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Home My WebLink AboutCertificate of Compliance - 101 CROSSBOW LANE 6/30/2010 %AoRT14 �+® 0 0 •W IL H O cocHiini°wKn �• R ORATED pPR �y �SS.�cwus�R PUBLIC HEALTH DEPARTMENT (ommunity Development Division C(-P2TrFI .XCF 0 F ,1'.GI As of-. June 30, 2010 This is to certify that the individua(subsurface disrposafsystem received a SWISEXCTORTIMPEC7IONof the: Rfp&cement of a Component: Disth6ution BM Tor an Site Sewage ' osafSyste (By. ToddBateson At: Cross6ow 106. ; Parcel 206 Wo-rthAndover, 9WA 01845 The Issuance of this certificate shaft not be construed as a guarantee that the system wiff function satisfactorily. •ter S an T Saw Public YfeaN(Direct r 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com TOWN OF NORTH ANDOVER NoRrk 0 Office of COMMUNITY DEVELOPMENT AND SERVICES 0 HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 1Z NORTH ANDOVER, MASSACHUSETTS 01845 S I 95C S NUSE usan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX .ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: MAP: LOT: INSTALLER: DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS "'") TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer E] Comments: Topography not appreciably altered SEPTIC TANK ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 2'4hrs) F-1 Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page 1 of 6 TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES ?pry "OOH Jot HEALTH DEPARTMENT p 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 "SSV"cNusEK`y Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 '/Z" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) El cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER f NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT � ° p 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 �qas pcHUs Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals F-1 orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OF NORTIR ANDOVER NoR11 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT - 1600 OSGOOD STREET•' Building 2-36 Awno NORTH ANDOVER,MASSACHUSETTS 01845 �SS ,,SE� Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory 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 -- E] Waterline 10 10 10' ❑ 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 Crib. (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 1 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 Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTIH ANDOVER f JORTH Office of COMMUNITY DEVELOPMENT AND SERVICES Fro HALTH DEPARTMENT A iK 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 ACHU SE Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6 0% Commonwealth of Massachusetts Map-Block-Lot 10620206 Board of Health ----------------------- Permit No North Andover BHP-2010-0610 ----------------------- BHP-2010-0610 N, it P.1. FEE �2SACHW, F.1. $125.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Todd Bateson ------- --------------------------------------------------------------------------------- to(Repair-DISTRIBUTION BOX ONLY)an Individual Sewage Disposal System. at No 1_0_1 CROSSBOW_LANE as shown on the application for Disposal Works Construction Permit No. .13HP-20-1-07061 DatedJune 02,_ ------------n-------------------------------------------------------------------- 02,_20I0 ----- ---- ------- ----------------- ---- --------Issued O-- Jun-02-20 10 Board of Health *O�4 RTN 4 Commonwealth of Massachusetts map-Block-Lot 4 10630206 Board of Health ----------------------- z' North Andover CERTIFICATE OF COMPLIANCE I&SACH , THIS IS TO CERTIFY,That the Individual Sewage Disposal System (Repair-DISTRIBUTION BOX by _jo-d-d-Bateson ------------------------------------------------------------------------- Installer at No 101 CROSSBOW LANE has been installed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the application for Disposal Works Construction Permit No. BHP-2010-061- Dated---June 02,2010-------- Printed On: Jun-16-2010 ----- - ------------------------------- ---------------------------- - - - - - -- ------------------------------------------------- Board of Health