HomeMy WebLinkAboutMiscellaneous - 205 BRENTWOOD CIRCLE 4/30/20187
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BOARD OF HEALTH
120 MAIN STREET
NORTH ANDOVER, MASS. 01845
APPLICATION FOR ABANDONMENT
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 copy ofthesewer connection permit
Name girl ► C:1.�. SS�'� f S 11�1 IG Phone
Address_, �'Grr
Contractor hired for work:
Name �G4 y e 1— yr E k
.2 lc= Phone" J�-
Address
Date for scheduled abandonment y1
Method of septic tank abandonment (check one).
( ) removal ( ) sandfill ( crush ( ) other (describe
below)
Other
Inspecting
Comments
PLEASE DO NOT WRITE IN THE SPACE BELOW
Ti nD U A T TTI Af-V TT 1 C TTC11 nT.TT V
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Date
872
APPLICATION FOR SEWER SERVICE CONNECTION.
0 11
I " . ;.
I
"llNorth Andover,' Mass. 9
Application by :thd undersigned is hereby.-,ma'de to connect,with the town sewer main in�
pp Street,
subject to the rules and regulations!of the Division of Public Works..; 11,
The premises are known as No zo Street
or s6bd!Vi's'iod lot n 0*.,'
'v I I L
Owner Address
Contractor Address
Ilk can(s5ignature,,
1 .3 ILI i,
:-A
J d it
0::A
PERMiT!T0 CONNECT WITH SEWER MAIN
The Division of Public Works hereby grants permission to _J
to make a, c6nne'ctilon'w' ith th6sewier'mai dI at*.,!-. J
subject to the rules and regulations of the Division of Public Works.
Inspected by
Date
OLrt:t:L
I
Division of Public Works
By
See back for rules and regulations
k
RULES AND REGULATIONS FOR GOVERN ING,THE`INSTALLATION .OF SEWER SERVICES
1. No unauthorized person shall uncover, make any connections with or opening into, use, alter, or disturb any public sewer
or appurtenance thereof -without .first obtaining a written permit from the Division of Public Works.
2:, All costs and expense incident to the.!nstallation and.connections of,the building sewer shall, be borne by,the owner., The
owner shall indemnify the (town) from any loss or damage. that may directly pr;;indirectly be occasioned, by the installation
of the building sewer.
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3. A separate and independent building sewer shall be provided for every building; except where one building stands at the
rear of another on an interior lot and no private sewer is available or can be constructed to the rear building through an
adjoining alley, court, yard, or driveway, the building sewer from the front building may be extended to the rear building
and the whole considered as one building sewer.. _
4. Old building sewers may be used in connection with new buildings only when they are found, on examination and test by
the (Superintendent), to meet all requirements of this ordinance.. - -
5. The size, slope, alignment, materials of construction of a building sewer, and the methods to be used in excavating,
-placing of the pipe, jointing, testing, -and backfilling the trench, shall all conform to the following requirements. The sewer
shall be 6" diameter SDR 35, PVC pipe. Minimum slope shall be 1/8" per foot. The minimum depth of sewer shall be four
feet below finish grade. Sewer pipe shall be installed on a stable trench bottom of hard durable crushed stone to a
minimum (6) inch depth below the pipe. After the pipe has been installed, crushed stone shall be brought up to the crown
of the pipe. Care shall be taken to carefully grade and compact the stone, and prevent pipe displacement. The remainder of
the trench shall then be backfilled in one foot lifts with mechanical tamping after each lift.
6. Whenever possible, the building sewer shall be brought to the building at an elevation below the basement floor. In all
buildings in which any building drain is too low to permit gravity flow to the public sewer, sanitary sewage carried by such
building drain shall be lifted by an approved means and discharged to the building sewer.
7. No person shall make connection of roof downspouts, exterior foundation drains, or other sources of surface runoff or
ground water to a building drain which in turn is connected directly or indirectly to a public sanitary sewer.
8. The applicant for the building sewer permit shall notify the (Superintendent) when the building sewer is ready for
inspection and connection to the;pp.�I,i4,sewer:.The connection shall;be,made under the supervision of the (Superinten-
dent) or his representative.
03 nolo; iii *,E_J , i E't , (1it1 ..1 e-!� , %:; Ai�l,;`1 i., i 'H k i, ; !
9. All excavations for building sewer installation shall be adequately guarded with barncades and lights so as to protect the
. public from hazard. Streets, sidewalks,. parkways, and. other public property,disturbed in thg,course of the work shall be
restored in a manner satisfactory to the (town). IV i ,iii
,.,. rJv '.111k11,,11. ii;,',(I
7
Location
No.
Date 4-345
MORTM
O��t�ae
TOWN OF NORTH ANDOVER
y�tio
3.t i., . • pt
i
Certificate of Occupancy
$
« s
Building/Frame Permit Fee
$
�ss�cHUSE<
Foundation Permit Fee
$
I
Other Permit Fee
$
67Z
Sewer Connection Fee
$
Water Connection Fee
$---------'
TOTAL
$
u' Id In ctorl �r
GLfi
N� R 4 Q R Div. u Works