HomeMy WebLinkAboutMiscellaneous - 20 COACHMANS LANE 4/30/2018 (3) �. a
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Title of File
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Action De artment
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Board of Appeals — Board of Heal h Plannan.g Board
onseruatiion Commission — B�i6dingD---- went---�—�—
7Tn,-05--
Please forward us as much of the followl.ng information th t ig possibl
1. Type of system
R. IV,5 Jbi S 7-/Q LIO—IOA/ �C rf/VD
2 .
Age
3. Locat ionj,N y
115' D11 LA ST
4— Maintenance records and date of last pumping out
i
/ 177
5. Documentation of repairs and reconstruction
0PAK&iZ/'MZ,4& to � �G`1��� � � o / 6�
6. Site conditions
7. Builder of system
Do lel 17- /'-/YD W
8. Engineer Who approved%
— Site DD IVT
-- S-ystem D® At(-r 16YQId
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9. Installation Procedure
3.0. Problems
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WATERSHED RESIDENTS QUESTIONNAIRE
HAROLD R. LYNCH
1. Name 115 Dale Street
North Andover, MA 01845
2. Street Address U. S. A.
3. How many members are in your household? �-
4. What type of sewage disposal system do you have?
❑ cesspool
CCseptic 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?
[Kyes ❑ no ❑ do not know.
6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years ❑ 11-20 years
V100,0-ver 20 years ❑ do not know
7. your sewage disposal system been rebuilt or repaired?
7yes ❑ no ❑ do not know
If yes, approximately how long ago? _ 0 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 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 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
clotheswasher / �,�,, P"✓� r ���
12. Does your property have a lawn? [ yes ❑ no
If yes, approximately what size? �/'
El less than 1/4 acre El 1/4 acre L�' 1/2 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 bl -
Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer.you use:
o 'C`
❑ Check here if your lawn is maintained by a professional landscape contractor.
LLL Harold Lynch
V 115 Dale Ot.
,✓JA't
M APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
` HEA TH DEPARVvENT--NORTH A14DOdER, MASS.
I hereby make application for a permit for a sewage disposal installation at
115 Dale St+ ________,. I will install this system in
accordance with all the layoi
s of the Cunonwealth 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 pipes the minimum
diameter being 4 inehest and will maintain a minimum grade of ls' until 10 feet
preceding the septic tank where the grade shall not exceed 216. I will 'install a
concrete septic tank of 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 open
jointed bell and spigot Ackron pipe at least 4 inches in diameter and laid in a
series of trenches, the bottom of which will provide a minimum of * —,
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 1/81t to 1/41'
(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 the line will exceed
100 feet in length and in any case, two lines of the 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 in—
stallation will be less than 100 feet from any private water supplyV 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 thig installation until_,,,pproved by thei_ nspe tc ion
officer, as provided below.. and to Incorporate any additional requirements that
may be attached to the permit. Plot Plans must be submitted with application.
DADTry E well as shown on plan. 4x8)
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Mssachusetts.
DATE
Signature of Health Agent
I have inspected the uncovered system 'indicated above and find everything done
as described.
DATE
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
BOARD OF HEALTH
T0911 OF NORT,i ANDOVER, WS,
r t32�
414
CX
112 '
-
1
DATE .
2. ADDRESS LOT NO l G}
3. N0, OF BEDROO11B DEN YES NO.. .
4. GARBAGE GRIIIDER YES NO.. . . . .
5. SHOW DITENSIONS OF HOUSE
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7, SHOW DIPlI BIONS OF LUT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK. OR CESSPOOL
9, NOTE LOCATION AND DISTANCE OF WELL FROTJ SWERAGE SYSTEM
I
I0. SHOW LOCATION OF BROOKS, STREAhS, DITCHES, LEDGE OUTCROP, THTC.
].l. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROI-4 HOUSE
NOTE: LOCAL REGULATIONS SHOULD TSE READ CAREFULLY.
HaroldL c'h
1I 115 Dale `-'t. \;
V a
APPLICATION FOR SEWAGE DISPOSAL IIwTALLATION
HEAT2H DEPARTIvENT--NORTH ATJDOJER, MASS.
I hereby make application for a permit for a sewage disposal installation at
5 Dale 5t . I will install this system in
accordance with all the laws of the CoLmonwealth of Massachusetts and regulations
of the Board of Health of the Torn 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
preceding the septic tank# where the grade shall not exceed 24. I will install a
concrete septic tank of i 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 open
Jointed bell, and spigot Ackron pipe at least 4 inches in diameter and laid in a
series of trenches, the bottom of which will provide a minimum of —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 3A 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'tto IAII
(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 the 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 dep�h of trench shall not exceed 36 inches. No part of the in-
stallation will be less than 100 feet from any private water supply, 25 feet from
an stream 20 feet from an dwelling or 10 feet from an property line I further
y , y g y P P y er
agree not to cover any portion of this installation until apnroved.bZ 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.
Dry well as shoran on plan,,.
DATE
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts,
DATE
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
AT
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
BOARD OF HEALTH
TOUtiIT OF NORTI1 ANDOVER, MASS.
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i
1. Nfilm . . DATE . . . . . . . . . .
2. ADDRESS . . . . . . LOT 140. TEL. .
3. NO, OF BEDROOM DEN YES N0,. . , .
4. GARBAGE GRINDER YES NO.. . .
5, SHOM DIMENSIONS OF HOUSE
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY L114ES
7, SHOW DIPENSIONS OF LOP
8, SHOW LOCATION AMID SIZE OF SEPTIC TANK OR CESSPOOL
- 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10, SHOW LOCATION OF BROOKS, STREA15, DITCHES, LEDGE OUTCROP, ETC.
11, SHOP DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD EE READ CAREFULLY.