HomeMy WebLinkAboutMiscellaneous - 1679 OSGOOD STREET 9/21/2015 I
PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: 9/16/15
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Complete Repair and Construction of an
On-Site Sewage Disposal System
Bye Dan Giard
At:
1679 Osgood Street
Map 61 Lot 16
North Andover A 01845
Tl� I suanc6 of this certffic�a e'shrall not be c nstrued as a guarantee that the system will function satisfactorily.
Michele Grant
Public Health Agent
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
i
1
so
PUBLIC HEALTH DEPARTMENT
(onrmunity Devolopinent Division
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( )constructed;( )repaired;
By: I/ IA,
(Print Name)
Located at: j �/, q
(Installation Address)
Was installed in conformance with the North Andover Board of Hea�ltth'approved plan, originally dated
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,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.
ilkr� d.
Bottom of Bed Inspection Date: + —�
Engineer Representative(Signature)
And—Print Name
Final Construction Inspection Date: I rC I ) 9
Engineer Representative(Signature)
And—Print Name
Installe r: r �,..�..m (Signature) Date C �
"
And—Print Name
Engineer: 01401A4 Signature) Date: 1-10-1 ..
And—Print Name
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.6 8.9540 Fox 978.6 .8476 Web littp://www.i,owiiofnorthtindover.com
Town of North Andover — Septic System a AS-BUILT CHECKLIST
1) L All changes to the design plan have been reflected and noted on the as-built plan
2) —Z—As-built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans)
3) Street Address,Assessor's Map and Lot Number
4) V Lot Lines and Location of Dwellings served by the system
'
....,
5) Locations,Elevations and Dimensions of As-built system compone s,mclu eserve if, pplicable)
6) Ties to all tank openings,d-box,and leach area from dwelling or Permanent ent Structure
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 wells
Watercourses or wetlands
0) Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system
9) Location of water,gas,electric lines,cable,control nel (if applicable)
10) Location of Structures within 6 Inches of Finished Grade dry, _ ; le", 4 0
11) Original Stamp&Signature 1 l
12 _44L Location and holder of an easements which could impact the system [ , , W
Y p Y �' ,,�9 ,
(pCZK(
13) Impervious Areas;Driveways,etc
14) North Arrow
15) Location&Elevation of Benchmark used
16) `� STATEMENT ON PLAN (NA 5.3)
a. "I certify the locations, elevations, ties,cover material;exposed component covers etc.,
shown on this as-built substantially agree with the approved plan and have determined that the
break out elevations,if applicable,have been met."
Signature of Designer Date
b. "If a STUCTURAL WALL IS PRESENT(NA 4.9)a Letter or statement on the as-built indicating
the wall- was, or was not,constructed in accordance with the intended design and any
manufacturer's specifications."
Signature of Designer Date
As of:Wednesday,September 16,2015
it
i
Grant, Michele
I
From: Chad Lawlor <crlawlorl @hotmail.com>
Sent: Wednesday, September 16, 2015 8:21 AM
To: Grant, Michele
Dear Michele,
I am sending you this email to inform you that I am able to maintain the area around the sewer covers on the
front lawn. Thank you.
Sincerely,
Chad R. Lawlor
i
Grant, Michele
From: Grant, Michele
Sent: Monday, September 14, 201S 12:46 PM
To: 'Chad Lawlor'; 'Vladimir Nemchenok'
Cc: 'MERRENG @aol.com'; 'Isaac Rowe';wrdufresne @comcast.net; Blackburn, Lisa
Subject: FW: 1679 Osgood St.
Good Afternoon Chad,
You have indicated that you will assume all responsibility for the final grading between the two (1) bedroom dwellings
only.This acceptance of responsibility will be sufficient.
However, there are a few outstanding items that need to be addressed prior to this office signing and issuing the
Certificate of Compliance.They are as follows:
1. Final grading for the main house has not been completed.The distribution box and pipes are still exposed.
2. After two inspections (9/9/15 and 9/11/15) by our consultant from Mill River Consulting (MRC), the slope of the pipes
from the distribution box outlet to the leach field inlet essentially have no slope (slopes vary from 0.000 to 0.002) and
are different from what was specified on the approved design plan. Furthermore,the elevations on the as-built plan do
not match the elevations obtained from our consultant from MRC.
3.A statement indicating if the designer, Vladimir Nemchenok, has examined the building sewer pipes to ensure they
meet the minimum specifications required per Title 5 regulations and the approved design plan.
The designer,Vladimir Nemchenok, will need provide a statement in writing to let the Town of North Andover know the
current conditions of the septic system piping and components are acceptable to him.
As of 12:30 today, we have not been able to reach the engineer for the property. If you are successful in reaching the
designer please have him contact this office or Isaac Rowe from MRC directly(976.836.6412)so Mr. Giard can finish
backfilling, and we can expedite the certificate of Compliance.
Many Thanks,
Michele E.Grant
Public Health Agent
Town of North Andover
1600 Osgood St l Suite 2035
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgrant townofnorthandover,com
Web www.TownofNorthAndover.com
1
i
1
•
I
North Andover Health Department
Community and Economic Development Division
ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 1679 Osgood St. MAP: 61 LOT: 16
INSTALLER: Daniel Giard
DESIGNER: Merrimack Engineering
PLAN DATE: 06/15/15, rev. 7/22/15
BOH APPROVAL DATE ON PLAN: 8/7/15
INSPECTIONS
TANK INSPECTION:
DATE OF BED BOTTOM INSPECTION:8/24/15
DATE OF FINAL CONSTRUCTION INSPFC:TinNI.49/15
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# 1 (1500 gallon)
® 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)
24" inch cover to finish grade installed over
inlet and outlet access ports
Neoprene boots around inlet & outlet
Comments: Only 1 tank hole was complete —the 1500 gal tank. They ran the
pipes from the top house down through the back of the second house, the pipes
were NOT bedded properly. They were bedded on dirt. I asked them to redo and
make sure they bed on sand or stone.
SEPTIC TANK#2 (2000 gallon)
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)
24" inch cover to finish grade installed over
middle and outlet access ports
Neoprene boots around inlet & outlet
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:
SOIL ABSORPTION SYSTEM (General)
I
® 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
N/A 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
N/A Retaining wall (boulder/ concrete /timber/ block)
❑ Final cover as per plan
Comments: No slope from the d-box outlet to the leach field inlet
SOIL ABSORPTION SYSTEM (Gravel-less Chambers)
® Brand and Model of Chamber: Low Profile
Standard Quick 4 Infiltrator Chambers
® Number of chambers per row: 12
® Number of rows (trenches): 5
Comments: Total Chambers = 60
FINAL GRADE
Loamed
Seeded
Cover per plan
Comments:
DOCUMENTS NEEDED
Q Certification of Installation Form submitted
By engineer and signed and dated by
Engineer and installer
M As-Built Plan
i
1
i
Setup #3 1
BM = 60.90
HR = 0.80 I
HI = 61.70
SYSTEM ELEVATIONS
ROD AS-BLT INVERT DESIGN INVERT
ELEVATION ELEV ELEV
Lip of CO 6.80
CO Inv 7.10 54.25 56.4
(2000 gal) Septic Tank IN 10.07 51.28 51.25
(2000 gal) Septic Tank 10.38 50.97 51.00
OUT
Distribution Box IN 11.99 49.36 49.40
Distribution Box OUT 12.13 49.22 49.23
Lateral 1 TOP 12.13
Lateral 1 INVERT 49.22 49.18
Lateral 2 TOP 12.13
Lateral 2 INVERT 49.22 49.18
Lateral 3 TOP 12.13
Lateral 3 INVERT 49.22 49.18
Lateral 4 TOP 12.14
Lateral 4 INVERT 49.21 49.18
Lateral 5 TOP 12.14
Lateral 5 INVERT 49.21 49.18
Top of Chamber 12.15 49.55 49.57
Bottom of Bed/Chamber 12.88 48.82 48.90
1
CRITICAL SETBACK DISTANCES
Mark those distances checked in the field against the design plan and regulatory
setback
Tank SAS Sewer
® Property line 10 1.0 --
® 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
i
i
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, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA
wetland bylaws
i
Commonwealth of Massachusetts Map-Block-Lot
061.000016 016
BOARD OF HEALTH Permit No
North Andover BHP-2015-0338----
P.I. FEE
F.I. $250.00
DISPOSAL T LJ `T I I`C
Permission is hereby granted Daniel-A. Giard
to(Construct)an Individual Sewage Disposal System.
at No 1679 OSGOOD STREET --_----_---__-------_---------------
as shown on the application for Disposal Works Construction Permit No. BHP-20151033 n Dated g__
u ust 07 2015
- - - ---
Issued On:Aug-07-2015 BOARD OF HEALTH
i
Awlication for Septic Disposal System
/�- TODA S D T
Construction Permit — TOWN OF
NO DOVE 01845 $5.00-Component
Important: Application is hereby made for a permit to:
When filling out ❑ Construct a new on-site sewage disposal system*
forms on the
computer, use ["Repair or replace an existing on-site sewage disposal system*
only the tab key
to move your ❑ Repair or replace an existing system component—What?
cursor-do not
use the return A. Facility Information
key. c,, <, , aK ;,❑.
Address or Lot#
V
City/Town
2.- *TYPE OF SEPTIC SYSTEM*: A. (l 0'
➢ ❑ Pump ❑ Gravity(choose one)
***If pump system, attach copy of electrical permit to application***
➢ ❑„ponventional System (pipe and stone system)
➢ Q 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 filter before DWC issuance)
Whatis the Make? Wbatis the Model?
2. Owner Information
Name
' f a
Address(if different from above)
City/Tov,fn State Zip Code
Email addr ess ...M �,
Telephone Number
I
3. Installer Information
Name M Name of Company
Address
City/Town State Zip Code
( .
Telephone Number(Cell Phone#if possible please)
4. Designer Information
M �
ail,�r,��.A,nm"�I�9i�"... �„,, ,r�.,�^," „�, �. .�a a, •'�'�.�«,_��„
Name Name of Company
Address
y M r
City/Town State Zip Code
d
y:
Telephone Number(Best#to Reach)
Application for Disposal System Construction Permit•Page 1 of 2
I
Application for Septic Disposal System
TODAY'S DATE
Construction Permit — TOWN OWN OF
NORTH ANDOVER, NU 01� $125.00 Component
PAGE 2 OF 2
A. Facility Information continued....
5. Type of Building: VResidential Dwelling or ❑Commercial
B. Agreement
The undersigned agrees to ensure the construction and maintenance of the afore-described
on-site sewage disposal system in accordance with the provisions of Title 5 of the
Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of
North Andover. I understand that until a final Certificate of Compliance has been issued by
#his- oard of Health, a installed system is not approved.
r �
Name Date
�'Aati ,.
Approve (Bo ard o Health Representative)
ilc,. �.
Nam Date
Application Disapproved for the following reasons:
For Office Use Only:
1. Fee Attached. Yes No
2. Pro'ectMana er Obligation Form Attached? Yes, No
3. Pump System? If so,Attach copy ofElectrical Permit Yes No
Applicant.received copy of
"Electrical Inspection Notes for Septic Systems" Yes No
Handout.
4. Reviewed approvallette; all paperworkreceived? Yes No
Missing.'
5, Foundation As-Built?(new construction only): Yes No
(Same scale as approved plan)
6. Floor Plans?(new construction only): Yes No
Application for Disposal System Construction Permit-Page 2 of 2
i
SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS
As the North Andover licensed installer for the construction for the septic system for the property at:
W `
y f
4
p a r����
(.4(.Idress of septic sysi nr ) For plans by _ m �v,
Relative to the application of " �� `""�' A
(Installer's name) And dated
ngin, date)
Dated
ocay s c Late with revisions dated
(Last revis .d date)
I understand the following obligations for management of this project:
1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to
performing any work on a site. I must have the approved plans and the permit on site when any work is
being done.
2. As the installer,I must call for any and all inspections. If homeowner,contractor,project manager,or any
other person not associated with my company schedules an inspection and the system is not ready, then
item three shall be applicable.
3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as
indicated below. I understand that requesting an inspection without completion of the items in accordance
with Title 5 and the Board of Health Regulations may result in a$50.00 fine being levied against me and/or
my company.
a. Bottom of Bed—Generally, this is the first (1'� inspection unless there is a retaining wall,which
should be done first. The installer must request the inspection but does not have to be present.
b. Final Construction Inspection—Engineer must first do their inspection for elevations,ties, etc.
As-built of verbal OK(or e-mail to: 17e althde ptz�t<,��r�srf�c�l�rrYlra:iduv�::r°,c��rr) from the engineer must
be submitted to the Board of Health,after which installer calls for an inspection time. Installer must
be present for this inspection. With a pump system,all electrical work must be ready and able to
cause pump to work and alarm to function.
c. Final Grade—Installer must request inspection when all grading is complete. Installer does not
have to be on-site.
4. As the installer, I understand that only I may perform the work (other than simple excamlion)and I am required
to complete the installation of the system identified in the attached application for installation. I further
understand that work done by others unlicensed to install septic systems in North Andover can constitute
reasons for denial of the system and/or revocation or suspension of my license to operate in the Town of
North Andover, significant fines to all persons involved are also possible
5. As the installer, I understand that I must be on-site during the performance of the following construction
steps:
a. Determination that the proper elevation of the excavation has been reached.
b. Inspection of the sand and stone to be used.
c. Final inspection by Board of Health staff or consultant.
d. Installation of tank, D-Box,pipes, stone, vent,pump chamber, retaining wall and other
components.
6. As the installer.I understand that I am solely responsible for the installation of the system as per the
approved plans. No instructions by the homeowner,general contractor, or any other persons shall absolve
me of this obligation.
Undersigned Licensed Septic Installer: (Today's Date)
w
N_aine—Prints) N ame.�..._Signed)
t_.,
II I f !
North Andover Health Department
Community and Economic Development Division
August 5, 2015
Chad Lawlor
1679 Osgood Street
North Andover, MA 01845
Re: Subsurface Sewage Disposal System Plan for 1679 Osgood Street(Map 61, Lot 16)
Dear Mr. Lawlor:
The proposed wastewater system design plan for the above site dated June 15, 2015 with a final
revision date of July 22, 2015 and received on July 27, 2015 has been approved.
The design plan has been approved for use in the construction of a new on-site septic system for
four residential dwellings units with a total of 7-bedrooms utilizing a Quick 4 Plus Standard LP
Infiltrator Chamber system. This design plan approval is valid until August 5, 2017.
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover. In the event an imminent health problem, such as sewage backup into the dwelling is
reduce the time period for which this plan is
Andover Board
of Health may redu p
•in the North P
occurring, Y
valid.
This approval is also subject to the following conditions:
1. If site conditions are found in the field to be different from those indicated on the
design plan and/or soil evaluation,the originally issued Disposal System Construction
Permit is void, installation shall stop, and the applicant shall reapply for a new
Disposal Systems Construction Permit(3 10 CMR 15.020(1)).
Page 1 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
1679 Osgood Street August 5, 2015
2. It is the responsibility of the applicant and/or the applicant's septic system designer,
septic system installer or other representative to ensure that all other state and
municipal requirements are met. These may include review by the Conservation
Commission, Zoning Board, Planning Board,Building Inspector,Plumbing Inspector
and/or Electrical Inspector. The issuance of a Disposal System Construction Pen-nit
shall not construe and/or imply compliance with any of the aforementioned
requirements.
3. At this time the proposed plumbing for the accessory garage is unknown. Therefore,
a letter from the owner indicating the proposed plumbing in the accessory garage will
be required prior to the Health Department signing off on a building permit
application.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely,,
f
I
Michele Grant
Health Inspector
Encl. Installers list
cc: Vladimir Nemchenok, P.E.
File
Page 2 of 2
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476