Loading...
HomeMy WebLinkAboutMiscellaneous - 230 JOHNSON STREET 4/30/2018 230 JOHNSON STREET t 290/0.97-0-D008-DWaO - P i • 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 or requirements. *****************************APPLICA-NT ftLLS OUT THIS SECTION*********************** APPLICANT �'4�'Z �T�i'U�s`T PHONE LOCATION: Assessor's Map Number PARCEL ' jz-+ SUBDIVISION LOT (S)'L -f i-L,}u ., T+e t. __� .1 f � t cfl S�.�e � it�l a•.a STREET --J 0 Jif N ST. NUMBER!:M(� **** *** ****** *************** *OFFICIAL USE ONLY *******, *** ***, , ** *** /A/SiD / RE"CNDATIONS OF TOWN AGENTS: COIItSS RV TION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOODINSPEC R-HEALTH DATE APPROVED DATE REJECTED I INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS 1 PUBLIC WORKS - SEWER/WATER CONNECTIONS U �T`T 3 —Z 2 DRIVEWAY PERMIT Gv / `i 1 iJ 22 FIRE DEPARTMENT RECEIVED BY BUIL-D4NG INSPECTOR DATE Revised 9197 jm Location No. Date % AM 7252 MORTM TOWN OF NORTH ANDOVER .•.. .. j_117/113 0� ,tip PAY °� • •. 0 0 Certificate of Occupancy n -2 Building/Frame Permit Fee $ DOLLARS To }bis,,r.o.'��� Foundation Permit Fee $ ORDER OF �V, SAC11U56 Other Permit Fee $ `j i �- 9L i'� Sewer Connection Fee $ J� Water Connection Fee $ ) \l 11600 7 2 5 2o TOTAL $ I NP f t: j `� Building�lnsp�tor , Div. Pubh6 Works I I 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 or requirements. *****************************APPLICA-NT-FILLS OUT THIS SECTION"" *****"** APPLICANT S'el f PHONE 6 LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET c) ST. NUMBER **** *** ****** ******************OFFICIAL USE RECOMMENDATIONS OF TOWN AGENTS: +a �t��� - ��, ;�► T t ti + jNSi D£ CON E (/ATION ADMI ISTRATOR DATE APPROVED DATE REJECTED COMMENTS ����i IyV ! , ` rl -IL1 TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD IN 1`-C OR-HEALTH DATE APPROVED �,/_�--'""�- DATE REJECTED S PTIC SPECTOR-REACT DATE APPROVED L DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS )L DRIVEWAY DRIVEWAY PERMIT i�li/ �� Ch I -3i A)C:, FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm PATRICK J. DONOVAN ASSOCIATES, INC. claim and Foss Adjastments P. O. BOX 110 26 WAKEFIELD, MA 01880 (617) 245-5540 — FAX (617) 245-7016 Septemver 17, 1997 Building Commissioner City or Town Hall North Andover, MA 01845 Insured : John C. & Sue Ellen Draper Property Address : 230 Johnson Street North Andover, MA 01845 Insurer : Preferred Mutual Policy Number : PHOO100572522 Type of Loss : Storm Damage Date of Loss : 12/07/96 Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 313 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 file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. qj'L4 Vern Laws AASSOCIATION OF INDEPENDENT INSURANCE ADJUSTERS ASSOW10" of Massachusetts j• __ Mrs. John Bowen Jr. 230 Johnson St. APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPAMI.IENT--NORTH A1TMOVER, MASS. I hereapplication by make applation for a permit for a sewage disposal installation at L& 230 Johnson St. . I will install this system in accordance with all the lays of the Commonwealth 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 pipes 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 2%. I will install a concrete septic tank of 50 gals, in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 3.2 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 . ),n lineal 7(A4 ;ifeet 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 lAt' (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 pant of the in- stallation will be less than 100 feet from any private water supply, 25 feet from any stream., 20 feet from any dwelling or 16 feet from any property line. Ifurthe_r agree not to cover any_ nortion of this installation until annroved 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. Trenches 2 ft. wide. DATE NIM `�, Signat s f Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover., Massachusetts, DATE 0 Sig tore of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE l l/ t e/S'Z ,�/��y�J�o-v-.,� 1 �i?.t,,�� l• f r•' '• r-"...� Signature of Inspecting Officer Percolation Test Garbage Grander A Cc a r tl 1-11 C- (Ai BO TiiMASS. i i. 4 1 NA12 Me C�5 Jai-acy Cao�u(Tc-�,. �� . . . . . DATE . P CA 00 U 2 ADDRESS 3 U Q 1,C�Sr U Cy S T LOT NO TEL* 3. NO. OF MROONIS . . .(5 . DEN YES NO.. . 4. GARBAGE GRINDER YES e. . Nose ' # . . �j. SHal DI%9ENSIOAIS OF HOUSE 6, SHOD DISTANCES OF HOUSE TO ALL PROPERTY LINES 7, SHOW D33 ENSIONS 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 BROOKS2 STREAP�Zq DITCHES, LEDGE OUTCROP, ETC. 11, SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS 57LREADEFU • .,o &3�4? �—lj August 20,1956 Miss Mary Sheridan R.N. Health Agent Board of Health North Andover, Massachusetts Dear Miss Sheridan: An examination has been made relative to the suitability of the soil for the sub-surface dis- posal of seivage on the premises of Mrs. Bowen on Johnson Street. An eight minute percolation test was con- ducted in soil consisting of clay. CD It is recommended that a 2250 gallon tan'_ be installed together with 540 lineal feet of pipe laid in a two foot trench. Very trul�yo yJurs, Ernest F. Romano I j SEPTIC SYSTEM INSPECTION FORM ADDRESS r DATE INSPECTED g 'S(� PROPERLY FUNCTIONING? N WEATHER CONDITIONS COMMENTS : a WA i ER QUALITY 'TES 1 n o Z SO TS? DYE TEST PERFORMED? Y N DATE? SKETCH: WATERSHED RESIDENTS QUESTIONNAIRE 1. Name ,f ' v 2. Street Address 3. How many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool 159- 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 T� do not know- 6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years ❑ 11-20 years ❑ over 20 years f4- 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 ` X, every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes C�K 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 1 dishwasher j garbage disposal dehumidifier drain sump pump toilet roof/pavement drains shower/bathtub 11. Please state the brand,anca (liquid or powder) of detergent you use for: dishwasher s Cif clotheswasher LL 12. Does your property have a lawn? yes ❑ no If yes, approximately what size? ❑ less than 1/4 acre ❑ 1/4 acre ❑ % acre ❑ 3/4 acre 1 acre ❑ more than 1 acre (Specify) acres 13. How often do you fertilize your lawn�7 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.