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Home My WebLink AboutCertificate of Compliance - 24 DEER MEADOW ROAD 11/30/2016 Arc� lqw PUBLIC HEALTH DEPARTMENT Town of North Andover Community and Economic Development Division CERTIFICATE OF COMPLIANCE As of: 11/34/16 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Replacement of an On--Site Sewage Disposal System By: Dean Dynan At: 24 Deer Meadow Road Map 104B Lot 68 N ��r oer-,�M_A 01845 The 'u cep of is certificate sh l t c trued as a guarantee the the system will function satisfactorily. Michele Grant Public Health Agent 120 Main St.,Norih Andover,Massachusetts 01845 Phone 918.688.9540 Fax 918.688.9542 Web www.northandoverma.gov I North Andover Health Department Community and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 24 Deer Meadow MAP: 104B LOT: 68 INSTALLER: Dean Dynan DESIGNER: Cornerstone Land Consultants PLAN DATE: 4/26/16, rev. 519/16 BOH APPROVAL DATE ON PLAN: 5/12/16 INSPECTIONS TANK INSPECTION: 7/8/16, 7/13/16 DATE OF BED BOTTOM INSPECTION:7/13/16 DATE OF FINAL CONSTRUCTION INSPECTION: 8/18/16 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS N/A Contractor reports any changes to design plan X 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 ® Cleanouts per plan X Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® 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 (effluent filter) 24" inch cover to finish grade installed over inlet and outlet access ports Neoprene boots around inlet & outlet Comments: 7/8/16 tank and pump chambers not set on 6" of stone. Spoke to engineer, must be set on 6" stone and be re-inspected (B. LaGrasse). 7/13/16 re-inspected and stone base ok (B. LaGrasse) Pump chamber Dean installed 2 float system. I spoke to the engineer and they will change it out to a 3 float system. Please check (M.G.) PUMP CHAMBER X Bottom of tank hole has 6" stone base Weep hole plugged 1000 gallon Pump Chamber installed H-10 loading Monolithic tank construction Inlet tee installed, centered under access port Pump(s) installed on stable base Alarm float working F-4,1" Pump On/Off floats working Separate on/off floats Drain hole in pressure line Z 24" cover at final grade installed over pump access port Z Water tightness of tank has been achieved by Visual testing Z Neoprene boots around inlet & outlet Comments: 8/18/16 — Pump test needs to be completed when installer confirms the electrical work is completed and water is in pump chamber. Installer will leave D-box accessible for pump test (I. Rowe) CONTROLPANEL CI Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped Location of control panel: outside of house on back deck ❑ Alarm signal located inside: basement Comments: 8/18/16 — Control panel needs to be inspected at time of pump chamber inspection (I. Rowe) DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ❑ Observed even distribution NIA Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: 8/18/16 - Equal distribution needs to be inspected at time of pump chamber inspection (I. Rowe) SOIL ABSORPTION SYSTEM (General) X Bottom of SAS excavated down to C soil layer, as provided on plan X Size of SAS excavated as per plan ® Title 5 sand installed, if specified on plan NIA 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 NN/ Retaining wall (boulder 1 concrete 1 timber/ block) Final cover as per plan Comments: FINAL GRADE Loamed [•� Seeded Cover per plan Comments: k j[ S Q _- �,,�� M (J-- DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer II ❑ As-Built Plan BM = 98.95 HR = 7.31 HI = 106.26 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 5.89 100.07 101.25 Septic Tank IN 7.38 98.53 100.57 Septic Tank OUT 7.78 98.13 100.32 Pump Chamber IN 7.81 98.10 100.28 Pum Chamber OUT 2" 7.52 98.57 100.03 Distribution Box IN 2" 224 103.85 103.89 Distribution Box OUT 4" 2.22 103.69 103.73 Lateral I TOP 2.2212,51 Lateral I INVERT 103.691 103.40 103.73 /103.50 Lateral 2 TOP 2.5212.86 Lateral 2 INVERT 103.391 103.05 103.231 103.00 Lateral 3 TOP 3.19 / 3.48 Lateral 3 INVERT 102.72 1 /102.43 102.73 / 10Z50 Lateral 4 TOP 3.60 / 3.95 Lateral 4 INVERT 102.31 / 101.96 102.23 / 102.00_ 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 I 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 I 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, 1 0.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws PUBLIC HEALTH DEPARTMENT Community Development Division TOWN OF NOWI'II ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CER'T'IFICATION I"he undersigned hereby certify that the Sewage Disposal System(constructed;( )repaired, (.Print Nance) Located at: (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated and last revised on with a desi n flow of M p .., . q g _._....gallons per day. T'he materials used were in conformance with those specified on the approved plan,the system was installed in accordance with the provisions of 310. CMIZ 15.000,T" nel local " regulations, and the final grading agrees substantially with the approved plan.All work is acc rattily represented on the As-built which has been submitted to the Board of I-lealth. Bottom of Bed Inspection Date: F gineer R presenta ive ignature) s r°' - And—Print Name Final Construction Inspection Date:, nginee Represent rove(Signature) And—Print Name Installer: (Signature) Date:--.---- And---Print Name Engineer: ) _.(Signature) Date ,� ,_.._ t ( 1 _ I And—Print Name J _ ..... -------------------- — -- 1600 Osgood Street, North Andover, Massachusetts 41845 Phone 978,688.9540 Fax 978.688,8476 Web http://www.northandoverma.gov F 0 ..,,,.. er PUBLIC HEALTH DEPARTMENT Community D4velopment Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION i The undersigned hereby certify that the Sewage Disposal System(V�constructcd;O repaired; (Print blame) Located at: Ne-e (installation Address) Was installed in conformance with the North Andover Board of health approved plan,originally dated ( ` :e- -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,']" and local"""`--.. regulations,and the Ptttal grading agrees substantially wIlth the approved plan.All work is acc'rately represented on the As-built which has been Submitted to the Board of Health. e Bottom of Bed Inspection Date:��-. Et gineer R presents ive sguature) And—Print Name Final Construction Inspection Date; i # Enginee ttepresent tive(Signature) L Atid—Pt int N'a Installer (Signature) ate: And Print Name Engineer; (Signature) Date: � � s ,1 » + And—Print Name r I 1600 Osgood Street, North Andover,Massachusetts 01845 — Phone 978.688.9540 Fox 978.68$;8476 Web http://www.nortliandoverma.gov To of North. Andover — Septic S ystem ~ AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected and noted on the as--built plan p 1 inch = 40 feet or fewer for plot plans) 2 built lan as a suitable i) „ trlvA ° ar Lot Number ...,... Location of Dwellings served by the system 1 Lot Lines and I, 5 tuitions Xlev f As-built sy enl components,including reserve (if applicable) ations and.Dimensions o , Q fi ell 1 ° all tank openings,d bc , �„� 1 ' , om dwelling or Permanent Structure 7) e„ Setback distances are shown on the as-built plan from system components to; Subsurface,interceptor&foundation drains Catch basins Property lines Dwellings or other structures Private water supply or irrigation walls Watercourses or wetlands f'1) Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) V" Location of water,gas,electric lines,cable,control panel (if applicable) 10) Location of Structures within 6 Inches of finished Grade 1.1) '"/Original Stamp &Signature 12) °° Location and holder of any easements which could impact the system 13) Impervious Areas;Driveways,etc 14) 7_1 North Arrow 15) 'f,Location &Elevation of Benchmark used 16) "� STATEMENT ON PLAN (NA 5.:3) a. "1 certify the locations, elevations, ties, cover material;exposed cornponent covers etc., Shown on this as-built substantially agree with the approved plan andhave determined that the break out elevations,if applicable,have been met." Signature of Designer Date b. "7f a ST UCTURAL WALL M FRF4F,NT(NA 4.9)a Letter or statement on the as-built indicatinx the wall w was or was not constructed in accordance with the in design and, manufacturer's specifications, Signature of Designer Date Revised 3/17/15 24 Deer Meadow Road- Tank/Pump Chamber Pics 7/7/26 J a � e /" Y �4 4 hi I� 4v"VE � NFL �qNr�� ➢I�f � �'1n i1!«f off'�,�'y� �U �i a I i j i I Page 1 of 4 24 Deer Meadow Road -Tank/Pump Chamber Pics 7/7/1.6 r, t 1 1 r r I� rz� q; r' J; ra r irk/ s i �rw ✓eeN,JrG%� p r�ri'�� , a,. i 1r m /irtA �r� r % IFV I / R` �wW IFY �r Page 2 of 4 24 Deer Meadow Road - Tank/Pump Chamber Pics 7/7/16 'r c 'b k � r Y J f !f Y pr k W f � a a m C i e lrtrXd'� II Y IV,Y 'III f i r 1 I 4 , i Page 3 of 4 24 Deer Meadow Road - Tank/Pump Chamber Pics 7/7/16 m 1 i lt� AA 1 lJ(J { w# � r i;it { �"o-l�� + �N � ✓x xr �y�r�� ' �'" s NypR � P 5 Page 4 of 4