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HomeMy WebLinkAboutMiscellaneous - 144 SULLIVAN STREET 4/30/2018 (2) 144 SULLIVAN STREET 't 210/107.13-0034-0000.0 Commonwealth of Massachusetts _ City/Town of . System Pumping-Record Form 4 DEP has provided this form for use-by local Boards of Health. Other forms may be'used, but the information must be substantially the same as that provided here. Before using.this form,check with your 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. A. Facility Information 1. System Location: Left/Right front of house, Left/Right rear of house, Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/Right rear of building, Under deck Address r Uy V S'{— 4� +tf, A—A� Cityrrown State A1Zip Code C 2. System Owner. � Name `" CAI- Address(if different from location) Citylrown State Zip Code Telephone Number o s i B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Ganons 3. Type-of s stem: ` y_ ❑ Cesspool(s) eptic Tank El Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes LSO If yes,was it cleaned? ❑ Yes ❑ No, 5. Condition Vk 6: System Pumped By: Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc- Company 7. owlae contents were disposed: S. Lowell Waste Water Sign aqtl-laullwU Date t5fomt4.doc•06/03 System Pumping Record•Page 1 of 1 ■\ Commonwealth of Massachusetts RECEIVED City/Town of AUG 0 6 20i lug System Pumping Record 2Form 4TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form'for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your 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. A. Facility Information 1. System Location: Left/Right front of house, Left/f kp gar of , Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/Right rear of building, Under deck Address C D-) Cityrrown State Zip Code 2. System Owner. Name Address(if different from location) City/Town State�� � Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) 2t Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes D No If yes,was it cleaned? ❑ Yes ❑ No 5. Conditiorl ofY S stem: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locatiere contents were disposed: G . Lowell Waste Water Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 a RT IVE $ Y ti ,p OVER M ACH' SE I, ��, !,.4i, �'! I', r„: G 6 2009 D�ovlded lhl,Ylorrn for pro , TOWN OF NORTH ANDOVER 00 =gin plod to lhr Iptll 8^rrc: tr a^o� 8oel , oHEALrtiDEPA TV�N pr Lino/ T•,, ; A, Faculty Infor(7)-a(lon ' S)'s am loceUon; -tea . ,•a " ': �drr.++ (114Uf,l,,nl,%p'n buVcn) "�����•C�` B,:Pumpflg Rl�a�ord ' . . . I..`.� I'll;•�: ,.�,1,',,,�!':.rT4r'"'' / 0949 01 P zo . . 3. .type 91 +yilem,.�. �1 • -i . 0 1Pool(,) $a01!c Tan, , r •� x',119/ �d '�•.,,.. ,; ' ebC(ib9,; hkVenl Too rFllle( cfesonr? [' Yo7 n'o II e� I r' ,Ti1. 8 7 i, Cr n 1 ;; ;�.,•• , .,.,ll�r,,'�jy�,�y,,,,� .•,', ea eve _ Yes S _ .��,1:,','�'�I,�'�i^��,'�'DyIIY 11{i.f�Y,i,',j;i';(�•;' •; �41I �i' �r� Y7h1u+ 'Jun1, — • .5:'?;'�, ••,•�,,,r�Y,li1 4��1,�l•"ti'�,y;e I' �r�'1�;1�?',.f ��;' . / . .'�.•.:, ,,�„ e�s,�oAlenU;were dlspos9v: rr.maga.porldep%weleilepp�OYeJsllblorm�,r'.�naln9�bcl �,�� ORTH;ANt •OVER MASSACHUSETTS '` SYSte, �Pumping Record m FcOm;4 �n�inf$.c x ,��V .►h 4�Y�'1}n ttJ S r Y�,\f1{'L fs ra,�f d ... DER has provided this form for use by local Boards of Health. The S stem Pumping Record m st be submitted to the local'Board of Health or other approving authori JUN - 4 2007 A. Facili Information ��. TOWN G tmRortant» HEAL NDOVER out 1 . : System Location :: ... _.._..__ `,1ENT forms on the'; ,•computer,use , only the tab key Address ` to move your: • :cursor•do not use the rotum C1ty/Town State Zip Coda ,� . key ., 2 System Owner, r Name. Address(Ir different tram location) CltylTown State Z-(�Code Telephone Number >: Pumping Record '., x 4 •1 �ltx4, t' �.'J� r'a� J�1SY.Li 14 }�-7� ::• r•� S- Date of Pumpina oats 2. Quantity Pumped: f©`� p Gallons TyP.q of system: ❑ Cesspool(s) Tank ❑ Tight Tank 0'0ther t;descrlbe): 4 Effluent Tea Filter present?.❑ Yes. if yes, was if cleaned? ❑ Yes a-, l i kl T' 5 Co►iditlon of:8yst ' � 1 6 Sy Pumped - .. ... . T J 1 • c .{ x j nr { Name•\��•„, ,�i'S si°.✓i 'f;• , Vehicle Ucen/*�e Number �.5 -+*` n4`3rr'hrr��','"f\J(' "('�',`.."���.�I�������' �iifc`ii (.CiC�•C� .�.�/ �r/]� // y'rxid'+•f.1 +�rti ,ayl. '�)i�11 y i t , 1 yr ' • w` - . rYr��Jl�.l�.f w Locaflon'wtiere contents yuere dloposed: t �y�//��� 1►////� /w/I r ' a r f 1 a.!, rf ;h 1't !�+'.•: 1 ':�r7 �'1 i i, � ' Date httpJ/www.mass.gov/dipJ ater/approvals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record-Page 1 of I uA I'k SYS'T-ENI PUMP 1NU KRc.,oK,.. Rc-c�'�ED 05 RE55 7s ' P _ 20 STEM t•" SOWN OF NQ XPi" i J N� TND EP RAMENTER �. 1��/� ATS OF _...___. � ....m... SPOOL NO- y1:� NA f VKb GN seRVIc_e: UeadA vR l"lUt�tJ. OOOD �. A V 0"A" OXCUSIY6 SOLID LEir1CKT�IGL C� RUN�,��;f. SOL FD CA KA YO YEA LO D EXPLAIN �'VMM1~NT�. I� I tf+tt rt 44- - - a- JL �- F 1 ` f 1 �- 1 4--t - r i I 1 t fir • , G, +'I _ � 1 e I �R �f I S T ;. 1 �' .y 4 •0: C t otC. R a 9 r Hoyt, Walter Sullivan Ave. ,w APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Sullivan Ave. . 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 gal, 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 180 lineal (KXXM) 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 be submitted with application. DATE G t Signature of App4f6ant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE Ugnature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE V714 t4zl Signature o nspecting Officer Percolation Test _ min_ SniI : sandy Garbage- Grinder No. BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. C)0 7 tliAju Lfn)ES A (0 0 GO v. ---- 7 o s adv O� 1. NAME G DATE _ d2&"--- 6 G 2. ADDRESS— , LOT NO. TEL. JZLd 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 q. 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 M-rch 28, 1966 NAME OF APPLICANT Walter Hoyt LOCATION Sullivan Avenue Address of lot no. BUILDING: Dwelling X Other SYSTEM: New X Repair GENERAL DESCRIPTION OF LAND Hih SUBSOIL: Clay Gravel_ Sand y X PERCOLATION TEST 3 minutes per inch.. - - - - - - - - - - - - - - - - - MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 1,000 gallon capacity. LEACH FIELD 180lineal feet of drain pipe. William J. D iscoll , En neer Board of He th i Rossi, Andrew J. Sullivan Ste APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at h%i livan 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 2qo. I will install a con- crete septic tank of 1000 galf 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 180 lineal (1LiSMfeet 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 be submitted with application. DATE�/� i} r / 0 i Signature of Ap licant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE Sigrkhture of Health Agent .I have inspected the uncovered system indicated above and find everything done as descrQibed. / DATE f (� Signature oVJnspecting Officer Percolation Test mine SAT3C:t� Garbage Grinder November 2, 1963 Miss Mary Sheridan R. N. Health Agent Board of Health North Andover, Mass. Dear Miss Sheridan: An examination was made as requested in order to determine the suitability of the soil for the subsurface disposal of sewage on the proposed Sullivan Street building site of Andrew Rossi, Jr. The land in general is high. The subsoil in the area was of a clay content and a 5-minute percolation test was conducted. It is recommended that a 1,000 gallon concrete septic tank be installed together with. 180 lineal ' feet of drain pipe . Very tru ly ,yours, yl`il1iam Driscoll WJ1):hd .r- BOARD OF HEALTH Q TOWN OF NORTH ANDOVER, MASS. 4Sl '�' 4S� to M�+�• 4-v 4V g'^ -40 o'--,7 — iK-- C4 _a "o r" .2 .2 0 ' 1. NAME Tndrew DATE i 3 U 2. ADDRESS 50//4*t do S LOT NO. i3 TEL.6 Z- !Y 3. NO. OF BEDROOMS 3 DEN YES NO t/ 4. GARBAGE GRINDER YES v 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 g. 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. i a �� avOJ ;Ylj1 t 0124 .'v �, _ — .. ! •a I11 ;I A T;b1rN 0.F NORTN 'ANpO r „1 PUMA �i> I Em uwr� R &'huo�icss SYST cM L�o�� T,o;, U rI C ,QFiP,�) MYyy�yy��}(� r (QUANTITY Pi�Jl�^f oll, �\�TUKEI;OFSERYICE R(D INE. '' EM ERCE�C'r r t _r_T___._ ���FU.I,L70 CUY( CX'C.ESSLYS $,QvIQS Fl 0;0DED' --- ,� SSQ�IU�'rrQAYY�RII�YO;Y$R:,�,, , ,p`HhR (i:xF�.� :�; • f51 1,..1 ,f 1trr:,l��� rnk�4 ,�' )1N,I.)�(�I I kt)�) }, , �7 `� V/t "I/ —_._ C h o y'', , 1 I. I f