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Home My WebLink AboutCertificate of Compliance - 550 BOXFORD STREET 12/28/2015 I ® e o o 3 I 1 1 PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE COMPLIANCE As of: 12/28/15 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Construction of an On-Site Sewage Disposal System By: Jesse Waffen At: 550 Boxford Street MapI05C Lot 22 North Andover, MA 01845 The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. T omas Trowbridge, DDS, MD BOH Chairman 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www,townofnorthandover.com I ED { 1 1 PUBLIC HEALTH DEPARTMENT Community Development Division RECEIVED TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System constructed;Orepaired; By: ��C',S Wit _T. WO r Q v) a ►.\t,), (Print Name) Located at:(D2 (3asfzvt_ L p r� ? ) �` (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated g 0 /S— and last revised on t2.3��/S� ,with a design flow of L4 I 0 gallons per day. The materials used were in conformance with thosApecified 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 Representative(Signature) And—Print Name Final Construction Inspection Date: r`I —/®'/S' 1 6 En eer Representative(Signature) And—Print Name Installer: nature) Date: And—Print Name Engineer: jgnature) Date: c /+ f'�kISr7r� , And—Print Name 1600 Osgood Street, North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com 0 Town of North Andover — Septi v �c �ystem - AS-BUI CHECKLIST 1) All changes to the design plan have been reflected and noted on the as-built plan 2) As-built plan has a suitable scale; (I inch = 40 feet or fewer for plot plans) 3) Street Address,Assessor's Map and Lot Number 4) � Lot Lines and Location of Dwellings served by the system _Locations,Elevations and Dimensions of As-built system components,including reserve (if applicable) 6) V Ties to all tank openings,d-box,and leach area from dwelling or Permanent Structure 7) -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 8) Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) -Location of water,gas,electric lines,cable,control panel (if applicable) 10) Location of Structures within 6 Inches of Finished Grade 11) Original Stamp&Signature 12) N rA Location and holder of any easements which could impact the system 13) -Impervious Areas;Driveways,etc 1\1011 VI 14) LNorth 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 approvedplan and have determined that the break out elevations,if applicable,ha vebeen met" Signature of Designer Date b. _If u.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 desi gn and any manufacturer's specifications. Signature of Designer Date As of:Thursday,September 17,2015 i i North Andover Health Department Community and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 602 Boxford St— Lot 2 MAP: 105C LOT: 22 INSTALLER: Jesse Warren DESIGNER: Phil Christiansen PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: 9/1/15 DATE OF BED BOTTOM INSPECTION: 9/1/15 DATE OF FINAL CONSTRUCTION INSPECTION: 911/15 DATE OF FINAL GRADE INSPECTION: of �1 ° 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: Raised the septic tank and building sewer slightly 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 ® Watertightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port i 1 F71 Outlet tee installed, centered under access port (gas baffle) j ® 24" inch cover to finish grade installed over j inlet and outlet access ports ® Neoprene boots around inlet & outlet Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box N/A 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) ® 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 N/A Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: High Capacity Standard Quick 4 Infiltrator Chambers ® Number of chambers per row: 10 ® Number of rows (trenches): 2 i 1 Comments: Total Chambers = 20 i FINAL GRADE X Loamed X Seeded X Cover per plan Comments: DOCUMENTS NEEDED X Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer X As-Built Plan i BM = 122.71 HR = 3.58 HI = 126.29 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 2.06 123.88 123.55 Septic Tank IN 2.74 123.20 123.09 Septic Tank OUT 3.00 122.94 122.84 Distribution Box IN 3.19 122.75 122.69 Distribution Box OUT 3.38 122.56 122.52 Lateral 1 TOP 3.50 1 Lateral 1 INVERT 122.44 122.52 Lateral 2 TOP 4.39 Lateral 2 INVERT 121.55 121.55 Top of Chamber Bottom of Bed/Chamber 121.48 / 120.59 121.56 / 120.59 f CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory j 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 1001 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Bank' 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 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 � / ox Willow Road,Ayer mAu/432 wobsue: Use this number with all correspondence Client: Well Water Connection John Larsen RepndDate: 12/22/2015 PO Box 1b8 Tewksbury, MAO107O Certificate of Analysis 55O8oxford Street/Lot#2\. North Andover, KA 9orumdwr Method Result MCL M0L Date oYAnalysis Analyst -8inh memp��1211a12o/o1o:o0:VuAxvuyRoland Total Coxfonn Bacteria,/1nom| ewZ.SUB.nM9xu3 Absent xbuam Absent 12/1812015 3:15o0 rM M'MA1118 Arsenic,Total,MG/L SMo11ne wn 0.01 0.001 12z112015 m'mx1118 Calcium.MG/L EPA 200.7 18.6 wmnpev 0.2 12/21/2015 M-MA1118 onpper.MG/L EPA 200.7 0u12 13 oona 12o1s015 m'MA1118 |mn.MG& EPA 200.7 wn 03 0.003 12/21o015 M-MA1118 Laao.MG/l Smn11os 0o01 0.015 0u01 12/21m015 M'mA1118 magnevmm.mGu EPA 200.7 2.5 Not Spec 01 12/21C2015 M-MA1118 Maogunoao.wo& EPA 200.7 0.003 o.o* 0.002 12/21m015 m'wm1118 Potass|um.mcvL EPA 200.7 0.5 Not Spec 0.1 12/21/2015 M'MA1110 ood|um.mo/L EPA 200.7 16.2 See Note nz 12o1o015 M-mx1118 | Nkminity.MG/L aM 23e0a 77 Not Spec 1 12/18/2015 M-mA111n � Ammonia aaw.ma/L am*n0m'NHo'o 0.11 Not Spec 0.1 12m1m015 M'Mx1118 � ch|nhdo.MmL EPA 300.0 12 250 1 12/18m015 M-MA1118 Chlorine,Free Residual,MG/L aM*ono-CL-G wo Not Spec 0.02 12/18/201e M-Mx1118 Color Apparent,CU GMe1uoa o 15 V 12/18/2015 m'mA1118 oondumivity.umnoa/Cm amuu1ne 230 Not Spec 1 12/18m015 m'mm1118 F|uonma.mG/L EPA 300.0 0.2 ^ 01 12/18m015 M'NN1118 Hardness,Total,MG/L ama34Va 57 Not Spec 1 12/21u015 M-MA1118 Nitrate oow.mo/L EPA 300.0 No 10 oon 12n8/205 M-MA1118 Nitrite oow.Mou EPA 300.0 No 1 0.02 12n8/2015 M-MA111u Odor,TON aM 2150o u u o 12/18m015 rN pH,PnxTosc oM*uou'*'e 7.6 6.5-8.5 wx 12/18/2015 m'Mx1118 Sod|mmnt.pus/naV ------------- wEs --- NeG 12/18s015 pw nu|fate.mmL EPA 300.0 10.4 250 1 12/18m015 m'mw1118 Turbidity,NTU EPA 180.1 0.2 wmopou oJ 12U8/2015 w-MA1118 / MCL MaximumComaminumLmm (EPALimn.mRL Minimum Reporting Level Sodium Guidelines-Mass zn.EPA cso. #=Result Exceeds Limit urGuideline No=None Detected(<MnL). Background Bacteria Noted Massachusetts Certified David LKnowlton Laboratory#m'mA1118 Laboratory Director Page 1v'1 Grant, Michele To: tat.buh@comcast.net Cc: Hodge, Uaa Subject: 5SUBoxford street L`+ f�� Attachments: 2O1511161I27.pdf Hi Tom, I have a Deed Restriction for 550 Boxford Street.They have a 4 Bedroom, 9 room home.They want to add an additional room bringing it to a total of 10 rooms. It's a brand new house and brand new system,that is compliant and has already been inspected.They have a buyer and the sale is contingent nn finishing the Attic. They have two choices, 1. Upgrade the system, or 2. Put a deed restriction on the 4 bedrooms, (Limiting it to a 4 bedroom home). Is this something you want to come in front of the board???Susan has always done this in the past, I can sign it and have it notarized here or you could stop by and it signed it and have it notarized here. Please see the attached Deed Restriction Michele E.Grant Public Health Agent Town uf North Andover 18UO Osgood St I Suite 2035 | � North Andover,KxA 81845 � | Phone 978�88.9540 � Fax 978,688.8476 � Email Web www,TowriofNorthAndover.com � � � � 1 Grant, Michele From: Grant, Michele Sent: Tuesday, November 17, 2015 7:55 AM To: 'tat.boh @comcast.net' Subject: RE: 550 Boxford street Lot 1 Good morning, Yes, It's a family room...... I will start the deed and notarizing process today.Thanks very much!! Michele From: tat.boh@comcast.net [mailto:tat.boh @comcast.net] Sent: Monday, November 16, 2015 11:53 PM To: Grant, Michele Subject: Re: 550 Boxford street Lot 1 Michelle-When you say 'finishing the attic,' I presume this means a playroom or some usage that will not add to the burden on the system. Given the deed restriction offer you have, if this is the case, I would be ok with you handling the signature on behalf of the department. Tom From: "Michele Grant" <MGrantCctownofnorthand over.com> To: "tat,boh a comcast.net" <tat.boh comcast.net> Cc: "Lisa Hadge" <Ihadgeia townofnorthandover.com> Sent: Monday, November 16, 2015 11:41:05 AM Subject: 550 Boxford street Lot 1 Hi Tom, I have a Deed Restriction for 550 Boxford Street.They have a 4 Bedroom, 9 room home.They want to add an additional room bringing it to a total of 10 rooms. It's a brand new house and brand new system,that is compliant and has already been inspected.They have a buyer and the sale is contingent on finishing the Attic. They have two choices, 1. Upgrade the system, or 2. Put a deed restriction on the 4 bedrooms. (Limiting it to a 4 bedroom home). Is this something you want to come in front of the board???Susan has always done this in the past, I can sign it and have it notarized here or you could stop by and it signed it and have it notarized here. Please,see the attache 'Deed Restriction Michele E.Grant Public Health Agent Town of North Andover 1600 Osgood St I Suite 2035 North Andover,MA 01845 Phone 978.688.9540 Fax 978.688.8476 Email mgrant @townofnorthandover.com Web www.TownofNorthAndover,com 1