �n �� -- --/ �.~-~ ---- x ____'[iuo to Lot Lines from leach area � � AU Locations o{Deep Holes &Peres | \ �^ 9) __ZIbpof Foundation Elevation / ,/~ | lN Locations of Wells,Drains,Watercourses within 1S0 feet of system I Location of water,guu'electric lines,cable z �� -� � S ( of8toxotorcavit6bn G inches of]5nio6ed Grade 13) -Original Stamp&Signature 14) cation and holder of any easements which could impact the system / . � i � 8 � � lm YH |__��North Arrow iN' -�---STATEMENT^ � eq. uu this as-built substmitiallyag-ree with the appiovedplaji mid have deteiwij�7ed that Me hivak otit Signature o[Designer Date b. ^Ifa Signature of Desi ner Dab As of:Friday,April 29,2011 S p � r PUBLI C lifAtt`ll i tPARI' ltd"t tnininonNy nDoove,loprmnni Divi,ion tell" TOWN OF NORTH ANDOVER t r SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( eonstructed;( )repaired; By: �j R1,J - i dR� (Print Name) Located (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 G 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; '� ;w"" f Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: " Engineer Representative(Signature) And—Pri tit Name Installer: ,. �� (Signature) Date: a se And—Print Name E finer: 1 Signature) Date: � l �" . And—Print Name 1600 Osgood S'treet, 14o t n over, Massachusetts 0 1845 Phone 978.6 .9540 Fax 978.688.84761 Web l�:ttli-://www.town:�wfi�iorthand(ver.com