HomeMy WebLinkAboutHealth Permit # 2/25/2005 .re��a'tani,tffia'"i,it� �� ��.�� �; i� t°at all"m:w�tServices Da.V:aaMm1011
Offkv of the Health Department
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4110 11Stm11t11.:S 111:"ET
Noith,.�indover, N4,a sachuseN6.±,Ctilti45 m�
1"aa.a;;aaa 1 Ra "t"a.^r,
1,',1,J N,/1
i`aal9Pwa 1 la::ulth 1.91a•ec1a>a° (974) 688J)540 • Phone
(978) 68 9542 1,a'a;x
Irate:
Address:"
��> �/'C ��� ��" �" �� ,1mlortla Andover,MA 01845
Re: Application for:
Dear: ats . ., ", t `� .1
Your application for 1 '�, .'t at has been reviewed by the Health
Department. The application was denied on, 2004 for the following reasons:
1. Missing information
2. W Passing Title 5 inspection of septic system required
3. ❑ Location of structure not acceptable
4. ❑ Undersized septic system
To address the roblem s):
If#1 is checked, please supply:
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a. Floor plan of existing and proposed addition—all rooms
b. Certified plot plan showing house,septic system and proposed project in scale
If#2 is checked:
a,� Have the septic system inspected by a certified Title 5 inspector to determine the size of the system and
_11 whether it is operating properly: OR
b. Tie-in to municipal sewer
If#3 is checked:
a. Relocate the project
If#4 is checked:
a. Provide additional information proving that the existing septic system meets current capacity
requirements. Please consult an engineer to determine the flow capacity of the septic system.
Please feel free to call the Health Office at 978•-688-9540 with any questions you may have.
Sincerely,
Reviewer
Cc:Cc: Building Department
File
d�&a,7hMD OF API p,fhV-,S 68V)5fl USWJ[Y MNJO 698-9545 G.O M PVM ION 69 a5.30 IVURM;, 688-9541""1"11 A NNNG 699J4535
Town of-North Andover MA'
Watershed Septic System
Servicing Report
Date:
Homeowner e Pumper
Street Address:
Phone °' Phony:
Nature of Service: Routine
Emergency
Observations: Good Condition
IX
Full to Cover
Baffles in Place
Leachfield Runback
Excessive Solids
Heavy Grease _
Roots
Other (Explain)
Description of Work:
a
Comments :
F'
MORTGAGE INSPECTION PLAN
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1, Sc REEN
419 ,� "j PoIZ6N
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THIS PLAN IS BASED ON A TAPE SURVEY AND IS TO BE USED FOR MORTAGE PURPOSES ONLY.
THIS IS NOT PREPARED FROM THE RESULTS OF AN INSTRUMENT SURVEY AND THE OFFSETS
AS SHOWN SHOULD NOT BE USED IN THE ESTABLISHMENT OF PROPERTY LINES.
COUNTY
DEED REFERENCE: PLAN REFERENCE: PLAN OF LAND
PKcc 9&17
BK.2221 PG. -5 7 PL.BK. PL. IN
I hereby certify that the existing building is located NORTH AW D aVVF2,
approximately as shown and was not in violation of the PREPARED FOR:
zoning bylaws at the time of construction. This building SroIjFHt'0. oP:-p"'-7
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is not located in a flood hazard area. --AMFS - 15uS.! CAMPBE. 1.
FLOOD HAZARD COMMUNITY NO. 2 SGG y
BOUNDARY MAP NO.001 C F EFFECTIVE 15 SCALE: I IN.= 4 O FEET
BAILLIE & COMPANY
JOHN ��� CIVIL ENGINEERS & LAND SURVEYORS
EGIS7'HED LAND SURVEYOR $ 89 VINE STREET
�pONNELL v+
DATE:/,2 ►,�n - / No Cpl READING, MA 01867
(617)944-2767
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FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
/APPLICANT: '&iRtNGL LAi?S �� Phone LF6—oS a
LOCATION: Assessor's Map Number Parcel
Subdivision Lot(s)
Street �.3 :-c2LZ5T St. Number `73
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
in,6 Date Approved `r 2
%Conservation Administrator Date Rejected
✓/
7 Comments
Date Approved
Town Planner Date Rejected
Comments
' J Date Approved g�
dltfi Agent Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
,?(; ,,ai" ..U.. r,.,ry yam,,gym ,.,. „ep:z^^ •,. „, .,5, mow..,, .,, „r.. i 1 ., ... ,.,.. ... .. ., ,,.
Board of R®nith SEPTIC SLSTEM
North Andoverzs®
INSTA'•LATICK CHECK LIST LOT mmy
;^ tF' OVID
DATE^r DISAPFtiWID X AVATI Og PAIL
�J easonst
f FAIL OK
2 _ 1. Distance Tot
a. Wetlands
b. Drains
C.. Well
2. Water Line Location
3. No PVC Pipe
4. Septic Tank
a. ..Tees -_Length k To Clean Out Covers
b. Cement Pipe to Tank Cap Both Sides of Tank
5. Distribution Box
a. Covers do Box - No Cracks
b. All Lines Flowing Equal Amounts
c. No Back Flow
6. ' teach Field or Trench
a. Dimensions
b. Stone Depth
c. Capped Inds
d. Clean ,Double Washed Stone
t
7. Leach Pits
a. Dimensions
b. Stone Depth
c. Splash Pads
d. Toes
e. Cement Pipe to Pit - Both Sides'
£. Clean Double Washed Stone
8. No Garbage Disposal
K
9. Final Grading Inspection
10. Barricading Covered System '
1.1. As Built Submitted
a. Lot Location
b. Dimensions of Sy-stem
c. Location with Regard-to Pere Test
d. Elevations
e.' Water Table
i
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BOARD OF HEALTH
No .Andover, 'Massa
SUBSOFACE DISPOSAL DESIGN CMK LIST
LOT
APPROVED DATE &-j m�." DISAPPROVED DATE
Pr Reasons:
Title V FAIL
Reg 2®5 The submitted plan must show as a mu: i
a) the let to be served-area.. ensions . ot #'abutters
b location and log deep observation ho �,s«distance to ties
c location and results percolation test, -distance to ties
d design calculations & calcuUtions sh, wing recMired leaching area
(e) location and dimensions of system-"no'.0 g reserve area
f) existing and proposed contours
(g) location any wet areas ulthin 1001 of uk-wage disposal system or
disclaimer-check wetlands mapping
(h) surface and subsurface drains within 1001 of sewage disposal
system or disclaimer
(i) location any drainage easements within 1001 of sevvge disposal
system or disci r-Planning Board files
(J) knoun sources of water supply within 2001 of sewage disposal
system or disclaimer
(k) location of any proposed well to serve lot41001 from leaching facility
(1) location of water lines on property-101 from leaching facility
(m) location of benchmark
(n) driveways
(o) garbage disposals
(p) no PVC to be used in construction
(q) profile of system-elavationB of basex. mtp plumb,,, pipe, septic tank.,
distribution box inlets and outlets, listribution field piping and
Other elevations
(r) maximum ground water elution in are - sewage disposal system
(s) plan must be prepared by a Profession I Engineer or other
professional authorized by law to pro-are suer plans
Reg 6 S tic Tanks
(a) capac t' es- 50% of flow, water tar ,e, tees., depth of tees,
access, pumping
(b) cl out
(c) 101 from cellar wall or inground swim.: ng pool
(d) 251 from subsurface drains
Reg,-10,2 7 Distribution Poxes
F(a) s apex greater 0®08
Reg 1.0.4 (b)