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Miscellaneous - 1289 SALEM STREET 4/30/2018 (2)
\` I E i � ;. i i E kk i Commonwealth of Massachusetts .�. v W City/Town of North Andover RECEIVE® W° System Pumping Record Form 4 JUL 07 2014 �M vey`OV TOWN OF NORTH ANDOVER DEP has provided this form for use by local Boards of Health. Other for sja'�.AM-eaRLU ��ut.the l information must be substantially the same as that provided here. Before using this form, check with your f local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, use only the tab key to move your Address cursor not ret use the retNorth Andover Ma 01886 urn key. City/TownState Zip Code r� 2. System Owner: G Name rerwn Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gauons 3. Type of system: ❑ Cesspool(s) ®-Septic Tank ❑ Tight Tank El Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. S stem Pu ed By: c, n� -D ame Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 ure of Hauler Date Si a ure of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 rermit # Lot 19 1289 Salem St. George Farr f APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot 19 1289 Salem 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 1000 in size. A manhole (s) permitting easy cleaning will be provided with removable cover (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 200 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 1-1/2 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 1/4" (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 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 a submitted with application. DATE 4-2 1-70 Sigr1th e o Applicant I hereby issue the above permit for the Board of Hof the Town of North Andover, Massachusetts. DATE 4-21-70 Signature of Health Agent I have inspected the uncovered system indicated above and find everything done as describ d. DATE Z © , l Signature f& Inspecting Office Percolation Test 7 Minutes Soil: Clay Garbage Grinder no BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS, C �'>lzA /,7- L'1 �'l�n. 57"� 1. NAME C?Y Y DATE '4/ -/ 7 -70 2. ADDRESS ;, LOT NO.-I 9 TEL.`� � G 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 9. NOTE 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 NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVER , MASSACHUSETTS SEWAGE DISPOSAL DATE 'Z- % Q t_ NAME OF APPLICANT _Q LOCATION Address of lot no. BUILDING: Dwelling Other SYSTEM: New Repair LI GENERAL DESCRIPTION OF LAND SUBSOIL: Clay avel Sand PERCOLATION TEST ` .minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK gallon capacity. LEACH FIELD ' o--I) lineal feet of drain pipe. William J. q4is6oll, Enginbpr Board of Hea h 1 0 RST ,Ij. ,��: , , 'd r• 'Record DEC 0 6 2008 C)EP.has Pt Ylded ;his loan for ao �, local r ,�q 1 n be + �ml{{od co the local Bcarc cl n0ar(n , �&l(� Toa!:^pp,T, • , �.'•,i ... ., � 9�L1'1'r y 3 10"7) P A, Faclllty Infornl�clon - 4' -5)'$:q^lloc4tion: TWO fWdl►44 g141111111AI /= 9 7e- bGiUcn) Cq^o.,n . TelopnOne Nvm01r"'���[Ci�S.. � pumping Ragord - Oe1e Of Pumpinp (� J •rYp9 of eyalem;.. CD Co99poo{(y) o C Tangy f.'� Erfluenl Toa Fllla rq�ant? [' Yv9 a 9 n' PVo anoo? ye »I,. t'':6„l`;Coridl�lori'Q(;9yl, m:,.l.:. . ., • ..d• SY �1;P�'mpod By:", .. ,1LMil,.k�.' y ' '. IT�,1'^v'S;,�1 i �� �L.iZ' Y!l• 7'�• �'' 1; �• (� 1 •�e'llcJo Jcon�� n'��m:;al .. ... •r•.S',;'�,'4 .: %,: or7ko,'1.� '�/•�l.�fd4'd ', �FS�f',1}V�!�,�,1/�•, / . ln.Where' . .; ��; .,:/�,;����•�'�'I,S�n��v� of h+v��y�.+;'u+<;,,.. "6+w1�-MaSJ, oY/da pp Dole 9 p!Yreiar/e rota s/16(orm�,nI.�npin9 ac{ i TOWN OF NORTH ANDOVER'-' '�a��o FA TM SYSTEM PUMPING RECORD MAR2t DATE: SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example: left front of house) f DATE OF PUMPING: _�- 1 �— QUANTITY PUMPED ISDO GALLONS CESSPOOL: NO �' YES SEPTIC TANK: NO YES _ NATURE OF SERVICE;: ROUTINE EMERGENCY i J I OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTSLEACHFIELD RUNBACK EXCESSIVE SOLIDS � FLOODED .SOLIDS CARRYOVER OTHER (EXPLAIN) _ ,� k SYSTEM PUMPED BY: �'�e('� OVA✓� i COMMENTS: ��,•, ��--� CONTENTS TRANSFEI:2RED TO: �a ................. . TOWN OF NORTH ANDOV U rt SYSTEM PUMPINQ RBC SYST ' OWNERdtADDRESS SYSTEM ATION i?f9 CSS . DATE OF P UMP'fN(3:_.1��9 tS�lL' Q YES.. _ .... 50c Tank:: NU ES NA PURE OF SERVICE: Rou'fIN!~ EMRRU!~NC'1` 08SERVATIONS: 000D CONDITIONULI. 'i'U COVER DEC 0 7 2004 HEAVY OR ASE BAPFI.,ES IN PLACC. ROp'T3 _. LHACHPII:I D RUN `�CU'N OF NORTH ANDC RUNBACK 4TH DEPART.^�-_N . SX(•E38IVE SOLIDS_ HE . FLOODED SOLID CARRYOVER,__.OTFfER EXPLAIN Jy.tem Pwnpcd by C5 7 �'UMMLNTS. ,,:UN rtr rs fKANSF'ERR.EP 1*0