HomeMy WebLinkAboutMiscellaneous - 15 WOODCREST DRIVE 4/30/2018 (2)Town of North Andover, MA
Watershed Septic System
Servicing Report
Date: J�
I M
Homeowner:
Street lS
Phone
Nature of Service:
Observations:
Routine
Emergency
Pumper
Address•
Phone
Good Condition-
Full to Cover
Baffles in Place
Leachfield Runback
Excessive Solids
-Heavy Grease
Roots
Other (Explain)
Lot 42 Woodcrest Drive
Perf ;� #32l� Ben Osgood
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
Lot 42 Woodcrest Drive . 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 ofl000 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 210 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 be submitted with application.
DATE 11-22-68
ignature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE 11-2268
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE 3 6
Signature of I sYe
cting Officer
Percolation Test 8 Min Soil: Clay
Garbage Grinder
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
ab
1. NAMES y
DA
dO
2. ADDRESS W6 ®p, G p- e S p- t U LOT NO. i_ TEL. � /
3. NO. OF BEDROOMS y 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.
4
BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS
NAME OF APPLICANT
LOCATION
SEWAGE DISPOSAL
DATE %Y
dress" of lot no,
BUILDING: Dwelling _Other
SYSTEM: New /1 Repair
GENERAL DESCRIPTION OF LAND l�
SUBSOIL: Clay__ Gravel Sand
PERCOLATION TEST 4 minutes per inch.
MINIMUM INSTALLATION RECOMMENDATIONS
CONCRETE SEPTIC TANK/000 gallon capacity.
LEACH FIELD o lineal feet of drain pipe,
1
illiam J, D scoll, Engine
Board of Heallh
dr
v
Julius Kay, M.D., Chrurm,m
R. George Caron
Edward J. Scanlon
BOARD OF HEALTH
NORTH ANDOVER
MASSACHUSETTS
01845
MIT— LAINT REPCET
coeur
APRIL711 sS
C H "I
VIF •
" It
TEL. 682-6400
Da t May 11, 1973
69 Old Village Lane, North Andover 683-9291
Surface water with probable sewerage contamination
is leaching
through the banking along the side of the roadway
After research of permit records I find that the sy.sIjeT_is located
75 feet from area shown on the .�ermit. A water test should be taken
-to determine- -if, water- -flow contains sewerage___
'tot 4A-Meadowview & Woodcrest')ccU*P"�'_r.-"
ddre s 7,
6 ' � L,- Y 't,b'7.S_c.i
SEPTIC SYSTEM INSPECTION FORM
ADDRESS
DATE INSPECTED ?"
PROPERLY FUNCTIONING? Y --N- `-'
WEATHER CONDITIONS
COMMENTS:
Lo AV
I— j 0.
(O-vq,-Z)
CG�(y C T L
wt. --k— Q -r2. G-
ootc� oll'�ctk Qom rx3
W'AiER a?,ALi i y T -ES 1 E'er ? Re!&OLTS? tc� Zumcm,;�v—
DYE TEST. PERFORMED? Y N
DATE?
SKETCH:
decd
�N5c
2
�, • me:rU ers are in your household?
:II• ct± sf2v.age disros4'. s_.•stPrn do you have?
s= '
... :. ;:nd leaching, arca
to municipal sewer
TI 0 NN kT RE
(drawings) for your sewage disposal system on file with the Board of Health?
no G do not know
�l r' i= VOLT r sewage disposal system? ❑ 0-5 years ❑ 6-10 years 11-20 years
GD do not know
J., disposal system been rebuilt or repaired?
no ❑ do not know
r.• : c.:;:mately how long ago.
L i
o i a eq ._ n t f y is your sewage disposal system pumped out? annually
c,.r•-= years ❑ every 5-10 years ❑ over 10 years ❑ never
y 1. ,r any problems with your sewage disposal system? yes El no
ii'-: ier zted pump -outs needed **��
U v sten clogs, backs up, or drains slowly ���Ur 7
_:..
`-� ���•: uge surfaces through ground
of c" -ch appli ce are connected to your •age disposal system?
S dis
S P
r!.; ciIine '✓ dishwasher arba a osal
i.,.;*6if:cr d1ain sump pump toilet
of 3ven-lt'Ili drains shower/bathtub
years. What was done?
Etre the* brand and type (liquid or powder) of detergent you use for:
asl:e- ✓� IJP-
"C"Ill property have a lawn? y�e�_
no
❑ ;/9 acre acre
aT,;,•-oxir•-;ately what size?
ti:..:l V; acre ❑ '/a acre ❑ '/z acre
ore iiian 1 acre (:•specify) acres
,C), '71) y(iu fertilize your lawn?
�. ;.. of;cans per year
:He year
brand and type (liquid or granular) of lawn fertilizer you use:
Cl- , c:: here if your 1t%,% -n is maintained by a professional landscape contractor.
WATERSAIED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ c>sruol
septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are t laps (drawings) for your sewage disposal system on file with the Board of Health?
yes ❑ no ❑ do not know
6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years, 11-20 years
❑ over 20 El do not know
7. Ha our sewage disposal system been rebuilt or repaired?
yes ❑ no ❑ do not know
If yes, approximately how long ago? years. What was done?
j, "
8. How frequently is your sewage disposal system pumped out? annually
❑ every 2-4 years ❑ every 5-10.yearsA ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system?yes ❑ no
If yes, wha oblems?
repeated pump -outs needed �j�
�❑�se
m clogs, backs up, or drains slowly %/�r r
sQ/ ' sage surfaces through ground �L`����"
10. How many of each applice are connected to your age disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub -
11. Please state the brand and t pv (liquid or powder) of detergent you use for:
dishwasher CAS
clotheswasher CN l K
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
O No. of applications per year
Season(s) of the year
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.
any members hers are in vour household?
ty;d of sewage disposal system, do you have?
I
Cc tank and leaching area
nncctiori to municipal sewer
Aef Ir (describe)
no! KTI0*V
l U -C,'STI 0 IN, SAIRE
.tans (drawings) for your sewage disposal system on file with the Board of Health?
.G ❑ no ❑ do not know
0 d ; s your sewage disposal system? ❑ 0-5 years ❑ 6-10 years e 11-20 years
er %yrs ❑ do not know
zr sev age disposal system been rebuilt or repaired?
❑ no ❑ do not know
-ow xizr�ately how long ago.�u
years. What was done?
O
01 rrequently is your sewage disposal system pumped out? /annually
J f 4-ery 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never .
a4C you had any problems with your sewage disposal system? yes ❑ no
yes, what.�ffroblems?
[LXrepeated pump -outs needed **��
❑ sN stem clogs, backs up, or drains slowly
[ev►-age surfaces through ground wagw
ov, of each appli �_ceare connected to yourage,disposal system?
a`.sg �-:;.clri �e dishwasher garbage disposal
•h� �Fd;E e. drain sump pump toilet
of,; ave -sent drains showerlbathtub
x st2te the'brand and tyW (liquid or powder) of detergent you use for:
;;�:
t;o=.=r property have a lawn? yes ❑ no
al i -s oxirnately what size?
>s t«: -E -/4 acre ❑ '/4 acre ❑ '/s acre ❑ 3/4 acre acre
ore than 1 acre (Specify) acres
e, c n x7ou fertilize your laivn?�
,<tiorEs per year
tie year
brand and type (liquid or granular) of lawn fertilizer you use:
Ci = C,: here if your lawn is maintained by a professional landscape contractor.
� /I
any members hers are in vour household?
ty;d of sewage disposal system, do you have?
I
Cc tank and leaching area
nncctiori to municipal sewer
Aef Ir (describe)
no! KTI0*V
l U -C,'STI 0 IN, SAIRE
.tans (drawings) for your sewage disposal system on file with the Board of Health?
.G ❑ no ❑ do not know
0 d ; s your sewage disposal system? ❑ 0-5 years ❑ 6-10 years e 11-20 years
er %yrs ❑ do not know
zr sev age disposal system been rebuilt or repaired?
❑ no ❑ do not know
-ow xizr�ately how long ago.�u
years. What was done?
O
01 rrequently is your sewage disposal system pumped out? /annually
J f 4-ery 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never .
a4C you had any problems with your sewage disposal system? yes ❑ no
yes, what.�ffroblems?
[LXrepeated pump -outs needed **��
❑ sN stem clogs, backs up, or drains slowly
[ev►-age surfaces through ground wagw
ov, of each appli �_ceare connected to yourage,disposal system?
a`.sg �-:;.clri �e dishwasher garbage disposal
•h� �Fd;E e. drain sump pump toilet
of,; ave -sent drains showerlbathtub
x st2te the'brand and tyW (liquid or powder) of detergent you use for:
;;�:
t;o=.=r property have a lawn? yes ❑ no
al i -s oxirnately what size?
>s t«: -E -/4 acre ❑ '/4 acre ❑ '/s acre ❑ 3/4 acre acre
ore than 1 acre (Specify) acres
e, c n x7ou fertilize your laivn?�
,<tiorEs per year
tie year
brand and type (liquid or granular) of lawn fertilizer you use:
Ci = C,: here if your lawn is maintained by a professional landscape contractor.
FORM 4 - SYSTEM PL11PL\G RECORD
Commonwealth of Massachusetts
, Massachusetts
,System Pumping Record
N -stem Ovmer SN,stem Location
l
Date of Pumping: vl -- 3— q5- Quantity Pumped: YC�-'�gallons
Cesspool: No Yes ❑ Septic Tank: No ❑ Yes
BJca-�
System Pumped by: � �
P License #:
Contents transferred to: G , (—. S . D
Date Inspector
BOARD OF HEALTH
146 MJ" AIN STREET
TELEPHONE# (508) 688-9540
APPLICA TION FOR ABA NDOAVENT
OF SUBSURFACE DISPOSAL SYSTEM
(SEPTIC SYSTEM)
Pursuant to Section 310 CMR 15.354
of the State Environmental Code, Title V
Name_ M nrCi S V
Address 15 IAI&o
Phone
rivep
Contractor hired forC'XCA
work:
Name Arc& da �pr'�i Phone
Address
22
Date for scheduled abandonment 5 C �— 21
The septic system at the above address has been ab doned according to
Title V specifications.
Signature of Contractor
Method of septic tank abandonment (check one). () removal () sandfill
(1k) crush ( ) other
Name of Offal Hauler �(i h gat SCI
This form must be returned to the North Andover Board of Health
PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH
REPRESENTATIVE'S USE ONLY.
\j
Inspecting Agent Date