HomeMy WebLinkAboutMiscellaneous - 175 OLYMPIC LANE 4/30/2018PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: 11/23/15
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Repair of pipe from house to tank
By: Todd Bateson
At:
175 Olympic Lane
Map 106.B Lot 0131
Orth Andover, MA 01845
of this e"icshall not eSopstrued as a guarantee that the system will function satisfactorily.
.chele Grant ' - '
blic Health Agent
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
North Andover Health Department
fommunity and Economic Development Division
ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 175 Olympic Lane
INSTALLER: Todd Bateson
DESIGNER:
PLAN DATE:
BOH APPROVAL DATE ON PLAN:
INSPECTIONS
MAP: 106.13 LOT: 0131
Pipe INSPECTION: 11/23/15 Broken pipe from house to tank replaced
DATE OF BED BOTTOM INSPECTION:
DATE OF FINAL CONSTRUCTION INSPECTION:
DATE OF FINAL GRADE INSPECTION:
SITE CONDITIONS
Comments:
SEPTIC TANK
❑ Contractor reports any changes to design plan
El [Existing septic tank properly abandoned'.
❑ Internal plumbing all to one building sewer
❑ Topography not appreciably altered
❑ Building sewer in continuous grade, on
compacted firm base
❑ Cleanouts per plan
❑ 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
(gas baffle/effluent filter)
❑ inch cover to within 6" of finish grade
installed over one access port
❑ Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 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
❑ Pump On/Off floats working
❑ Separate on/off floats
❑ Drain hole in pressure line
❑ cover at final grade installed over pump
access port
❑ Water tightness of tank has been achieved by
testing
❑ Hydraulic cement around inlet & outlet
Comments:
CONTROLPANEL
❑ Alarm & Pump are on separate circuits
❑ Alarm sounds when float is tripped
❑ Location of control panel: basement
❑ Alarm signal located inside: basement
Comments:
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
❑ Speed levelers provided (not required)
❑ Schedule 40 PVC Pipe
Comments:
.y jn—
at
.----------------------------------------------------------------------------------------------------------------------------
Installer o MPIC ANEh be ' accor ance with th pro isions of TIT E 5 o the State En ironm tal Code s desc ' ed in the
a • plicatsp al orks Construc 'o Permit No. B - 15-091 Dat d ovember 1 201
----------------------------------- -- --------------------------
Printed On: Nov -19-2015 BOARD OF HEALTH
----------------------------------------------------------------------------------
Commonwealth of Massachusetts
Map -Block -Lot
106.60131
BOARD OF HEALTH
---------------------
Permit No
North Andover
- BHP -2015-0911 - --------------- --
FEE
$125.00
---------------------
DISPOSAL WORKS CONSTRUCTION PERMIT
Permission is hereby granted Todd B-ateson
- - - - -----------------------------------------------------------------------------------------
to (Repair) an Individual Sewage Disposal System.
atNo -OLYMPIC C LANE -------------------------------------------------------------------------------------------------------------------------------------------------
as shown on the application for Disposal Works Construction Permit No. BHP -2015-091 Dated November 19, 2015
------------------------
-- .-----------------------------
-------------.:. ----------------
Issued On: Nov -19-2015 L` BOARD OF I EA�LT
Syr Application for S:00 , , Disposal . S,►stern
Construction; Per -TOWN OF
NOR'T'H ANDOVER, MA 0.18.45
Important:
1Nhen`filling out
forms on the
computer, use
only -,the tab key
to move your
cursor -do not
use the return
key.
a new on-site'sewage disposal system*
// /%--/.S
TODAY'S DATE
$ 250A0 - Full Repair
$425.00 -Component
❑7epair
it or replace an existing on-site sewage disposal system* _
or replace an existing system component — What? I � fir° "^ �A^�
A. Facility Information
i 75 e -9l
Address or Lot #
Cityfrown RECEIVED
2: *TYPE OF SEPTI -SYSTEM*:
➢ ❑ Pump 04ravity (choose one) NOV 19 2015
—if pump system. attach copy of electrical permit to application'
➢ onventional System (pipe and stone system) TOWN OF NORTH ANDOVER
➢ ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certificafiorW system.)
➢ ❑ Pressure Distribution S.A.S. (No D -Box)
➢ ❑ Pressure Dosed (D -Box Present) SAS.
➢ ❑ Does the system require an effluent filter? Yes No
If yes, does plan specify make and model of filter? YES = (no further info. needed)
NO = (installer must specify brand of filter before DWC issuance)
WAetis theMakc?
2. Owner Information
Address (if different from above)
-Ae. A j
City/Town
3. Installer Information
What is theModat"
s 0ly^;e-
State
97g G1r.3
Telephone Number
,018A-15—
Zip Code
Name Name of CompOECON ENTE:4PRISES, INC. .
)L� �r� (l4 �• 111 ARG ILLA ROAD
Address L
ANuavER, MA01810
Cityfrown
4. DeSI. r
Name
Address
Cityfrown
State
Zip Code
_ f %$� �t!✓r'- a yds
Telephone Number (Cell Phone # If possible please)
Name of Company
State Zip Code
Telephone Number (Best # to Reach)
Application for Disposal System Construction Permit • Page 1 of 2
0
PAGE20F2-
A. Fafflity:Information C. formation continued....
S. Type, of Building: Ve'sIdentlal Dwelling or []Commercial
B. Agreement
The undersigned agrees to ensure the construction and maintenance of the afore-deicribed
on site sewage disposal system In accordance With the Provisions of T1691of the
EnvIronmental Code, as well as the Local Subsurhice Disposal Regulations for the Town of
North Andover, and not to placethe system 1h Operation until a Certificate of ComplIahce has
been Issue O- Y this Board of Health.
Name Dite
ptvlBk:
Lppr6. ed ed oarHd6
o h. Ith Representative)
Nae Date
Application Miappr.oved.. for the following reasons:
For Office Use Only:
1. Fee AttAr-bed?:
Yes NO
2-- PtOlcctMgb2gerObligation Fon2zAtwc.'be'd? yis
3- Pump SMtem? Ifsoi A=cb CoDy afEka*01 pemit
4. Fbundgdaa As-BWM? (new construction -ronly).-
Yes.
(Same scale as approvedpIka).
S. F1oorPL1ns?*(hew construction, only).-
$Y3ti3M-:C:dnstMCfiOh Permn � Page 2 Of 2
M i
SEM C'S.'Y3TM•MVAL- M. 'Mlk ' mm► , N :OB%irATtoNS
As flW-Nqt& Aadavrr.li =cd fr�� i� ht=ttcd4tt'f6a•theaeptia syetc fo2.thap�op tty
Ph"dwan=4 Abd Mad
Dated
'• ��i A va tevidw
d
I nndethe foilow*g► obliptiom fot sz sagemcnt ofws project:
.-
i. As the fastsllec, I sirss.obl�gatod fp 6bWa AIIpeapatr aad B. ad offIeatth ipproved phma� to
pe g any.' vak ft a s
2. ds die .I. i waIl a°9 and iS'wpwdwL mhooemniii.� Anp
oupeam nutft4oe *Tcampkyg&"'mlnqfudm end tho spstefin is namady theft
item 6=VAMzbt
Ast6Wdftc4-jvj I!.&- jr~ fp. hm A6 o_ebwW.work. idz the 23
ispect Oat ea•nothave tob4pmsart:
l ZIPtf 1a' ap fcr ci ii�os .t , e&--
•OIC'(at a fi�m the of Pft gust
.. .
• ba itibmittied•to �to.Bo�ad ofiia�, a�brt: .• for�iii � peu. 'I�stallea must
beet tfttt thi ,3asp ithat per; &ctdmt"e ba#�lym d$we to
• . '- 'eat .txitd►ork�ctzo.. :. . - ' •
`-silera�at�agt'iaaPoawhiIlags eotupitte: insml�ct does zxot
have to be!ottifbe. �'' • .
4. As•the imsmlIq I undid dutady itmyp to '�itbrrth�r�d ,(Q �) i atti leggited
is ctpiet jm has. of the sy rtag its% #tits ed r r iaat dtAtioa: j� �
• -- - ,m SIO r� �ti�efaM e�tl• ernitif�#1fYes'
men>n • eid fol e• !' frfiaoar Q� '�'�F•+�.olr+� rWatior �J�
5.. SSU • I tl� pct pf tb� oamitao
a
Detimmia that. psrercdeval�da�o a�ftlre e�ate�,adan lbe�pr s+e�
brl U awd
. �'Phul�aapea�aabj►Bo�otat�Tailt��l�otcoaeutdatit�, • . .
d •�'• �i a Croat,PAF , `AftwgFmOother .
c�ampoaeatlt;
6.
5 1flJln•.^,twr Va1X.A la111 LVl jr
-0VED DATg IDI PdOVa AVA Ob FA
eaepnst
3 -
J?M 0K
1. Distance Tot
a. Wetlands
b. Drains
c. well
' 2. Water Line Location
3• No PVC Pipe .
i�. Septic Tank - -
i a.. _ Tess - -_Length & To Clean -Oat Cowers. -
b. Cement Pipe to Tank pn Both Sides of Tank
Distribution Box
a. Covers kBox - No Cracks -
b. All Lines .Flowing Equal Amounts _
'
C. No Back Flow
6.- Leach Field or Trench
a. Dimensions
b. Stone Depth
'.. e: Capped Inds
d. Clem .Double Washed Stone
?. Le/StonD*th
hplts
"
a.s '
b.
c.ds'd.e.pe to Pit - Both Sides.
f. Clean Double Washed Stone
8. No Garbage Disposal.
9. -Anal, Grading Inspection
10. Barricading Covered System
x€ 11. As Built Sabudtted
-C _ a. Lot Location -. = --
b. Dimensions of System
c. Location -.4th Regard -to Pere Test
d. Elevations
e. Water Table
44
.f '
J _
4
':PPROV ED DATE PROVIDED
Title 5
Reg. 2.5 IF
i
Reg. 6
ail
?dOR"LH ANDOVER BOARD OF HEALTH
1,e r#
DISAPPROVED DATE 'TIME REASON
Th submitted plan must show as a minumum:
/
(a) the lot to be served (area,dimensions ,lot #,abutters)
(Planning Board -files)
(b). location and log of deep observation holes -distance
to ties
(c location and results of percolation tests -distance
to ties
(d f tions & calculations showing required
design calcula
leaching area
location and dimensions sf system -(including reserve
area)
�f existing and proposed.contours
M location of any wet areas within '100'of wetla e sewag
disposal- system- ot-" disclaimer (checkmapping
/ .) surface and subsurface drain's within 100' of sewage
disposal system or disclaimer within '100' of
(i) location of any.dralnage easements board
sewage disposal system or disclaimer (planning
files)-
l known_-:-sou-rces_ of _Lvater- supply .wit-hin-- 200' of sewage'.
dlspos:ai-.system_ ar-_disciaiiner
(k location- of any -proposed well to serve=:the lot ('100
from leaching facility)'
(l. location -of water lines. on property ('IO' from- leachi�
facilities)
1location of benchmark
n driveways
garbage disposers
P) no PVC is to be used in construction
�q) a profile of the system (elevations of basement, plu
pipe septic tank, distribution box inlets and outle:-
distribution. -field piping and any other elevations)
( maximum ground water elevation in area of sewage dis
system
(s) plan must be prepared by a Professional Engineer or
other professional authorized by law to prepare Bucy
plans
S"t i c Tank s
Capacities 150% of flow, water table, tees, depth
of tees, access, pumping,
0b Cleanout
from cellar wall or in-groundswimming pool
(d 25'. from subsurface drains
I)-
ail
Distribution Boxes
tic, Slope greater than 0.08
'A
(b� Sump
Leaching Pit
Leaching pits a referred whej?e the installation -is
Leaching
pits
s a p
possible
(a) Cale ations of leaching area (minimum 500 S.F.)
SP
(b Sp-,cing
r r c
face drainage 2%
(
4-
d Cgver material
V?_ S -12'74"I e -A
+ -re C Alt.
LL e h
in Fields
a) %Greater than 20 minutes/inch
Area (minimum _900 S.F.)
Coristruction of field
Surface drainage 2%
(e 201. from -cellar wall or inground swimming pool
Leaching Trenches
(a Calculations
leaching
eachi1g area (min. 500 S.F.)
(b Spacing t. min. Gft. with reserve between):
c Dimens ns
nstructI on.
(e--Stone7
(f Surface drainage
2%
Downhill Slope
�a� Slope I/X to be shown
b 150 to
be shown
Pumps
(a)- ApDrov
.(b) Stan y power
A?PRUP IM
Provided:
DISOPROM DATE
Reasons s
LOT #
Title V FA11
Reg 2.5 The submitted plan must show as a minimum*
I(e
a) the lot to be served-area,elmensions lot �#3abutters
b location and log deep observation h¢leis-distannce to ties
clocation and results percolation tests -distance to ties
d design calculations & calculations sho-.dng requireel leaching area
) location and dimensions of- system -including reserve area
f) -wdsting and --proposed contours
T:7(g) location any wet areas Athin 1001 of sewage disposal- system or
disclaimer -check wetlands mapping
!"" (h) tourface and subsurfaces &- ins within 2001 of sewage dibposel
System or disclzaimer
(i) locate drainage e> sements � tlzn l00' of a&w e disposal
systtm or disclairer-Muini.iag Roard files
(�} known sources of water, ==ply vithim 200' of aa,,mge disposal
system or disclaimer
✓ (k) location of my proposed well to serve lot -1001 from leaching facility
(1) location of water lines on property -10 from leaching facility
(m) location of benchmarks
(n) driveways
(o) garbage disposals
(p) no IVC to be used in construction -
(q) profile of system -elevations of basement, plumb, pipe, eeptic tank,
distribution boat inlets and outlets, distribution field piping and
tither elevations
(r) ymm ground water elevation in area sett -age disposal sy,4tem
_ (s) plan mist be prepared by a Professional Engineer or other
professional authorized 'by lay; to prepare such plans
Reg 6 otic Tis
(a) ckac�50% of flaw, water table, tees, depth of tees,
access, pumping
(b) cleanout
e -(c) IO from cellar wall or in.ground si g pool
d) 25+ from subsurface drains
Reg 10.2 I Distribution Box_6s
-✓ a) slops gr ester than 0.08
Reg 1.0.4 b) sump
Reg 15.1
15.1
15.8
3.7
Reg 14.1
-14.3
14.4
3.4.6
14.7
1.10
Reg 9.1
9.6
'4 _-'a% V
OK I
�aR les�w�M'4
LewUng Pits
Leaching pits sre referred where the installation is possible
a) calculations leading area -minim m 500 sq ft
b) spacing
c) surface a 2%
d) cover terial
e) It x44 splash pad
f) at elbow
g) bends in pipe from d -box to pipe
Leaching_ Fields
a) no greater than 20 minutes/inch
0) area -minimi 900 aq ft
9) construction of field
d) Mace drainage 2 %
e) 20t from cellar wall or. inground -swim g p*oj.
Leaching
a) ca c�ieachixzg area 500 eq ft
b)spacing• t min 6 ft with reserve between
d)co 1ction
e) roe
f) sarface drainage 2%
I ouihill Slop e
a) s �oe y/i =�to be ewe)
b) y/x X 150 = (to be shown)
a) approval
b) stand-by poorer