HomeMy WebLinkAboutMiscellaneous - 980 WINTER STREET 1/6/2016 To of North Anduver
Office o�f the Heal. ° Department
Community Development and Services Division
27 arles Slrett
North Andover, Massachusetts 01845
Sandra Starr Telephone(978)688-9FAO
Public Health Director Fax(978)688-9542
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
05/03/02
This is to certify that
the individual subsurface disposal system
constructed (X) or repaired
by
Thomas Sawyer
at
980 Winter Street
has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the
North Andover Board of Health regulations.
The Issuance of this certificate shall not be conshued as a guarantee that the system will function
satisfactorily.
Bri
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AS-BUILT CHECKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP& PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
/ INCLUDING RESERVE
✓ TIES TO LOT LINES &DWELLING, WELLS
d. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES&PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS,DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM
LOCATION OF WATER,GAS,ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK&D-BOAC
ORIGINAL STAMP &SIGNATURE
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
`� _ LOCATION(&ELEVATIONS OF BENCHMARK USED
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TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System(� constructed;
( )repaired;
located at
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit# , dated with an approved 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.
Bed inspection date: ' > e *,
Engineer Rep esentative
7
Final inspection date: Z- -2_,4j o-2
Engineer Representative
Installer: 2 Lic.#: Date: j_.
Design Engineer. Date: N
N&M Job number l 770/ 01(5',"A
TOWN OF NORTH ANDOVER
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
t
Site; Final Date:
1
Installer: � 0 G
a Tel;
Date Yes No Initials
A. Bottom of Bed
1. Excavation to proper depth
2. With trenches, sides of excavation are beneath B horizon
3. Edge of excavation specified distance from foundation,etc.
Comments: (Use back of sheet for diagrams.)
B. Retaining Wall
1. Wall height and width as specified
2. Waterproofed
3. Wall minimum 10' to leaching facility
4. Wall meets specifications of plan
Comments:
C. Building Sewer
1. Pipe diameter minimum 4"
2. Schedule 40 pipe
3. Inlet to tank cemented
4. Slope minimum 0.01 or 1/8"per foot minimum
5. Pipe properly set on compact firm base
6. Pipe laid on continuous grade in straight line
7. Cleanouts precede all change in alignment and grade
8. Manholes at any 90°change
9. 10'minimum offset to water line
Comments:
D. Septic Tank
1. Level '
2. 1,500 gal minimum
3. Gas baffle present on outlet
4. Manhole to Win 6"of grade
5. Manholes over center and each tee
6. 3-20"manholes — -
7. Outlet line cemented
8. 2"—3"drop from inlet to outlet
9. Pipe set
10. Compact base with 6"of 3/4"crushed stone under tank
11. Tank is watertight
12. Tees 12"off side of tank ,''
N&M Job number 1770/
Comments:
Date Yes No Initials
1
I
I
i
E. Pump Chamber
1. If separate from tank, compact base with 6"of 3/a"stone underneath
2. Minimum 2"pipe to d-box if gravity system
3. 20"access manhole
4. Tank Ievel
5. Watertight
6. Tank size agrees with plan specification A
7. Manhole to grade
8. Check valve and bleeder hole present r`
9. Alarm in building on separate circuit
10. Alarm functions
11. Manual operating switch
12. Pump delivers liquid to d-box
r Comments:
V
i
s
r
F. Distribution Box � � �
1. D-box level
2. Minimum 0.1 T'(2")drop from inlet to outlet
3. Minimum 6"sump
4. Outlet pipes show equal distributionh
5. Compact base with 6"of stone beneath box
6. Box is watertight
7. All lines cemented with hydraulic cement -
8. Schedule 40 pipe
9. First 2'from box laid level
Comments:
r° , ,,�� , F
"P &.d^- "P d r ✓,o, r �� <<%. � �, fs. �)'�'°e "V ,!e a F' f h X24,.,.,,
G. Soil Absorption system
1. All stone double-washed—3/a"— 1 %z" ,
-pea stone j
Bucket test done? 1
2. Minimum 2"of pea stone above distribution lines
3. Minimum 6"stone beneath pipe
4. Distribution lines capped or connected together
5. Toe of slope stops minimum 5' from edge of property;
5a. if not,then swale.
Comments:
Z6, 9
N&M Job number 1770/
i
I
Date Yes No
Initials
H. Leach Trenches
i
1. Minimum 2 trenches
2. Length of trenches agrees with plan. (Max. length 100')
3. Width of trenches agrees with plan Minimum 2';maximum—4'.
4. Vent present if>50 feet or specified
5. Minimum distance between trenches 10'
6. Pipe slope minimum 0.005 or 6"per 100'
7. Depth of trenches below outlet invert minimum of 6".
8. Pipes set on stable base. T---
Comments:
I. Leach Field
1. Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6"per 100'
3. Separation between pipes 6'maximum
4. Pipes connected at end&vent end raised
5. Separation between adjacent fields 10'minimum
6. Pipes set on stable base
7. Maximum 4' separation from edge of field to first line
8. Minimum two distribution lines
Comments:
J. Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between 12"and 48"wide
4. Access manholes on each pit
5. Pipes cemented with hydraulic cement
6.
Comments:
K. Final Grade
L Slope over soil absorption system minimum 0.02
2. All system components covered by at least 9"soil
3. Cover soil free of stones larger than 6"
4. Grading slopes away from dwelling
5. No areas over system that may pond
6. Grading meets 3:1 slope
7. Minimum of 9"of fill graded over system
f
E
Mc DOWELL, INC.
25 Bridge Street, Suite 6, Billerica, MA 01821®1023
Voice(978) 667-9736 Fax (978) 671-9565
Email: nm(a,netwa
Date August 2, 2001
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, MA 01845
RE: Subsurface Sewage Disposal System
Plan Review, 1770/026
980 Winter Street
Assessors Map 104B, Lot 3
Dear Members of the Board,
Please be advised that Noonan& McDowell, Inc. has reviewed the plan dated 7/16/01,
By Merrimack Engineering Services.
It is our opinion that the proposed design will meet the requirements of Title 5 and the North
Andover Board of Health`By-Laws" if the following is addressed:
1) Show setback from septic tank to wetland. NA8.03a-c
2) Show setback from leaching area to wetland on West side of Winter Street.
NA8.03a-c.
3) Show D-Box at least 2 feet from beginning of leaching line to ensure sufficient
space for first 2 ft level.
4) Profile is not drawn to scale. Plan must be revised to comply with 220 (4)(0),NA
8.02c.
..• , "" 5) Provide a vent detail.
6) Relocate pump chamber to reduce fill over top. 221(7). If Item 4 above were
performed the Design Engineer would have seen this flaw in his design.
7) Add proposed driveway NA8.02y
8) Add break-out contour/spot shots (103x1 & 103x4), 220(4) (g)
9) Identify on plan view where bench mark is located 220(4)(q).
10) Provide a note on plan listing requested variances 220(4)(p).
1 l) It is assumed that the leaching facility is within a water supply area, tributary and
public well unless stated otherwise. Provide necessary documentation and/or
notes. 220(4).
12) Provide a note stating, "At time of installation inspection by Board of Health the
existing septic tank liquid level shall be below the bottom of the outlet tee".
13) Distribution header pipes for the leaching system should have some slope. Having
none can cause flow problems for outer distribution lines.
14) Provide pump performance curve 220(4)(r). The operating curve for various
discharge rates must be plotted on manufacturer's pump performance curve. The
velocity within the force main shall also be submitted.
Respectfully,
Land Surveyors Civil Engineers Environmental Planners
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from I
Boards and Departments having jurisdiction have been obtained. This does not relieve 'I
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************]
APPLICANT PHO
LOCATION: Assessor's Map Number PARCEL
SUBDIVISION LOT(S)
STREET / �-e/, ST. NUMBER !10(e
*********************************OFFICIAL USE
REC MEN ON OF TOWN AGENTS:
7
CONSER,YAffION)�I &MfNISTRATOR DATE APPROVED
DATE REJECTED
------------------
,J\J
COMMENTS;-- t-A -&,l t,�l
TOWN PLANNER DATE APPROVED. C)
—+LdDATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED Z
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWERAUATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECT DATE
Revised 9\97 I'm
Town of North Andover MoRrw
O�j�46D 4a�ya
Office of the Health Department
a2 - w-
Cc mmunity Development and Services Division 41 1
27 Charles Street ' °�4.x°�° ••
���sACNUS��Rry
North Andover, Massachusetts 01845 I
Sandra Starr Telephone (978)688-9540
Health Director
Fax (978)688-9542
October 30, 2001
CO-
Bill Dufresne
Merrimack Engineering Services
66 Park Street
Andover, MA 01810
Re: 980 Winter Street
Dear Mr. Dufresne:
This is to notify you that the revised plans dated 10/18/01 for 980 Winter Street have
been approved.
If you have any questions,please do not hesitate to call the Board of Health Office at
978-688-9540.
Sincerely,
Sandra Starr, R.S., C.H.O.
Health Director
Cc: File
Barrett
SS/aem
BOARD OF.APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535
I
BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
I
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: .•.. " CURRENT INSTALLER'S LICENSE#
LOCATION: °' n',,
LICENSED INSTALL
SIGNATURE: ,� ',,� TELEPHONE#
Y i
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
$160.00 Fee Attached? Yes No
Foundation As-Built? Yes No
Floor Plans? Yes No
Approval Date; f
INSTALLER PROJECT MANAGEMENT OBLIGATIONS
An the North Andover licensed installer for the construction ofthe septic system for the
Wd�a�6u�n
���� �� u�o
o dated ry|uoyby and
dated with revisions dated
I understand the following obligations for management of this project:
I. /\m the installer Iunz obligated to call for any and all inspections. If homeowner, contractor,
project manger, or any other person not associated with my company schedules an inspection
and the system im not ready then item two shall beapplicable.
2. As the installer unnrequired to have the necessary work completed prior to the uyp|ioub|o
iooyecdnnu as indicated below. I understand that rugnomdog an inspection, without
completion of the items in accordance with Tile 5 and the Board of Health Regulations may
result in u$50.O8 fine being levied against my company.
u) Bottom of Bed - generally first inspection unless there is u retaining pmU which should he done
first. Installer must request the inspection but does not have|o6opresent,
h) Final iuopoutinu — DoQiuocr must first do their inspection for elevations, dmx, uuu. Aa'buU| or
vo/6ol 0}{ from oogiuoax must be muhmiKoJ to Board of Health, o8or vvkicb inuiu]|cr calls for
inspection time. Installer must be present for this iuopoohoo. With pump system all electrical
work must 6e ready and able Wcause pump W work and alarm/ofunction.
o) Final Grade—Installer must request inspection when all grading is oozup|o(o. Does not have|o be
on site.
3. As the buatuUur Inndcra1uod that persons or companies not associated with ug' company may
not perform the work required by my company to 000zploin the installation of the system |
identified in the u1toobed application for inu(oUuduo. l further understand that work by odboru
unlicensed to iuutuU septic eyatcozm in Y4odb Andover can 000ah8uhe reasons for denial of the
|
ayaion, and/or revocation or ouaycnmiou of my |hcmnm: in the Th=o of North Andover plus
significant fines(o all persons involved.
4. As the Installer Iunderstand that T must bu on site during the performance o[ the following
construction steps:
x) Determination that the proper elevation of the excavation has been reached.
6) Inspection of the sand and stone to be used.
c) Final inspection 6yBoard nf Health staff.
d) IuaiuDxdnu of tank, D-box, pipes, omuo, vent, pump obuoubur, retaining wall and other
components.
5. As the inotu|bz londuza1und that I uzu solely responsible for the installation of the mym{eno as
per the approved plans. No inx8nub000 by the homeowner, geuo,u| contractor, or any other
persons shall absolve neof this obligation.
Undersigned /
Dxte
`-
Disposal Works Construction Permit
i
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Form No.3
Town of North Andover, Massachusetts
BOARD OF HEALTH
NORTH // r!— d✓ c.-
41 '6
O A
DISPOSAL WORKS CONSTRUCTION PERMIT
pSS�CHUSEc
• Applicant 1���--�'
NAME ADDRESS
.�,.
Site Location rr� '
Permission is hereby granted to Construct ( ) or Repair (I n Individual Soil Absorption
: Sewage Disposal System as shown on the Design Approval S.S. No.
CHAIRMAN,BOARD OF HEALTH
D.W.C. No.
Fee
Town of North Andover, Massachusetts Form No. 1
XAORTH BOARD OF HEALTH 1
pF� �e° bgti0 1
APPLICATION FOR SITE TESTING/INSPECTION
lip QORATE°P7R��4J
SSACHUS�
r
Applicant
NAME ADDRESS TELEPHONE
Site Location
Engineer NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
CHAIRMAN,BOARD OF HEALTH
Fee Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
Town of North Andover, Massachusetts Form No.2
1 NoR*a BOARD OF HEALTH
o`A,,... ,g9yo
*y,1gA.�oY.af"14 DESIGN APPROVAL FOR
Ss"CH°5�` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant 1 Test No.
Site Location � < ;
Reference Plans and Sp
ecs. � .
NG NEER y ESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
• C IRMAN,BOARD OF HEALTH
r
Fee / '
Site System Permit No.
• I
I
Mc DOWELL,
25 Bridge Street, Suite 6, Billerica, MA 01821-1023
t
Voice (978) 667-9736 Fax (978) 671-9565
Email: nm @netway.com
Date
Town of North Andover
Office of the Health Department
Community Development and Services Division
27 Charles Street
North Andover, MA 01845
RE: Subsurface Sewage Disposal System
Plan Review, 1770/ (2
Assessors Map ;,Lot 75
Dear Members of the Board,
Please be advised that Noonan &McDowell, Inc.has reviewed the plan dated
w j
by
It is our opinion that the proposed design will meet the requirements of Title 5 and the North
Andover Board of Health "By-Laws"if the following is addressed:
' , '
., t'r7,.�^'
Respect ully, C ' �r , ( z'
F,,1< 0U
John L. Noonan,P.L.S.-P.E.
G:office/forms/tonarev
;�r )
Land Surveyors Civil Engineers Environmental Planners
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TWAY
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lot, 6
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+u'' v" �'-!�` �,-.w.,.� ,r � �,,�""wW�yW'm� �� �"""'•,,,�, �, �� ,�'r.� .: Diu.--�i. a��
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SEPTIC PLAN SUBMITTAL
l
LOCATION: L01 KW2-- �
I
NEW PLANS: YES $160.00/Plan
REVISED PLANS: - $ 60.001P1a� �� ��
SITE EVALUATION FORMS INCLUDED: YES
DATE: I'�[-�
DESIGN ENGINEER: gr-ll-4tJ I raj
DATE TO CONSULTANT:
i
When the submission is all in place, route to the Health Secretary.
I
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I 1
P
MODELS. FEATURES:
LE31 M 115V, 10.5a, Manual +Vortex impeller, made of high temperature*RYTON®
LE31 A 115V, 10.5a, Automatic permits passage of solids without clogging
+Cast iron construction with all stainless and
Automatic models feature a mercury-free wide angle brass fasteners
float with series plug-allows for manual operation of +416 stainless pte, I rotor shaft .
pump separate from switch. +Oil-filled,thermally protectedAnotor
• Permanently lubricated bearings
• Unitized shaft seal
® 10'U.L.approved power cord with quick disconnect
design allows replacement of cord in seconds
without breaking seals to motor(20' optional)
• 1-1/2"FNPT discharge
*RYTON®is a registered trademark of the Phillips 66 Company
LE30=SERIES TECHNICAL SPECIFICATIONS
PUMP IMPELLER
The pump(s)shall be model The pump shall have a VORTEX style impeller
as manufactured by Liberty Pumps, Bergen, NY, made of high temperature*RYTON@), capable of
or equal. passing a minimum 3/4" spherical solid.
The pump(s)shall have a capacity of—GPM at
a total dynamic head of SEAL
feet. Motor size shall
be 1/3 horsepower, single phase, 60 hz. and 115 The shaft seal shall be of the carbon/ceramic
volt operation. unitized design, with BONA N elastomers and
MOTOR stainless housings.
The pump motor shall be of the submersible EKTERNAL CONSTRUCTION
type, oil filled, hermetically sealed and shall be The pump volute, legs and motor housing
thermally protected.The overload element shall shall be heavy gray iron castings, class 25 or
automatically reset when motor cools. Motor better.All castings shall be enamel coated before
windings shall be of the class A insulation rating. assembly.All fasteners shall be of 300-series
The rotor shaft shall be made of 416 stainless stainless steel or brass.
steel and shall be supported by lower bronze LEVEL CONTROL
and upper sleeve bearings.
The pump shall be controlled by an adjustable
mercury-free switch sealed in PVC float, and shall
have a series plug for manual by-pass operation.
MODELS HP VOLTS PHASE AMPS DISCHARGE AUTOMATIC IMPELLER
LE31 M 1/3 115 1 10.5 1-1/2" FN PT NO VORTEX
LE31 A 1/3 115 1 10.5 1-1/2" FN PT YES VORTEX
10'cord standard on above models.
For 20'option,add a"-2"suffix to model number. Example:LE31 A-2
DIMENSIONAL DATA: PERFORMANCE CURVE
Weight: LE31 M:31 LBS. 20 1550 RPM
6--
Height:9.6" OWN
16 is-
Major Width:9.8" (manual models) t 4-- 'T
12
Maximum fluid temperature 145 degrees F. _0
7
8
*RYTON(D is a registered trademark of the Phillips 66 Company
2--
4
0
0 10 20 30 40 50 60
SSPMA U.S. Gallons Per Minute
co-Certified
4.2
City of LA certification available 0 1.4 2.8 Liters Per Second
Liberty Pumps• 7307 Lake Rd •Bergen,New York 14416•Phone(716)494-1817 Fax(716)494-1839 7240-131/94
1
i
Mc DOWELL,
25 Bridge Street, Suite 6, Billerica, MA 01821®1023
Voice (978) 667-9736 Fax (978) 671-9565
Email: nniA e!way.co n
r
I
Date August 2, 2001
Town of North Andover
Office of the Health Departments`°
Community Development and Services Division
27 Charles Street
North Andover,MA 01845 C63,.�
RE: Subsurface Sewage Disposal System
Plan Review, 1770/026
980 Winter Street �
Assessors Map 104B, Lot 3
Dear Members of the Board,
Please be advised that Noonan&McDowell, Inc. has reviewed the plan dated 7/16/01,
By Merrimack Engineering Services.
It is our opinion that the proposed design will meet the requirements of Title 5 and the North
Andover Board of Health`By-Laws"if the following is addressed:
1) Show setback from septic tank to wetland. NA8.03a-c
2) Show setback from leaching area to wetland on West side of Winter Street.
NA8.03a-c.
3) Show D-Box at least 2 feet from beginning of leaching line to ensure sufficient
space for first 2 R level.
4) Profile is not drawn to scale. Plan must be revised to comply with 220 (4)(0), NA
8.02c.
5) Provide a vent detail.
6) Relocate pump chamber to reduce fill over top. 221(7). If Item 4 above were
performed the Design Engineer would have seen this flaw in his design.
7) Add proposed driveway NA8.02y
8) Add break-out contour/spot shots (103x1 & 103x4), 220(4) (g)
9) Identify on plan view where bench mark is located 220(4)(q).
10) Provide a note on plan listing requested variances 220(4)(p).
11) It is assumed that the leaching facility is within a water supply area, tributary and
public well unless stated otherwise. Provide necessary documentation and/or
notes. 220(4).
Land Surveyors Civil Engineers Environmental Planners
I
I
I
1
12) Provide a note stating, "At time of installation inspection by Board of Health the
existing septic tank liquid level shall be below the bottom of the outlet tee".
13) Distribution header pipes for the leaching system should have some slope. Having t
none can cause flow problems for outer distribution lines.
14) Provide pump performance curve 220(4)(r). The operating curve for various
discharge rates must be plotted on manufacturer's pump performance curve. The
velocity within the force main shall also be submitted.
Respectfully,
M
Jbhn L. Noonan, P.L.S.-P.E.
G;office/boh/1770026
Land Surveyors Civil Engineers Environmental Planners
2