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HomeMy WebLinkAboutCorrespondence - 208 OLD CART WAY 11/20/1995 Town of North Andover t40RTH OFFICE OF ��o' ro 6�ti00 COMMUNITY DEVELOPMENT AND SERVICES ° 146 Main Street KENNETH R.MAHONY North Andover,Massachusetts 01845 �SSACHLO) Director (508) 688-9533 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE This is to certify that the individual subsurface disposal system constructed �V or repaired ( ) by 1 /w ZL&G VIA,) installer at C" i /,/- has been installed in accordance with the provisions of TITLE 5 of the State Sanitary Code and with Board of Health regulations as described in the Design Approval Permit ##� dated / llehoZ . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY. Board of H alth Inspector i BOARD OF APPEALS 688-9541 BUH DING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Parrino D.Robert Nicetta Michael Howard Sandra Stair Kail om Bradley Colwell Town of North Andover, Massachusetts Form No.3 E NORTH BOARD OF HEALTH STIfD =6,4, { * t DISPOSAL WORKS CONSTRUCTION PERMIT SACHi75E Applicant—Tvl--� NAME ADDRESS TELEPHONE Site Location `^ I G� �• a r � ? a.. Permission is hereby granted to Construct ( ) or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. f 7��, CHAIRMAN,BOARD OF HEALTH Fee �fi �� D.W.C. No. SN .ti`s f ` } ti � � _' ti Ali '{. f-} \. X111 � ` a 1.ti'\` t- •1 \ }� ' y l ��.`n�i.,'k5 �'':''.�i.!d1 t.'_i_ ..it�4a-4s1Tt}.F�itr: i...lti.\l�tk C2 cor Z m C �6 Ci O cs -+ Z O H MM C8¢ C] CD MCD T C ••!� a .� C CD C o co 7q CIS Cl) � C �, ° � C " cD n Z � � CO)C o„ pow � 0• T co � � w C° 4 v .. CD CD CO2 w CD CD W ca CD O G .. to (! _ p y CD L"1 C y � cts CL Cr CD w CD �, O a Q � A cp CD F f_ 04 CD f y co zo M CD co CA m m co c. 51- ko PL CD W czn -c o O zo CD Zc a ►�'t r n r H © .A o= � Z CL O cn n Rd 7� :11 ° ° ° ° 0 EL rL CD M - � a MIMIt a n O-� T\ I cp (�A p CL ;U U C �4 o > m z , _ 0 * N (D m Z C�N (� cn U) o == o -n z O � cn o � -i o r -1 3n_r C J z n -0 O N i in (D (D -a t11 o o Z 0O a < � < m rn mm to o c �c 00 rn Op (r, N , --1 X i u z (0 � 0 zr � rr ur z 7T m ° cn ° CL W (D �--N, f C,( W y' (D '� 3 ° Ski 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***************** � 3? � APPLICANT: _5�� CQ�'kl�� �h C - Phone Y � / LOCATION: Assessor' s Map Number Parcel Subdivision V� W Lots) Street © St. Number Use only************************ RECD NDATIO S OF TOWN AGENTS: / L6V - Date Approved -tom Conservation A ministrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected _ Date Approved 2�L� Septic Inspector--Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date --- DATE Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE I PERMIT DATE RECEIVED # 713 APPLICANT ASSESSOR' S MAP /L ADDRESS PARCEL # �ZZ LOT ENGINEER STREET ADDRESS PLAN DATE REVISION DATE CONDITIONS OF APPROVAL: 0/V APPROVED DISAPPROVED PLAN REVIEW CHECKLIST ADDRESS. ER ! ENGINE GENERAL 3 COPIES STAMP ° LOCUS NORTH ARROW SCALE µ . �' " HMARKe� SOIL & CONTOURS �-� PROFILE �.....-- SECTION BENC PERC INFO ELEVATIONS "' WETS. DISCLAIMER e..- WELLS & WETLANDS WATERSHED? 14 DRIVEWAYS '' c (Elev} WATER LINE ' FDN DRAIN SCH40 TESTS CURRENT? � SEPTIC TANK MIN 1500G. . 17 INVERT DROP GARB. GRINDERL" (+200% EDF) 25' TO CELLAR MANHOLE TO GRADE ELEV ESC: GWL D-BOX SIZE ;L� -5 # LINES FIRST 2 ' LEVEL STATEMENT INLET✓'-t(,-,j j - OUTLET?. ( = t (2 OR . 17 FT) TEE REQ'D? ;"� ' LEACHING RESERVE AREA , 4 ' FROM PRIMARY? ,.f 100' TO WETLANDS f 2% SLOPE 100' TO WELLS t-Z 35' TO FND & INTRCPTR DRAINS �- '' 4' TO S.H.GW 325' TO SURFACE H2O SUPP / 4' PERM. SOIL BELOW FACILITY MIN 12 COVER C FILL? ,/ --- (251 if above natural ele ; 10' if' below) BREAKOUT MET? TRENCHES MIN 660 gpdJ SLOPE (min . 005 or 6111100' ) x.-- >3' COVER? - VENT SIDEWALL DIST. 2X EFF. W OR D (MIN 6' ) ✓' IS RESERVE BETWEEN TRENCHES? .' IN FILL? MUST BE 10' MIN.L--"- 4" PEA STONE? (y/, .. BOT !� {L x�W x #) X SIDE SID(DxLx2 X LDNG TOTE x#) i I Town of North Andover, Massachusetts Farm No.2 NORiy BOARD OF HEALTH s. O� ' � p DESIGN APPROVAL FOR ss^�"SSE` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant l) M.__/VLCaf. U(.1vs_ �� Test No. ' Site Location L1 , Reference Plans and Specs. f- ENGINEER DESIGN DATE a 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 g�g 9 Fee Site System Permit No. ..,_ 9 9 1 a i I i �I E I