HomeMy WebLinkAboutTitle V Inspection Report - 851 FOREST STREET 10/31/2017 APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby mak
a�
plication for a permit for a sewage disposal installation at
1 will install this system in ac-
cordan_cewith all the laws of the Commonwealth of Massachusetts and regulations of
the Board 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 eo. I will install a con-
crete septic tank of in size. A manhole (s) permitting easy cleaning
will be provided with removable ;'over (s) of iron or concrete within 12 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 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 (dia. ) 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 1/81, 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 agree not to cover any j2ortion of this installation until_appraved by the
in2ptction officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE e)
r '
-V —STg—hat—ure of ApplicaniT 7_
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE 0
Signature of ealth Agent
I have inspected the uncovered system indicated above and find everything done
as describ d.
DATE E
In Signature of in ecting Officer
Percolation Test )IYX(eliR
Garbage Grinder'
BOARD OF HEALTH
TOWN OF NORM ANDOVER, MASS.
1'
1-7
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1. NAME �, v DATE
__jJSj;b�j/ j
2. ADDRESS / . �� ` LOT N0. TEL. , �
3. NO. OF BEDROOMS _ DEN YES NO
4. GARBAGE GRINDER YES NO
5. SHOW DIMENSIONS OF HOUSE
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
`7. SHOW DIMENSIONS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL " );0"-
9. NO`T'E. 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 / le �
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS
SEWAGE DISPOSAL
DATE
NAME OF APPLICANT
LOCATION
Address of lot no.
BUILDING: Dwelling_X_Other
SYSTEM: New— x Repair
GENERAL
ePair---
GENERAL DESCRIPTION OF LAND hirph
SUBSOIL: Clay_ Gravel_&_ Sand
PERCOLATION TEST— q -minutes per inch.
- - - - - - - - - - - - -
MINIMUM INSTALLATION RECOMMENDATIONS
CONCRETE SEPTIC TANK onn _gallon capacity.
LEACH FIELD jRn lineal feet of drain pipe.
William J. DripcIly Engineer
Board of Healthj