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Home My WebLink AboutMiscellaneous - 129 WINTER STREET 4/30/2018 (2)N OO 04/06/1997 15:02 5083736611 STEWART/ANDOVER _ PAGE 01 Avz6v r 12,&1+.- »m ,,, st, /4/i itl A noay.i- - �7 !' A 01835 Wmw 1 Lie. 191 -opµ 978-372-7471, "Ma or pM qCW Cr %p S Svc nnan fir. 15od 073 -7 Cori kn !an a l5ao 5-7 /e n" 5f g JA -5 Racle +BraotC ld�p nc u m Sdd 5-7 O -j /10 h tq / �v (vs:� Din ewn 10r ! o Iq L7 %mat Vern ✓1 r 15Q� 1 Len K".,kre o4c ::,, i +er h 74 scan n c APPLICATION FOR SEWER SERVICE CONNECTION C North Andover, Mass.. t/ Application by the undersigned is hereby made to connect with the town sewer main in t/i!;.�/i �'� Street, subject to the rules and regulations of the Division of Public Works. 7, The premises are known as No. C� �� `P� Street or subdivision lot no Owner C Contractor r p yil j FP ✓ ,-%-/ O A—) Address Di R F- `tT ?- cCo :3 3d3 -7,?2 PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at subject to the rules and regulations of the Division of Public Works.. Inspected by Date By See back for rules and regulations Street Division of Public Works If APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. �� k9— Application by the undersigned is hereby made to connect with the town sewer main in v� Street, subject to the rules and regulations of the Division of Public Works. / , The premises are known as No. 14 0 Zd l'l l Street or subdivision lot no. Owner Contractor 49A)SX12✓ Fl (0AJ r Address C)'-<5 Sia 4 ZC��3-3 %moo PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to to make a connection with the sewer main at subject to the rules and regulations of the Division of Public Works.. Inspected by Date By See back for rules and regulations s--721 - I Street Division of Public Works d 191 WATERSHED RESIDENTS QUESTIONNAIRE 1. Name J r.,c�lyaC lbrc_ c1 p'6t l t t, r'e� Mci J irl; — 2. Street Address gat? 3. How many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool E septic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑ do not know ca - 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? Y] yes ❑ no ❑ do not know 6. How old is your sewage disposal system? 2 0-5 years ❑ 6-10 years ❑ 11-20 years'` ❑ over 20 years ❑ do not know 7. Has your sewage disposal system been rebuilt or repaired? ❑ yes )l no ❑ do not know If yes, approximately how long ago? years. What was done? S. How frequently is your sewage disposal system pumped out? NI annually ❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes no - If yes, what problems? ❑ repeated pump -outs needed ❑ system clogs, backs up, or drains slowly ❑ odors ❑ sewage surfaces through ground 10. How many of each appliance are connected to your sewage disposal system? washing machine X dishwasher Y garbage disposal dehumidifier drain sump pump toilet_ roof/pavement drains shower/bathtub �< 11. Please state the brand anti type (liquid or powder) of detergent you use for: dishwasher cosco- clotheswasher 6_ �� G'�t✓r 12. Does your property have a lawn? If yes, approximately what size? ❑ less than 1/4 acre ❑ 1/4 acre ❑ more than 1 acre (Specify) 13. How often do you fertilize your lawn? No. of applications per year n ��— Season(s) of the year ❑ yes )0 no ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre acres 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: ❑ Check here if your lawn is maintained by a professional landscape contractor. 8 undersigned agree to all terms arki conditions. Customer Signature n '� T �tJ s. ; 411 � ` '`a '� Sd , Wd -7 �,�' ��+�i�t..i�'.�.'.#�Sw�+�W.ra,++-�t,d%'"'W�`1�"* 'd AN VE U. f T117a It , "M IMPAY Customer Name - s- T 11'�Tll�&4,VNI "IR a IV I MAWN, A0 ya� ',,4, P.0, ox 4.173 B Station Z�W n over MA 01 8104 Service Location/ 4, f Ito tlt 508) 475 -2593 Phone: Professional Septic & Drain Contact: Locally Owned and Operated Emergency 24 Hr. Svc. — 7 Days Billing Address: City: Zip: Special Instructions Completed Completed ❑complete Reason: Per: AM/PM Services Rendered Pumping Observations Drain Cleaning ptic Tank Sem Good Con ttion ❑ Main Line ❑ Drywell 1:1 Leech Pit / Overflow ❑ Leechfiedunback Riding High Toilet B:I, LL 0 D -Box 13 Pump Chamber (liquid lev Full to C over 0 Balltub ffShower 0 Vanity Z-/ 0Y 0 Grease Trap. Excessive Solids 0 FI C1 Catch Basin TOP Bottom 0 Use No Powd red Soap I red I -0 Yi Mrd • Portable Toilet • Other El Heavy Grease C] Vent El Sewer Jet 6), j PI Z� f -- oty: C3 Roots A El Oth rl" Size: C3 Under 1000 gallons 0 1000 gallon 1500 gallons ,tri 0 Suggest Electni Rootering PV '! g,i)- 0 2000 gallons 0 3000 gallons 00 gallons 11, 0 Van Called 0Other Y 0 5000 gallons 0 other 04111 all Misc. E3 Digging Charge Win. ❑Backhoe hrs. � ❑P-C3,)16id0,4- El Location 0 Service Call El Consultation �,to 0 Estimate son: $b Pump Re E3 Labor 0 Waiting Time 0 Portable Toilet Rental 0 �0 Repair Baffle El Chemical 1 trs Digging Charge Is Per Driver 9 Discretion •0 Other -4 Ail Description of Work Q. CY Recom endati m ri of Payment Nm Parts cu , Pump!i gL ;!! Drain Cleaning 15 DAYS Tax Month -11PNET Yr. M�� Discount '-Tc r 5PS) & Conditions C1 C;hhr Chock Credit Nv��OsK &0 cu Ki. responsible for damage beyond r3� Im. per month will be charged to accounts past T. # 2. plaints shall be reported with S. \ , * zop, `:c, 4. The purchaser agrees to. pay all cost of Coll in 8 4)-. r 1��, ,, 8 undersigned agree to all terms arki conditions. Customer Signature n '� T �tJ s. ; SEPTIC SYSTEM INSPECTION FORM ADDRESS 12 -9 DATE INSPECTED g gCp PROPERLY FUNCTIONING? N WEATHER CONDITIONS COMMENTS:. WATER OUALI T Y TES i Eb ? IMSULT.S? DYE TEST PERFORMED? Y N DATE? SKETCH: Board of Health SEPTIC S15Tai 'North. AndoverzHaae. INSTAMATICK CHECK LIST LOT ` _ _- WED DATE EXCA ---�1� eaaonst AAn ��w<C. YP7 1 4-Z_i 1. Distance Tot a. Wetlands b. Drains C., Well 2. Water Line Location 3. No PVC Pipe 4. Septic Tank a. _Tees -_Length & To Clean Out Covers. b. Cement Pipe to Tank On Both Sides of Tank 5. Distribution Box a. Covers.& Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flow. 6. Leach Field or Trench a. Dimensions b. Stone Depth a- Capped Inds d. Clean Double Washed Stone 7. Leach Pits a. Dimensions b. Stone Depth c. Splash Pads d. Tees e. Cwent Pipe to Pit - Both Sides f. Clean Double Washed Stone S. No Garbage Disposal.. 9. -Final 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 e: Water Table ATI CRi OK RAI L k.. r^ ., .- may,-` _• _ Board of Health - Nark}:. 'Lndover,Kasa' r - ' SUBSITRFACE DISPOSAL DF,SIQd CF7Cg LZST �f/f5'SI�/A , ` .' , - - _•LOT � h/✓%�/Z �! .- APPROVID DATE DISAPPRQVED DATE { deds i` Reasons' Provi 410 r5V Title Q FAIL a The submitted plan must show as a �? �l�+t ns Reg 2.5 dimension of a) the lot to be served-area, dimlot t ,abutters to v b location and log deep obsery location and results percolation teststion �distanceeio tieas d design calculations & calculatioonnssh owing required ve area area tez-e) location and dimensions of sys ✓ ) .existing and proposed contours g) location any wet areas thin � t of sewage disposal system or disclaimer-check wetlands napping (h) surface and subsurface drains within Mot of sewage disposal system or disclaimer (i) location any drainage easements vithin y0pt of sage disposal system or disclaimer-PZ•ann nv Board files � '`` j) know sources of eater supply within 2001 of sewage disposal. a stem or disclaimer ,`"'s •J osed wiell _to serve 1_ ot-10`from leaching fac; ovation-ef -a- proP .. 1 location of mater lines on prop -location from leaching fa.cilit m) location of benchmark. �- -- .dri�e�,-�ys - .. (o-. garbage disposals I '`) no PVC to be used in construction profile of s3stem-elevations of basement, plumb, pipe, septic tau distribution box-inlets-and- outlets, distribution field piping an ' CtLer elevations and mater elevation in: area Be age disposal system (r) maxum gro eer or other (s) plan must be prepared by a Professional .Mngin professional authorized by law to prepare such plans Peg 6 Septic Tanks t % (a) capacities-150%- of flow, s.-ater. tables tees, depth of tees, .. - access, p�-g (b) cleanout Pool - c)- 10' from cellar �l� or ingrotmd- s�3�ng P d) 251 from subsurface drains E Distribution Boxes � Reg 10.2 r . a) s ope greater. than 0.08 r Reg 10.4 ( '- b) �;�