HomeMy WebLinkAboutMiscellaneous - 1806 SALEM STREET 4/30/2018,
~`
MAP # LOT #______________ -_
PARCEL # STREET
CONG-TRUC33ON_APPBOVAL
HAS PLAN REVIEW FEE BEEN PAID? NO
PLAN APPROVAL: DATE APP. BY
DESIGNER: PLAN Df -I [E
CONDITIONS
7,0
WATER SUPPLY:
. WELL PERMIT__
. WELL TESTS:
COMMENTS:
FORM U APPROVAL:
DATE ISSUED
CONDITIONS:
`
TOWN WELL
DRILLER.-...
CHEMICAL UAlE APPHUVED
�
8ACl RlA l DA|E A|`PRUVED
BACTERIA Il DA)E Al-:,PRUVED_____ _
APPROVAL- TU ISSUE NO
Y _
�~
__
-----
FINAL APPROVAL:
ALL PERMITS PAID
WELL CONSTRUCTION APPROVAL Yp-S
SEPTIC SYSTEM CONSTRUCTION APPROVA
OTHER YES
ANY VARIANCE NEEDED YES
FINAL BOARD OF HEALTH APPROVAL: DAlE:
UO
NO
NO
NO
SEPTI �SYZE.LN.519.411,a•Ll QN
yIS THE INSTALLER LICENSED? Y
YES NO
;
' - '• ry '�s ` •S- :y a--$_ ate: _: `� �: ,_. 1 '; r - -,' •'
�
- ,1 ..t,. -'A
1 _ TYPE OF CONSTRUCTION
-
NEW /\•�(/EP�A I+/^
�
:. • y �` y - •. Y - ..
• fir/ .
T NEW CONSTRUCTION CERTIFIED PLOT PLAN REVIEW
YES NO
CONDITIONS OF.. APPROVAL
YES NO
�� (FROM FORM U) _
i ; M.
-
t iii \ • i .{ ):
t
;ISSUANCE OF DWC PERMIT.";,-
YES NO
DWC[ PERMIT • N0.>.. INSTALLER:`'C�sGoo�
HEGIN INSPECTION YES 0: i�0�%` �/ mlz/G
-v`-zb Ib
NEEDE
EXCAVATION, INSPECTION: D:
, ( s �
•t' .. l y. ,� ii 1 IA -t '•5 ri mf � -° 1 - -
•} ../av 1 r x
.. -
' fir- t"4 .+.: Std ... +� v t c, ..
. •L ..
' �',.,
-
•' ^.PASSED e HY
CONSTRUCTION INSPECTION=' NEEDED:
ti
AS BUILT PLAN SATISFACTORY: < YESs
APPROVAL TO BACKFILL. DATE. rale l BY
hJ
' 1 t '. ' .. ., :., •'•'• fi. is _ ' -
./
F;NA L.GRADING APPROVAL:' DATE BY
•G/•—''.,.
FINAL CONSTRUCTION APPROVAL: DATE:
BY
BUTTERWORTH & O'TOOLE, INC.
P.O. BOX 8294
SALEM, MA 01971-8294
ADJUSTERS/APPRAISERS
FOR INSURANCE COMPANIES ONLY
TELEPHONE (978) 741-5731
November 17, 2000
FAX (978)740-9109
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
TO: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
City/Town Hall
ADDRESSES
N. Andover, MA 01845
RE: Insured: Robert Bonenfant
Address: 1806 Salem Street
North Andover, MA 01845
Policy No.: H09508289
Loss of: 11/17/00
File or Claim No.: 08-1718
City/Town Hall
N. Andover, MA 01845
Claim has been made involving loss, damage or destruction of the
above captioned property, which may either exceed $1,000.00 or cause
Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice
under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it
to the attention of the writer and include a reference to the captioned
insured, location, policy number, date of loss and claim or file number.
If no reply is received from your office within ten days, we will
assume you have no liens of any type against this property and we will
recommend to the insuring company that this claim is paid.
Edward Welch
Adjuster
21
DATE �12-1--
Sheet of
BOARD OF HEALTH
TOWN OF NORTH ANDOVER
` SUBSURFACE DISPOSAL DESIGN REVIEW
FEE_ L� PERMIT #DATE DATE RECEIVED_
APPLICANT ASSESSOR'S MAP
ADDRESS
ENGINEER 4' K*O )
ADDRESS
PLAN DATE
CONDITIONS OF APPROVAL:�� n.
APPROVED C�
DISAPPROVED
PARCEL #
LOT #
STREET
REVISION DATE
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: A'A" 4 a-zw 6c1� .�ui<�L�,� � Phone 689 -20"
LOCATION: Assessor's Map Number /066 oly Parcel
Subdivision
/ // Lot (s)
Street S do -yl ST St. Number 1966
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Conservation Administrator
Comments
Planner
Comments
;/IV7iL/L,,
Health Agent
Comments
Date Approved
Date Rejected
Date Approved-�Z-
Datte Rejected
Date Approved
Date Rejected
Public Works - sewer/water connection$ r?Lu_12_S kV� ke&A reJMS19Z,-)
- driveway permit
Fire Department
VJP/12
Received by Building Inspector Date
-
•
a
• N
CAi
n42d
'% +i
e jA
A
i 7
FOQ
t4« ?All
CD
o a a
N
rn
a
y
co
y
-h ci
0o S. Z
O
o
F
a c m
V p
m
O
o
°, c
ZC)
Do
_
Z
CASU
Lo)
� �
M
D
i 0
D '
O
a
m 0
o
2A
p D
m
cnr'..
r3
t
N
OQ ryn 0
a
a Z WIA
c` "p
m
tj ;`
c`_
3
No
CD
-
•
a
PITS
MIN 660 LEACHING GW MIN 4' BELOW BOTTOM MANHOLE/PIT
EXCAV 2x EFF W OR D 12"-48" STONE SURROUNDING
BOT + SIDE x LOAD = TOTAL
(L x W x #) (2 x (L+W) x D x #)
CHAMBERS
COVER >3 FT - VENT
FIELDS
MIN 900 ft2 LEACHING C,--' PERC RATE FASTER THAN 20M/IN L--' GW MIN
4' BELOW BOTTOM OF FIELD i/ PIPE ENDS JOINED W/NON-PERF. PIPE?
/�1-der �Z'�OK
4" PEA STONE? �.0b(f DIST LINE SLOPE .005? >3' COVER - VENT
SCH 40 t-- MIN 12" COVER f/ L x W = T x LDNG > DESIGN FLOW? �02�o d T qOd
DOSING TANKS AND PUMPS
DIMENSIONS X X = PUMP CAPACITY gpm
L W W Vol.
DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME
gpm
MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1' below
inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL
OP. SWITCH
161146h�
a/ - - A6e
r
4•
0
vee
Vit- X3,5
N�
Qh
-5�6. L- c, n.it
150,00'
1 t4V D1DE OUT
F E 1 a-� o �► 5 ui L -T
-O'TA1.1tL 1Dto�
lti•/ PIPEQUTOFTn�!1�__—tn(D t ► _ �'J Vey- S U �L�' E D 5 POJ+A1�--
INV PIPE
I NV, r Dr v PlO a 5 d t
4�i r_.fe� 0;:: -PI PIS I OS 17 IN �' •
,�
SGa.LE I" _ 40 1-71I"
�Lf15%7S FRA1�11C GC7E�-��AS ASSUGto"( ES
E t� Cwt NSE f25 �. ARS-rr-t tTE•GT' S
4
i
I
PLAN REVIEW CHECKLIST
ADDRESS /�j��j},QQ ENGINEER. 'p,
GENERAL
3 COPIES L/ STAMP LOCUS t/ SCALE 1/ CONTOURS
PROFILE 1/ SECTION BENCHMARK (/ ELEVATIONS SOIL
& PERC INFO WETS. DISCLAIMER c/ WELLS & WETLANDS
WATERSHED?,,LL DRIVEWAY WATER LINE DRAINS
SCH40 ✓ SLOPE
SEPTIC TANK
MIN 1500G. .17 INVERT DROP GARB. GRINDER(+200% EDF)
25' TO CELLAR MANHOLE TO GRADE ELEV GW
D -BOX
SIZE
INLET
LEACHING
- OUTLET
# LINES FIRST 2' LEVEL STATEMENT
(2" OR .17 FT)
RESERVE AREA 4' FROM PRIMARY? 100' TO WETLANDS 2% SLOPE
100' TO WELLS 325' TO SURFACE H2O SUPP 35' TO FND & INTRCPTR
DRAINS 4' TO S.H.GW 4' PERM. SOIL BELOW FACILITY MIN
12" COVER FILL? (25' if above natural elevation; 101if below)
TRENCHES
MIN 660 gpd SLOPE (min .005 or 6"/1001) >3' COVER? - VENT
SIDEWALL DIST. 2X EFF. W OR D (MIN 61) IS RESERVE BETWEEN
TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE?
BOT X LDNG + SIDE X LDNG = TOT
(L x W x #) (G/ft2) (DxLx2x#)
FRI
S!G.NED
ia:.:PT.D JCO.
23-175- -400 SETS 'M. 13-37C-- 200 SETS
oHT,s A.;:)�V R EO :U1 UF iiEAzT x Lo T /= S4,4so"
PPROVE11,DtkTE PROVIDED DISAPPROVED -DATE TINE REASON
Title 5
Reg. 2.5 Fail OK T submitted plan must show as a minumum:
the lot to be served (area, dimensions, lot //,abutters)
(Planning Board -files)
( )- location and log of deep observation holes -distance
to ties
(c location and results of percolation tests -distance
to ties
(d) design calculations & calculations showing required
leaching area
(e location and dimensions sf system _(including reserve
area)
g�existing and proposed contours
ocation of any wet areas within 100' of the sewage
disposal system ot-•disclaimer (check wetlands mapping,
(h) surface and subsurface drains within 100' of sewage
disposal system or- disclaimer
(i) location of any drainage easements within 100' of
sewage disposal system or disclaimer (planning board
• files)_
= known.- sources_ of --water supply within 200' of sewage
- disposal --system= ar- _disclaimer
- -
k--1 any proposed well to serve -the lot (100'
from leaching facility)
(1 location of water lines on property (10' from.leachin
facilities)
Olocation of benchmark
driveways
garbage disposers
no PVC is to be used in construction
f- a profile of the system (elevations of basement, plum
pipe septic tank, distribution box inlets and outle'
distribution.. -field piping and any other elevations)
(r) maximum ground water elevation in area of sewage disp
system
( (s) plan must be prepared by a Professional Engineer or
other professional authorized by law to prepare such
plans
Septic Tanks
Reg. 6 (a) Capacities - 150% of flow, water table, tees, depth
of tees, access, pumping,
� b Cleanout
(c 10'•from cellar wall or inground swimming pool
d 25' from subsurface drains
�g102 I
19:10:4
• Distribution Boxes
(a. Slope greater than 0.08
(b� Sump _
Leaching Pits
Leaching pits arreferred where the installation is
possible
(a Ca lations of leaching area (minimum 500 S.F.)
(b acing
c Surface drainage 2,.
Cgver material
p,aching Fields
12
L JJ JJ
tl:Greater than 20 minutes
/inch
Area', (minimum -900 S.F.)
c Construction of field
d '-201
Surface drainage 2%
{e - 20' from• cellar wall or inground swimming pool
Leaching Trenches
(a Calculations o eaching area (min. 500 S.F.)
(b Spacing (4 min. 6 ft. with reserve between).
(c Dimensio
(d -Cons rue -tion. _ L.
(e) Stere
(f) Surface .drainage 2%.------
4.,,f4
% _-
Downhill Slope
Slope y/x = to -be shown
b y/x X 150 = o be shown
Pumila
(a) . App val
(b and -by power
C
SOIL PROFILE & PERCOLA,.TION TEST DATA 1
Town/City C - No.&Street �, �� Lot No. V
Loc./S
ubdiv . �-� �.rrr Plan Own �-
Investigator Observer
SOIL PROFILES -DATE
ti
Elev.
1• ?' Elev. 3• Elev. 4Elev.
-- .. .�,. ---
Benchmark
Elevation
1
2
3
4
5
6
7
8
9
10
Location
Datum
Percolation Tests -Date
1
2
3
4
5
6
7
8
9
10
Pit Number 3 1 2 3 4 5
Z.
Start Saturation
Soak -Mins. �►''�`�
Start Test -Time
Drop of 3" -Time
37 -
Drop of "-Time
Mins.lst "Dro
Notes &YSketches on Back Frank C. Gelinas & Associates, North And.
r
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD �
/ - Q
I CM OWNER &-A DDRCSS
OR,, AN-
OF HF AN -
SYSTEM LOC'-�TION -- - --
(rx�mPle:
,F;/z7n-f - 0-,-A Hatsc'
E OF PUMPINC: (QUANTITY PUMPED/5Z-0 r
��I UUL NO YES SEPTICTANK: NO YE
"'ATURC Or SERVICE: ROUTINE X EM ERCENCY
C,'OOD CONDITION x
HFAVY CREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
— -! L'M PUMPED BY
i�I�-IFNTS:
�� 1 !,'N I'J 1'IZANSFCIZIZLD TO:
FULL TO COVE
3AFFLLIS IN
LEACH FI CLD IZ
FLOODED
Oj HER (EXPLAIN)