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Home My WebLink AboutMiscellaneous - 1044 JOHNSON STREET 4/30/2018%83_3 floc>� w� F,) S C (e d— FORM - U - LOT RELEASE FORM - cDy D j INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. Y/ APPLICANT J 111,V L O IL16jtIZ A U PHONE %� ` Z e 3 d ASSESSORS MAP NUMBER /0 �— LOT NUMBER SUBDIVISION LOT NUMBER STREET L,0 AISOn/ �7� STREET NUMBER �U7 ............................................................................ OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED CONB/fENTS TOWN PLANNER COMNIENi'S DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED I�yal�mKN COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Q 05/30/2001 13:01 19786880188 y tp Baa 0 4 0 LOMBARDO PAGE 01 fo. 12 0 Pn zo 3 H ob �� D=am z ��n w � �t � �Tl � 2",!r T �_ C/ FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. Y/ APPLICANT /V'06 L. O 1-164r1ZA U PHONE %V " 6 ee - Z e 3 o ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER STREET:. oAl sol j STREET NUMBER �! T . ..� ................ . ...... . OFFICIAL USE ONLY INNEENESEERENE RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED CONPAENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD� - HEALTH DATE REJECTED /INSPECTOR DATE APPROVED / SEPTIC INSPECTOR - HEALTH v DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DA' Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director % D Y -y -lc, /� ,c)_-;-61_�, fi F. North Andover, MA 01845 Re: Application for pc� ) Dear: /V15, 40M,13/9•e�)CC' Telephone (978) 688-9540 Fax (978) 688-9542 Your application for -- a �(/e at is y'I Tc;-A""5o4 has been reviewed by the Health Department. The application was denied on -�--/v ? J2001 for the following reasons: 1. Y Missing information 2. ❑ Passing Title 5 inspection of septic system required 3. ❑ Location of structure not acceptable To address the problem(s): If#1 is checked, please supply: a. Floor plan of existing and proposed addition 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 whether it is operating properly: OR b. Tie-in to municipal sewer If #3 is checked: a. Relocate the project Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, Reviewer Cc: Building Department File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANtiTNG 688-9535 1 CI QD � y U L Q F"A a; = 07 k 25 Z W a W Gy wlll F v Lll CC LL IF ZxxOU WW z °EN�uf Z(rjWV LL i_o aHrn U hal WQ co Z (n oC S O , $. v E o U. WWF HCC W ci°i8i10�v2 f_^ Q Z i.- - U °1._. C.. Q3Q 0o wg ►- o."m`.`� LL1 V NJ 2 Q C]4 0 z t' p1 ^/ ' i rU' f � U H I , N C l U, C U N `=car ILI On- b��n da 0 -1r W L c o WW ,}'.,, 4�. - 2 q C. s Irv r. L a� r.a c W cc c' t �nn10N Pg g$€ OC caU `� 0lm4z so ui CL 22.2 c= =c t1-O'Ra) C f0 Oda Vi �N{D D t .Q. LL X O o y v E m J Q woo O O UL W i 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 `fi_^lls out \\3Dt--his section***************** in APPLICANT: J_ � (� IN Wm� av Phone l �� LOCATION: Assessor's Map Number Parcel 13_,) Subdivision //��11 n(( nn Lot (s) ( L Street C_JA M Sdiy � St. Number o i ************************Official Use Only************************ 1 7 7h4 NDATIONS OF TOWN AGENTS: pDate Approved Conservation Administrator Date Rejected Comments Town Planner 74761 Comments Food Inspector -Health (� Septic Inspector -Health Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Comments /U'`l e&)I_�i r)_ Z' G' ep 3 3 5 Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date 1 wow �m ■aoe WWWWWWW mpg MMEME loommom IMMEMEM mommomm WWWWWWW INUMEME immommso IIIIIIIIIIIIIINEEMEN IWOMMEME1 EMMEMENI 4 Sawyer., John 1044 Johnson St APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at 1044 Johnson St. . I will install this system in ac- cordance with 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 2%. I will install a con- crete septic tank of �ppW in size. A manhole (s) permitting easy cleaning will be provided with xemova`tiver (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 160 lineal (=tire) 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 1-1/2 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 1/8" to 1/41, (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 tile line will exceed 100 feet in length and in any case, two lines of tile 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 portion of this installation until approved by the inspection 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 4/11/66 �A^ 9 Z Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE 4/11/66 ignature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE �° 1 Signature o nspecting Offi er Percolation Test 4 min. Soil: Sandy -clay Garbage Grinder No 1. NAME 2. ADDR 3. N0. - ------ 4. GARBAGE GRINDER BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. T 4o YES 'D DATE LOT NO. 13 TEL. DEN YES NO 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 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM � bG 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. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE 4,,,_ NAME OF APPLICANT Too -n Sawve� r LOCATION ,1044 .Tobnsan c, t,rRPt. Address of lot no. BUILDING: Dwelling y Other SYSTEM: New Repair, GENERAL DESCRIPTION OF LAND'4jV,;, SUBSOIL: Clay Gravel Sand Y Clay x PERCOLATION TEST 4 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 1,000 gallon capacity. LEACH FIELD 160 lineal feet of drain pipe. . bim., �'�l t -.1-i William J. Dr's oll, Enginee Board of Healt