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Home My WebLink AboutCertificate of Compliance - 81 BRADFORD STREET 12/10/2015 i l r PUBLIC HEALTH DEPARTMENT Town of Forth Andover Community Development Division CERTIFICATE u"F -- COMPLIANCE A of.- 12/10/15 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete i On-Site Sewage Disposal System y® Todd Bateson At: 81 Bradford Street Map 61 Lot 37 )t Andover, MA 01845 The, ss6ance of this certificate sial1�not be 7nstrued as a guarantee that the system will function satisfactorily. f Michele Grant Public Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.6889540 Fax 978.688.8476 Web www,townofnortliandover.com i I • North Andover Health Department fommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 81 Bradford St. MAP: 61 LOT: 37 INSTALLER: Todd Bateson DESIGNER: Christiansen & Sergi PLAN DATE: 10/26/15, REV 11/6/15 BOH APPROVAL DATE ON PLAN: 11/11/15 INSPECTIONS TANK INSPECTION: 11/23/15 DATE OF BED BOTTOM INSPECTION: 11/24/15 DATE OF FINAL CONSTRUCTION INSPECTION: 12/1/15 DATE OF FINAL GRADE INSPECTION: ,r SITE CONDITIONS N/A 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 N/A 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 Z Outlet tee installed, centered under access port (gas baffle) Z 24" inch cover to within 6" of finish grade installed over one access port Z Neoprene boots around inlet & outlet Comments: DISTRIBUTION-BOX Z installed on stable stone base Z H-20 D-Box N/A Inlet tee (if pumped or >0.08'/foot) Z Hydraulic cement around inlet & outlets Z Observed even distribution Z Speed levelers; provided (not required) Z Schedule 40 PVC Pipe Comments: SOIL ABSORPTION SYSTEM (General) Z Bottom of SAS excavated down to C soil layer, as provided on plan Z Size of SAS excavated as per plan Z Title 5 sand installed, if specified on plan Z 40 Mil HIDPE barrier installed Z Laterals installed and ends connected to header (and vented if impervious material above) Z Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: 37 Y21- x 32 W, depth 60" FINAL GRADE Loamed Seeded F-A Cover per plan i i l Comments: i DOQUMENTS NEEDED u Certification of Installation Form submitted y engineer and signed and dated by Engineer and installer As-Built Plan i BM = 100-00 HR = 9.10 HI = 109.10 SYSTEM ELEVATIONS ROD AS-IBLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark - Building Sewer OUT 6.10 102.65 101.85 Septic Tank IN 6.99 101.76 101.65 Septic Tank OUT 7.29 101.46 101.40 -' Distribution Box IN 7.53 101.22 101.20 Distribution Box OUT 7.70 101.05 101.03 Lateral 1 TOP 7.76 / 7.90 Lateral 1 INVERT 100.99 / 100.85 100.98 / 100.85 Lateral 2 TOP 7.76 / 7.90 100.98 / 100.85 100.99 / 100.85 Lateral 2 INVERT - Lateral 3 TOP 7.76 / 7.90 100.99 / 1 100.98 / 100.85 Lateral 3 INVERT - Lateral 4 TOP 7.76 / 7-.9-0 Lateral 4 INVERT 100.99 / 100.85 100.98 / 100.85 Lateral 5 TOP 7.76 / 7.90 Lateral 5 INVERT 100.99 / 100.85 100.98 / 100.85 Top of Chamber Bottom of Bed.L-- 8.76 100.34 100.5 1 i i CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback i Tank SAS Sewer t ® Property line 10 10 -- M Cellar wall 10 20 -- M Inground pool 10 20 -- M Slab foundation 10 10 -- M Deck, on footings, etc 5 10 -- M Waterline 10 10 101 M Private drinking well 75 1002 50 M Irrigation well 75 100 M Surface Water 25 50 M Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Bank3 75 100 M Wetlands bordering surface water supply or trib. (in Watershed) 150 150 M Trib. to surface water supply 325 325 M Public well 400 400 M Interim Wellhead Prot. Area M Reservoirs 400 400 M Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 M Drains (Other)Foundation 10(5) 20(10) M Drywells 20 25 I r 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 1 1 1 i 1 PUBLIC HEALTH DEPARTMENT RECEIVED Community Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION �� The undersigned hereby certify that the Sewage Disposal System( )constructed; ,repaired; (Print Name) Located at: / /° -C)f-6 1> <'S%ff'C° (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan, originally dated and last revised on x/16 12 V-.,5 ry 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. Bottom of Bed Inspection Date: ? / Engineer RepOntative(Signture) And—Print Name Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name Installer: �-Y J g nature f w_ ) Date• r° And—Print Name Engines , =; ignature) Date: rlF> l f ..,. And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.coni Town of North Andover — Septi Lc System - AS-BUILT CLIECKLIST 1) Al)changes to the design plan have been reflected and noted on the as-built plan 2) 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) Ipt Lines and Location of Dwellings served by the system 5) —Locations,Elevations and Dimensions of As-built system components,including reserve (if applicable) 6) """Ties to all tank openings,d-box,and leach area from dwelling or Permanent Structure —Setback distances are shown on the as-built plan from system components to: Subsurface,interceptor&foundation drains Catch basins Property lines AD e '�gs or 0 other struc ur es Private water supply or irrigation wells Watercourses or wetlands 8) 1 LLocations of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) LLocation of water,gas,electric lines,cable,control panel (if applicable) 10) Location of Structures within 6 Inches of Finished Grade 11) —Loriginal Stamp&Signature 12) �N Location and holder of any easements which could impact the system 13) impervious Areas;Driveways,etc 14) _�Z_North Arrow I Location &Elevation of Benchmark used 16) STATEMENT ON PLAN (NA 5.3) 3. "1 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 an manufacturer's specifications." Signature of Designer Date As of:Thursday,December 10,2015