HomeMy WebLinkAboutApplication - 161 RALEIGH TAVERN LANE 4/24/1996 : Town of North Andover, Massachusetts Form N®.2
Q "OWTIy BOARD OF HEALTH
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DESIGN APPROVAL FOR
: ss^CH f. SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant Test No.
: Site Location ��/ �'rG- /t%f3' i9(/ �� 2,
Reference Plans and Specs.--23
ENGINEER DESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
CHAIRMAN, BOARD OF HEALTH
Fee Site System Permit No.
BOARD OF HEALTH OF NORTH ANDOVER , MASSACHUSETTS
SEWAGE DISPOSAL
NAME OF APPLICANT ID (_i
LOCATION L23 r
jaj.(3�0 L.,-h
,rLIa�rerrij an(-)
Address of lot no.
BUILDING: DwellirigL_ Other
SYSTEM: New -Repair
GENERAL DESCRIPTION OF LAND Lih
SUBSOIL: Clay Gravel- Sand
PERCOLATION TEST -minutes per inch.
- - - - - - - - - - - - -
MINIMUM INSTALLATION RECOMMENDATIONS
CONCRETE SEPTIC TANK 1 000 gallon capacitv.
LEACH FIELD- 200 -lineal feet of drain pipe®
WitliaFn D scoll , Enginee
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Board oTlHeaTh
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APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I here.y mane application for a permit for a sewage disposal. installation at
�� � °��the lawa ., ��x 1 w�,�.l install this system in �,c-
� of the Commonwealth
of Massachusetts and regulations of
cordance with
the Hoard of Health of the 'Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1/ until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2/.
I will install a con-
crete septic tank of / { in size. A manhole (s) permitting easy cleaning
will be provided with removable cover (s) of iron or concrete within ]. inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of "Le lineal (square) feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel. or crushed stone ranging
in size from 3/4 to 1-112 inches (die.. ) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/$" to 1/4" (dia. ) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
the line will exceed 100 feet in length and in any case, two lines of the will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further ai4ree not toc912E an anion of this installation until a roved b the
ins ecton officer, as provided below, and to incorporate any addi tional. requirements
that may be attached to the permit. Plot plans must be submitted with application.
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DATE
ignature of Applicant
I hereby issue the above permit for e Board of Health of the Town of North
Andover, Massachusetts.
DATE ' '
m Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE :, f
If
I .",.
Signature 0;'J nspecting Officer
Percolation Test
Garbage Grinder
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
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1. NAME DATE, ��'t, �' �.
s ADDRESS `;, ...�, v.,- , , OT NO. TEL. f„
3, NO. OF BEDROOMS DEN YES NO
GARBAGE GRINDER YES NO
5a SHOW DIMENSIONS OF HOUSE
6> SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
`gym SHOW DIMENSIONS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
q. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC.
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE. LOCAL REGULATIONS SHOULD BE READ CAREFULLY.