HomeMy WebLinkAboutMiscellaneous - 17 KIERAN ROAD 4/30/2018 11 KIERAN ROAD
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BOARD OF HEALTH
° ' • 120 MAIN STREET TEL. 682-6483
S�ICHUSE""° .S•tt5 NORTH ANDOVER, MASS. 01845 Extl3
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APPLICATION FOR ABANDONMENT
SEP 1 21996 �
OF SUBSURFACE DISPOSAL SYSTEM
(SEPTIC SYSTEM)
PURSUANT TO SECTION 310 CMR 15 . 354
OF THE STATE ENVIRONMENTAL CODE, TITLE V
This form must be submitted to the Board of Health no less than
five (5) days prior to date of abandonment and be accompanied with
a coj�y of the sewer connection permit.
Name Wil / 1 o ,, Cz 1 Phone
Address l 7
Contractor hired for work:
Name
v1 G Phone
Address 21
Date for scheduled abandonment
Method of septic tank abandonment (check one) .
( )
removal sandfill (!_. crush ( ) other (describe
( )
below)
Other
s,
PLEASE DO NOT WRITE IN THE SPACE BELOW
FOR HEALTH AGENT' S USE ONLY
Inspecting Agent Date
Comments
:�
�J � �� ��
��� �� �a�
e
SEPTIC SYSTEM INSPECTION FORM
ADDRESS L �GQM
DATE INSPECTED
PROPERLY FUNCTIONING? N
WEATHER CONDITIONS
COMMENTS:
WATER QUALITY TES I E'ts ? IZESULTs?
DYE TEST PERFORMED? Y N
DATE?
SKETCH:
WATERSHED RESIDENTS QUESTIONNAIRE
/ �r
1. Name L' 1 i L G to to CJ L L—
2. Street Address Z -7 /< 1,e 2 A IV 'R D �lG � a912G VI-Le
3. How many members are in your household? e�
4. What type of sewage disposal system do you have?
❑ cesspool
® septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (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
JR over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes no ❑ do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ 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 J no
If yes, what problems?
❑ repeated pump-outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
10: H6w many of each appliance are connected to your sewage disposal system?
washing machine X dishwasher garbage disposal
dehumidifier drain sump pump toilet _
roof/pavement drains shower/bathtub
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher Cgg e.«n lJOWPE 9
clotheswasher '7-7 DJ • L!Q✓, �I D
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre LJ 1/4\acre ❑ % acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year
Season(s) of the year 5 I'R/�clG
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
131?A /%/0 "�/aR10A(5) �oUIj>G12 r6gAy
❑ Check here if your lawn is maintained by a professional landscape contractor.
I I
NORTH
Town of North Andover f
OFFICE OF ?O�tto e`�Ot
COMMUNITY DEVELOPMENT AND SERVICES A
27 Charles Street :�o
North Andover, Massachusetts 01845 ssgcHus���y
WILLIAM J. SCOTT
Director
(978)688-9531 Fax(978)688-9542
March 24, 2000
Mr. &Mrs. William O'Connell
17 Kieran Road
No. Andover, MA 01845
Re: Sewer Tie-in
Dear Mr. &Mrs. O'Connell:
The Health Department has been supplied with a list of all residences, currently on septic,
which have access to the municipal sewer system. As previously published at a Public
Hearing on March 17, 1994, the Board of Health has adopted regulations concerning the
required sewer tie-in. The following timetable concerning your property status was
adopted:
4.1 All establishments that currently do not have municipal sewer available
to them must connect to the sewer as soon as it becomes available, with a
maximum time limit of six months.
The purpose of these regulations is to safeguard North Andover's drinking water, surface
waters, groundwater and surrounding environment. Sanitary sewer is believed to be the
most effective form of wastewater treatment. A copy of the entire regulation can be
obtained at our office.
Your property is in violation of this Board of Health regulation. Please contact the Health
Department regarding this matter immediately. If we do not hear from you by May 10,
2000 your name will be placed on the regularly scheduled Board of Health meeting agenda
and placed on public notice. The meeting will be held on May 25, 2000 for discussion of
legal action including court hearings.
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Sewer Tie-In 17 Kieran Road Page 2
i
i
Any questions concerning this regulation should be directed to the Board of Health at
(978) 688-9540. Additional inquiries regarding the physical tie-in and permitting process
should be directed to the Department of Public Works at (978) 685-0950. Please be
advised this Board intends to persevere in this regulation.
Yours truly,
Ga�;�I*Osgood, Chamijlan
21
Francis P. MacMillan, M.D., Member
deKS. Rizza, D.M.D., e er
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