HomeMy WebLinkAboutMiscellaneous - 210 GRANVILLE LANE 4/22/2003 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 or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT P,ASTO61 PHONE S� �VyG
LOCATION: Assessor's Map Number L96 PARCEL__��
SUBDIVISION LOT(S)
STREET 0 (i 0n1 VI L L L,v II SGST. NUMBER 2
�************************************OFFICIAL USE ONLY*(**************************** ****
REC MEND I0 WN AGENTS:
CONSERVATN ADMINIS
IO ATOR DATE APPROVED 1,11 111 CPA 1 11170
DATE.REJECTED
COMMENTS SmcJ1 _l 5 6 nT
al cr� +0 bac K — �m�s h�f � tk1
ak:iti,Q
T2y✓- 0 ro.dt2 cTi on
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
k DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED 0
((��'' (DATE REJECTED
lV�
COMMENTS
� � �� ,� � TBI�M S�
PUBLIC WORKS- SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
y
Bo and of''H alth
North r)49Y! ass. SEPTIC SYSTFA R
INSTALLATICK CHECK LIST LOT
FAIL
1. Distance To:
a. Wetlands
b. Drains
c. Well
2. Water Line Location.
No PVC Pipe
4. Septic T
a. _Tees w._Length & To Clean Out Covers
b. Cement Wipe to Tarim - 0n Both Sides of Tank
5. Distribution Box
a. Corers & Box - No Cracks
b. All Lines Flowing Equal Amounts
c. No Bach Flow
6. Leach Field or Trench
a. Dimensions
b. Stone Barth
c. Capped ids
'
d. Clean Double Washed Stone
j
' 7. Leach Pits ' �
a. Di sions
b. Stone Depth
c. Splash Pais
d. Tees
e. Cement Pipe to Pit Bath Sides
f. Clean Double Washed Stone
8. No Garbage Disposal
q. al Grading Inspection
10. Barricading Covered System
11.. As Built Submitted
` a. Lot Location
b. Dimensions of System
c. Location with Regard_to Pere Test
d. Elevations
e4' Water Table
c
ell
+' 2, 5 Fall OK The E, Jbtfitl;r', d plan 1:1 IN1I"1t7iTlUM
1." ( a) Me lot l.a V be served (4"'.#1 o n. y E i! Y 1{in.K miIo n s , lot ��«.� PW to 1
(Planning Board t` i.ii.LVS)
(t7) location rir:td 1.o}a of cAo;ap (_)C er.'vat,it_in 1",oIcs._d1 si,-anct
to ties
�(c) location -;anti rcsulc,s r:>f pc;rGola.1;-3_on, cr.ysis .diatanee
to ties
Ad) d C.s:! S C'1 c.�
area
c 1� 1 <1 'la,1 Fy C�a"�;"� ���r�
f L 4 :1c }t tn
(e) location and d:] ma,11t'Hi,t'11"1s of system ( 2 r1('1_Ltc1 i fpay I: 1
existing and p:i,opo ;c A coIr l ol,l I s
(g location of any wet a 1. cans A 1,M =01 of l;i l C ,7 c: w l",
disposal system (11.: c:11 faC,,1 !r1 ?,l(sr (Mck t^J(,t'1 ,' ds, map( i
( h) surface and 7L7�: su 1. .V_ %:?co !� 4'x i W3 `�"rl NO 11 100 ' Of �sPVj c' "
disposal 135"SUM 01" (MI(IIIIij!Jer
( l_) lC7(.a , 1. C..7T"1 of any c r u n 1 1 1 q g e t',,a.t:,c..'1€I r l l_,b ` t o "il
y disc ry _ d
� .')�.1 r�,e d 1 a,a°'�°u�s r,"�,„_ ,y,�F Lam Y 11 o h" 1 nom' l hair )� 't r 1 t'��!_I I r 7 i f a v
( j ) w`:1lown :s(`)1)rC;es of a"` .L r I..sopply !'1::_i,i1`l..n _'.(.)U ' of
disposal system or discl a! Mer
W (k) location of any proposed wo 1.l i,o r�:.1:°ve L-1nc�, lot ('1 001
from leaching facility)
(1) location of water 1.:i nes On property 110' fUc�M 1_r°r on'd
facilities)
L-Am) location of bcncbmNrk
.P V( f> 'u O "be 7 7':f':C:1. �'i in
t
( q) a1 19rof-11_e of r-fats 'J ,_. WE1
"
p 1 p e septic n , U _- Y_ ra box 1 I f1 c;K3 and O�N I, 1 O
distribution field & 1M11 and nny c7i:'Ir;c A uv ii;i(nis)
f. ( C`) Maximum gr.'oun Kt;i e l.(_, v f kj on. in q:i_`(;;a, (a f, rr x.,., �r i
J: t",'ITS
y ,
m ,
pia_' E7 S'
� ,,- [7 plan �a11_t;.i 1. �)(r l.i f.: G„y`�nJ i,( . b a
t'7I;her f7a C) 'i''r?s s'1_onRl. n11 i;ho 1 '✓:,E:,d by U_w i.,o
P
peptic (' 1,; � ! s-
p
of Won DCCOSS , Pun, Ian
(” ) 1 0 f r r���7 a � a �^ i 1 � t.� i �,�;rtd ' 1., ^�.t�i l g ��C:,
s
( r )
F 4 (b Sump
Leaebina Pit
Leaching pits are preferred ,,Yhere the installation is
possible
Reg, 11 ® 2 ( a) Calculations of leaching area (minimum 500 S,F® )
Teg.11 . 4 (b) Spacing
Reg-11 - 110 ( c) Surface drainage 2%
( d) Cover t e r i a I
-4�
L e a c b�n g_
Reg.15. 1 ( a) bGreater than' so minutes/inch
?Og. 15. 1 (b) Area (minimum 900 S.F. )
7eg.15. 4 (c) Construction of field
Pe g.15. 8 W Surfac'e' drainage 2%
Fc-tF:�,. 3. 7 ( e) 201 rom cellar wall or inground swimming pool.
L,e a eb i n Trenches
les, 14®1 Calculations of leaebing, apea (min . 500 S.F. )
6 It, itla reserve between)
E
pg. -1 It. k (.b b Sp acing (4 ft, min® w
Reg.14. cc! Dinensions
14. 5
Rega14. 6 '-(d)
Reg ,( e):,. 14. 7 / Stone
14. 1 C Surface draij�aGe s%
o j)e
(a) Slope ylx , (to be shown)
(b) Y1x X 150 = (to be shown)
Reg. 9.1 (a) Approval
Reg. 9A (b) Skand-by power
C,lEIt�`l.�EFfN Cod F `lj"j C- INN] )1-^ l(]1 i��G
Frank w ��li�°�� and Associates t, � r � �
Engineers & Architects
North Andover Office Park
NORTH ANDOVER, MASS. 01845 __. ..._
rl IOr! NO.
MTE rrEN I0N
Phone 687-1483
TO
nc-
a _.
GENTLEMEN:
W E ARE SENDING YOU I-.J Attached C-1 Under separate cover via— — _._--. — ---the fallowing items:
Shop drawings Prints ❑ Flans CJ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑ ---
Prla
a SCRI N —
COPIES DATE NO.
E
L... t
THESE ARE TRANSMITTED as checked below:
/For approval C_l Approved as submitted O Resubmit copies for approval
❑ For your use [_J Approved as noted F] Submit_.--copies for distribution
❑ As requester) C::J Returned for corrections ❑ Return- .—corrected prints
For review and comment Cl _._...._-----_.._--------------------------
[:j FOR BIDS DUE....__...___...__..._..—._._.._—__.____.__1q---._ ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS-- -_...._..---......---_____..".
COPY '1'0.....---_..._.—._—....—.-----------..----.—.--_.---. --
SIGNSD:_._.—__.—..
If enclosures are riot as noted, kindly notify us at once.