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Home My WebLink AboutMiscellaneous - 185 BRIDGES LANE 4/30/2018PUBLIC HEALTH DEPARTMENT Town of North Andover Community and Economic Development Division CERTIFICATE OF COMPLIANCE As of: December 6, 2017 Cep This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: D -Box & Pipe Repair of On -Site Sewage Disposal System By: Todd Bateson — Bateson Enterprises, Inc. At: 185 Bridges Lane Map 104.D Lot 109 NMtndover,_MA 01845 this certific'a`te ctrued as a guarantee that the system will function satisfactorily. c Michele E. Grant Public Health Inspector 120 Main St., North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web www.northandoverma.gov 4 i O� NORTH qti m �®o z SSA C H uS� North Andover Health Department Community and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 185 Bridges Lane MAP: LOT: INSTALLER: Bateson Enterprises DESIGNER: PLAN DATE` BOH APPROVAL DATE ON PLAN: Component Repair: 11/17/2017 Michele Grant D -Box & Pipe to Tank Inspection INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑ Contractor reports any changes to design plan ❑ 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 ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading ❑ Monolithic tank construction s ❑ Water tightness of tank has been achieved by _ visual testing _ ❑ Inlet tee installed, centered under access port - s..' ❑ 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 ❑ Watertightness of tank has been achieved by testing ❑ Hydraulic cement around inlet & outlet Comments: CONTROLPANEL Comments: DISTRIBUTION -BOX ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: basement ❑ Alarm signal located inside: basement ® 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: Also Replaced a pipe and put in a "T" 4 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 ❑ 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: SOIL ABSORPTION SYSTEM (Gravel -less Chambers) ❑ Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ❑ Number of chambers per row: ❑ Number of rows (trenches): Comments: Total Chambers = FINAL GRADE ❑ Loamed ❑ Seeded ❑ Cover per plan Comments: DOCUMENTS NEEDED ❑ Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer ❑ As -Built Plan BM = HR= HI = SYSTEM ELEVATIONS SKETCH PLAN ROD AS -BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 TOP Lateral 1 INVERT Lateral 2 TOP Lateral 2 INVERT Lateral 3 TOP Lateral 3 INVERT Lateral 4 TOP Lateral 4 INVERT Lateral 5 TOP Lateral 5 INVERT Lateral 6 TOP Lateral 6 INVERT Top of Chamber Bottom of Bed/Chamber SKETCH PLAN 4 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback ® Wetlands bordering surface water supply or trib. (in Watershed) 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 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland / Coastal Banka 75 100 ® Wetlands bordering surface ' 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 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 CAR] C ( 11 IFI -OD Commonwealth of Massachusetts RECEIVED Title 5 Official Inspection Form Nov 70 201 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments TOWN OF NORTH ANDOVER M , 185 Bridges Lane "MTH DEPARTMENT Property Address Barry Burbank Owner Owner's Name information is North Andover MA 01845 11/10/2017 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand -sketch in the area below ❑ drawing attached separately tsins.doc • rev. sits/ lZ�(�-��•""'•-' /..Q.!.t.S�C,e�2�1P2 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17 0LLJ-... I I 1 .1 1 1--1 Q a Ln Q D k 9p CO Ln Z v O O v 0 n 0 a, 3 Q p D Lr) I c� O >y Q O _+ avv � o a+ 0 3 c S 0 I' m O rr 3 7 3� O (DD O Q A fi r m S I 0 m v 0 c 3 I �I 0LLJ-... I I 1 .1 1 1--1 Q a Ln Q D k 9p CO Ln R Commonwealth of Massachusetts Map -Block -Lot 104.D0109 BOARD OF HEALTH Permit No North Andover -BHP-2017-1094 ----------------- P.I. FEE F.I. $175.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Bateson Enterprises - -------- ---------------- to (Construct) an Individual Sewage Disposal System. 06Z0Z/41^ fd E�4r6 at No 185 BRIDGES LANE as shown on the application for Disposal Works Construction Permit No. BHP -20- 9''�ate.d November 09, 2017 ---------- I- C (-------------- ----------------------------------------------------------------- Issued On: Nov -09-2017 BOARD OF HEALTH ��D Application for Se t c Disposal System /'/- 7 constrnctton Po ft.rdt - TOWN OF Tonars DATE NORTH ANDOVER, MA 01845 $230.00—Full Repair $125.00 - Component _Application is hereby made for a permit to: Construct a new on -Rite sewage disposal system* ❑ Repair or replace an existing. on-site sewage disposal' system* 011epair or replace an existing system component — What? b— v�- a u -a 17 , n- 7 1--;, 1 T 4,✓ k A. Facility Information (I: Address or Lot # %Ud. City/Town 14� NOV 0 8 2017 2.- *TYPE OF SEPT YSTEW: TOWN OF NORTH ANDOVER ➢ ❑ Pump Gravity (choose one) HEALTH DEPARTMENT ***If pump system attach copy of electrical permit to application**' ❑ Conventional System (pipe and stone system) ➢ ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system.) ➢ ❑ Pressure Distribution S.A.S. (No D -Box) ➢ ❑ Pressure Dosed (D -Box Present) S.A.S. ➢ ❑ 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 friter before DWC issuance) what is the Make? 2. Owner Information What is the ModcP ,` n,✓ k Name Address (if different from above) Cityfrown State Zip Code Telephone Number 3. Installer Information e Name Name of Company $ )1 a� SES, INth r5�1 • 11,4 Y V - ANDOVER M ROAp� Address CityRown, State Zip Code 1 z V �f/S- 9703 Telephone Number (Cell Phone # if possible please) a. Desi . ner"lnfonnati n Name Name of Company Address City1rown State Zip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit - Page 1 of 2 .r n . PAGE 2 OF 2 TODAY'S DATE $:250.00 Full Repair S'125.00 • Compon;ent A. Faciliiy.lnforma#ion con#inued 5. Type'of Building: Residential.DwellIng or 00ommercial B. Agre:emeni The unders;lgned agrees to ensure the construction and maintenance of the afore -described on site sewage disposal system,In accordance with the. provisions of TItle3 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place. he system fn operation until a Certlflcate of Compllattce has been I y Is Board of Health. Name Date Application Approved By: (Board of Health' Representative) Name [late Application Disapproved, for the following reasons: For Office Use Oniy: 1. Fee Attached? Yes/ _ No 2.. ProjcetMattaget Obligation Form Attached? 3.; &=44=? Ifso) Atta�nv ofFr��rri� 1 Permit I'es — No_ 4. FouadatioftAs:Bu&? (new construc601) •ronlyr); (Same scale as approvedplan) — 5. F1oorPLws?'(he.W Corisfruction only); v !lpblfCat(dn'tonpisppsai. ystetiS:Do11*ucCoh Pemift � Rsae 2 ri1 :' �t ed As OWNpt& AndoverZcmediki� frsF tete t�nstntt#Qn the eptia ay�te�, fc .thc p ya h L/' . (Ad4" e69pdc sytt=) P'6r pun b9 R*tift to *Uppbadou of (Ah -s s qme Ahd dated Dited I uaderatand the Wowing bbligatlom for mKjtagemam of*S -Drolect: i. 14s the iQatalte I axn.abl tad tp obtain ttIIpt and hoard, VPIDVC4 PIMSOC to pet g ony Volk ci t :; este..I moat have thattavedm Qma anti tba p aim nen amr ss 3. As lhi mUtf .IMtmttxUfovmry and " � ' g�Ct�7tL001! 1itTt• �OC��Cd W�tlt � � Item %lynx• my Tr m and the sptcfn is not�eady. thea . ia+ie�l�t• ��dt� �' �+ 'mum-. '.,..th .a��pllp�lyyigt}}b��jeja�,f2g . .....1r.. r .s'•'°��r! 'Sal't�C'7 � 4. �rMl�MYn� .fin-?k.�I"'pa- thez,GC isrc�iiug tel, siidr b. 3�t0JtL L Gies 310t hm t� b4 pr t8 — . d 'vyetU OK �� o-msil t��tf �!-lxM. zba17 C.. . -�ba Aib2Yfltfi d,to etc Bc=d dfn ` tha et#g tteeE 131i?st e-PlestHt for �11as�UaE sfiii�t barnae .to �+arlr :'� ��`�•� s�dable of ' :' G ��-�tttst�staoatt+e�tt�it'iaapdaroa�t.. •,� •'• � � .. - have to bt; ng tte. docs not 4. Artie kstalIez;'I u mid that m mr4P� „��t t " n of td I asci gt�ired tell 4 WA dist Aft • f� 1 5.. Alt th�cfns�teti.I m derat> I s> 4<3- p tx of .ton a De at t. prmperekr►�bdara aftbe e.�det 'grs,t Aw I pe a aet�tbee daadat %CIO be sued a PIpe*mby8oia�.%iltlisA'ascaaasi d .�+[�ort�,afmxrlr, Ia-.,�esaq�, �to�e, veal F Abri t�� Ilsatl other 6. Undid �cettud Stptic.T� w elo&Aj,- 1 //-'49_/ -4.47. 8082 „ORTH • , Town of Noah Andover `b'•"fi,= HEALTH DEPARTMENT S334 t3st CHECK #:6/ a 8 DATE: LOCATION: /S 5 H/O NAME: Jco.rrt/ CONTRACTOR NAME:�1<�S6/i Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic - Soil Testing. $ ❑ Septic - Design Approval AA/ -✓r $ ' Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other: (Indicate) $ HeaTtl'i Agent Initials White - Applicant Yellow - Health Pink - Treasurer , k vi Qu ri IZ t,3 vi -4 sz U N% � m a ;� 4e IZ a Q� �d. ., �.,� � � � z oq 7 a q v�.�� .eat a a a� W� 3 Q V IT C3 yj ts<7 tu 41 4 % _j V1 NJ T Vol Eti,W 9 Qrl rS-5-z—s A cs A'Q 0 m Nj W 67 I z I � Q W � v v W Z 0 Q , W I Board of Health North An4.2v8r2Habs. « SEPTIC SZSTEH INSTA.S.ATICK CHECK LIST LOT'i Ran ,APP OVM DATE DISAPPRUi'ED AVATIC�J Ob ML easons: �I j OK FAZZ 1. Distance To's a. Wetlands b. Drains c.. Well .i . 2. Water Line Location 3- NO PVC Pipe 4* Septic Tank - a. _'lees -_Length & To ,Clean Out Covers b. ement Pipe to Tank Gh Both Sides of Tank 5• ME, tribution Boa a. Covera & Box - No Cracks b. All Lines Flossing Fqual Amounts c. No. Back Flow 6. • Leach Field or Trench a. Dimensions b. Stone Depth a, Capped Bads d. Clean Double Washed Stone ?• Leach Pits a. Dimensions b. Stone Depth c. Splash Pads . , d.. Tees e. . Cement Pipe to Pit - Both Siues 3. Clean Double Washed Stone 8. No Garbage Disposal .9. FbMi Grading Inspection 10. Barricading Covered System 11. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard -to Pere Test d. Elevations e. Water Table BLrd of Health .- N. ce...k+ .indoverpMus SUBSURFACE DISPOSAL DESIGN CHECK '.IST LOT APPROVE) DATE ... i r Provided: DISAPPROVED DATE -. Reasons: Title V Reg 2.5 -- - Reg 6 FAIL OS The submitted plan must show as a mdniimim: a) the lot to be served-area,dimensions lot #,abutters b location and log deep observation hoes -distance to ties c location and results percolation tests -distance to ties d design calculations & calculations showing required leaching area (e) location and dimensions of system -including reserve area f) existing and proposed contours (g) location any wet areas within 100' of sewage disposal system or disclaimer -check wetlands mapping J(h) surface and subsurface drains within 1.00' of sewage disposal system or disclaimer (i) location any drainage easements withi,t3001 of sewage disposal systems or disclaimer -Planning Board f. les (j) known sources of water supply within x'001 of sewage disposal o system or disclaimer (k) location of arq proposed well to sere: lot -1001 from leaching Pacilit; (1) location of water lines on property -1 I from leaching facility (m) location. of benchmark (n) driveways (o) garbage disposals (p) no PVC to be used in construction (q) profile of system -elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Omer elevations (r) maximum ground water elevation in area sewage disposal system (s) plan must be prepared by a Professional Engineer or other professional authorized by lax to prepare such plans Septic Tanks (a) capacities -15D% of flow, water table, tees, depth of tees, access, pumping (b) cleanout (c) 101 from cellar wall or inground swimming pool (d) 251 from subsurface drains Reg 10.2 Distribution Boxes 1(a) ape greater' 0.08 Reg 110.4 Hca Design Check VA FAIL M. Reg 15.1 15.4 15.8 3.7 Reg 14.1 .14.3 14.4 14.6 14.7 14.10 Reg 9.1 List Pogo 2 Leaching__Pits Leaching pits are preferred where the installation is possible a) calculations of leaching area -minimum 500 eq ft b) spacing 0 surface drainage,2% d)cover material ,e) I'x2'x4" splash pad f) tee at elbow g) no bonds in pipe from d -box to pipe Leaching Tields, a) no greater than 20 minutes/inch b) area -minimum 900 eq ft 0 construction of field A) surface drainage 2 % e) 201 from cellar van or inground swimming, pool Leaching Trenches a)—calculations or Leaching area -min 500 eq A b) spacing -4 ft min 6 ft with reserve be,leex 0 dimensions d) construction e) stone - f) surface drainage'2% Downhill Slope a) slope y --Tio be shown) b) y/x X 150 - (to be shown) a) approve b) stand-by power t s5 <<_ f ------ --- --- TkR SOIL PROFILE & PERCOLATION TEST DATA North Andover, Mass. Street No —?>,QlID Lot No • LDC/Subdiv. Pland Owner Investigator Observer SOIL PROFILE DATES 1_)El.ev 2.Elev 3.Elev 4.Elev 1 1 �S �DdvP X11 � Benchmark Elevation 2 3 4 5 6 7 8 9 10 DATES 2 3 1 +5' f 2 3 6 4 6 4 5 1 +5' f 5 6 6 7 8 1 +5' f -_ 7 8 9 9 10 - 1 10 Location Datum PERCOJLATION TESTS Timms P,s Test Pit Number- 1 +5' f ?-2 Start Saturation Soak -Minutes 0! V.0V Start. ' est7-Time �0 Lo 1 iv IT - Drop of 3 " -Time - Alb 0:0 it 10 Drop of 6" -Time M6ms-lst 3" drop"A0 Ar 21 b - N,ins . 2nd " Drop Percolation �; J ,, �,. A� 0 19 �J TO: NORTH ANDOVER, MASS 1►'' ° BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at 0 bG-?-5� L0 -A,, le North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated