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Home My WebLink AboutMiscellaneous - 27 LISA LANE 4/30/2018'IT 0 21) co OD 0 m 0 p CD FORK U L40T RELEASE FORK 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***************** f Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) ,�-ttreet #2 7 2- /s� u) &j e St. Number 12 icial Use Only************************ RECO77ATI F ENTS: OV ',*?'E Date Approved - Conservation Administrator Date Rejected Comments 6 Pp ( CLLL�� Date Approved town Planner Date Rejected Comments 9 Food InnLspec+-or-Health b---`Sepl�ic I-nspect6r-Health Comments Public Works - sewer/water connections Date Approved Date Rejected Date Approved -57/) zz -5 Date Rejected - / - driveway permit V--fre Department/iL etJ 0, � C 4a�-- �1- A- o e�— rec c, ;4L tyo� 6a7r jOe,,Z�� , r pit r 1'1�5,1'2� kJ—J)A-C- 4_,7-(2 C 6C Received by Building Inspector Date No 894 APPLICATION FOR SEWER SERVICE CONNECTION North Andover 19 ,Mass. Application by the undersigned is hereby made to connect with the town sewer main in e�4,1 Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. 27 I—kl Street or subdivision lot no. Owner Contractor Address Address Applicant's Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to 3, to make a connection with the sewer main at — Z—,,, ---�LTf -e .. Street subject to the rules and regulations of the Division of Public Works. inspected by Date Division of Public Works By See back for rules and regulations ser oez-,Ao porz EAset-Ye�A-)T% T -T- n IR I - 7-0 rV,- ;-174�- IAIS,��OetAIV eo,-.47�r-�o oA,,' 0,=- AJO. AAvCOVE,? 6.AydWAd( 0// 0A 7r K-'lllx'l 1 - MAIL. - .00ff ,47-10,V 774,e6U1 rl - z9oz 14=z- o r R TH A" 0 Hk -S . e,4,hP'A'l 1=02W SUX H/ /Z1v/;12C . cc�-'El-ta F12J /?? / Toyn of North Andover, MA Watershed Septic System servicing Report Date:q -t)7-q V Homeowner: Pumper . ........... .... . . ... UO�-� Address: street LA Phone - �* t - Phone Nature of service: observations: Routine Emergency Good Condition -'17— Full to Cover Baffles in Place Leachfield Runback Excessive Solids Heavy Grease Roots Other (Explain). M b6scription of Work: J. J. Segadellis Inc. Lot # 22, Lisa Lane APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lnt # 22$ Lisa Lane 0 1 will install this system in ac- cordance with all the laws of the Commonwealth 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 pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre- ceding the septic tank, where the grade shall not exceed 2%. 1 will install a con- crete septic tank of _1000 gal, in size. A manhole (s) permitting easy cleaning will be provided with removable er (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 180 -lineal (Xq)u=) 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 1/81, to 1/4" (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 part of the installation will be less than 100 feet from any private water supply, 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 this installation until approved by the i spection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit, Plot Plans must be submitted with application. DATE (r-2 7, V A � 1 /9 I hereby issue the above permit for th Andover, Massachusetts. DATE S "� P 9 7 Sign-"4*ure of Health Agent 7 I have inspected the uncovered system indicated above and find everything done as descr*b d. DATE 4- :: 9 Signature bif Inspecting Offic Percolation Test 3 min, Saill may Garbage Grinder No 3 7' / BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. 4-r'- - - . - I 4.Cl D C3 000 GAL, 60JC. Jr I of 4-7 / zf- 1. NAME— DATE z-, 2. ADDRESS Z/ -s-y LOT NO. -0 2 2- 3. NO. OF BEDROOMS DEN YES NO 4. GARBAGE GRINDER 'YES NO 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM /-'�o )1-f_ 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. /�C>)'j 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. 7- �'p .' : I BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE September 18, 1965 NAME OF APPLICANT J. J. Segadelli, Inc. LOCATION— Lisa Lane, loot #22 Address of lot no. BUILDING: Dwellin x -Other SYSTEM: New x —Repair GENERAL DESCRIPTION OF LAND high SUBSOIL: Clay x Gravel Sand PERCOLATION TEST 3 minutes per inch. MINI MUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 1,000 --gallon capacity. LEACH FIELD 180 lineal feet of drain pipe. 7�illiam . J. D�#scoll, Engineeil- Board of Health SEPTIC SYSTEM INSPECTION FORM ADDRESS 17 '/, -1 L DATE INSPECTED PROPERLY FUNCTIONING? Q N WEATHER CONDITIONS COMMENTS: WArrE:P, allALITY TESTIEb?. 'RESULTS� DYE TEST PERFORMED? Y N DATE? SKETCH: WATE r'SXHED. ESIDENTS QUESTIONNAIRE 1. Nam TJe'1rj/V\(--�r0 2. Street Address L�5n- 3. How many in embers are in your household? 4. What type of sewage disposal system do you have? D cesspool septic tank and leaching area connection to municipal sewer El other (describe) El do not know 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? El yes El no do not know", 6. How old is your sewage dispo S -al system?'E]-- 0-5 years 6-10 years 11-20 years F-1 over 20 years 0 do not know 7. Has your sewage disposal system been rebuilt or repaired? El yes 0 no iK do not know If yes, approximately how long ago? years. What was done? 8. How frequently is your sewage disposal system pumped out? El annually El every 2-4 years El every 5-10 years El over 10 years X never 9. Have you had any problems with your sewage disposal system? yes no If yes, what problems? F1 repeated pump -outs needed El system clogs, backs up, or drains slowly [I odors El sewage surfaces through ground 10. How many of each ap iance are connected to your sewage disposal system? washing machine dishwasher garbage disposal dehumidifier drain sump pump toilet roof/pavement drains showerlbathtub 11. Please state the brand a d e (li *d owder) of detergent you use for: dishwasher qplaf-= clotheswasher 77W FR;6Vv_ 12. Does your property have a lawn? T5( yes El no If yes, approximately what size? D less than 1/4acre D 1/4 acre El %acre 3/4acre El I acre El. more than 1 acre (Specify) - acres 13. How often do you fertilize your lawn? No. of applications per yea Season(s) of the year 4`0 f±'3t, f:�aia, 14. Please state the',brand and type (liquid or granular) of lawn fertilizer you use: yo* El Check here if ur awn is ma�htained by""a professional landscape contractor. A & -9 Town of Nortli Andover. MA Watershed Septic System servicing Report D ate: Rea' t4eA Homeowner: Pumper Street Address:—.10) Phone PI)one Nature of S:�rvice: Observations: Routine D( Emergency Go od Condition Full to Cover Baffles in Place Leachfield Runback .Excessive solids Heavy Grease Roots Other (Explain) Description of Work: ................. Comments: my I f Town of North Andover, MA Watershed Septic -system servicing Report Date: Homeowner:- Pumper Street wn .. nr-CA��Mu Korl, Address:-11�. Phone (ak2%- 23:Z Phone JJA�Z- Nature of Service: observations: Description of Work: I ) Comments: Routine �X- Emergency Good Condition Full to Cover A/ Baffles in Place 7 Leachfield Runback 0 Excessive Solids NO - Heavy Grease fV a Roots Other (Explain) Town of North Aridover,.MA Watershed Septic sysbcm Servicing r.eport Date: Homeowner: Pumper Street Acdress: E Phone Ph.one Nature 0 f &arvice: Routine Emergency Observation!;: Go'od Condition Full to Cover Baffles in Place Leachfield Runback Excessive Solids Heavy Grease Roots Other (Explain) Descriptijo.ki of Work: Comments: Town of North Andover, Watershed Septic SVste Servicing Report Date: Homeowner: Street 1� q (IMI/hIl Phone (, CC3 -.:2 i:h Pumper :� Address: Phone : Nature of Service: Routine Emergency Observations: Good Condition Full to Cover Baffles in Place Leachfield Runback A16 Excessive Solids 11jo Heavy Grease fi/O R oots NO O,ther (Explain) Description of Work: Comments Date: LIAL &O-Cfi —0 Homeowner: Street 15.9 EaLL Phone I ds!b- �� Town of North Andover, Watershed Septic Syste servicing teport Pumper : &4Le Address: jj� Phone : le Nature of Service: Routine X Emergency 3bserva tions: Good Condition Full to Cover V"b Baffles in Place KA-10,� T - Leachfield Runback -N)O Excessive Solids Heavy Grease M3 Roots M3 Other (Explain) Description of Work: )AA0 �omments: Town of North Andover, MA Wate*rshed Septic System servicing I�eport Date: �IAAt-, Homeow Street Phone Nature of Service: Routine Emergency Pi�mper Ac: dr e s s: PI -one Observations: Good Condition Full to Cover in Place. UeX Leachfield Runback Excessive solids Vb Heavy Grease Roots NO Other (Explain) Description of Work: Comments: Town of North Andoyer MA Watershed�Septic"SVstem servicing Repcjrt D a t e Homeowner: Pumper Street Address: Phone Phone Nature of Service: Routine z Emergency c5 observations: Good Condition J�J- Full to Cover Baffles in'Place, L Leachfield Runback 'VO Excessive Solids MCI Heavy Grease Mo -Roots Va Other (Explain) Description of Work Comments: % I . Date: Homeowner: Street Phone j Nature of Service: Observations: Description of Work: Comments: Town of North Andover, MA Watershed Septic Svstem servicing ReDort Pumper :_ o�,& pttk) Address: &Q4 -1) - Phone Wn— Routine Emergency Good Condition Full to Cover > Baffles in Place Leachfield Runback Excessive Solids Heavy Grease Roots Other (Explain) t Date F--5/-5/-9qj Complaint CornplaintO F-401 Complaintant I Neiman Addresse 27 Lisa Lane No. Andover, MA 1975-9887 Action Owner of Property I Owner's Address Comer of Lisa Lane & I Johnson Street Cats - nuisance, excessive numbers hanging out on my porch. Concerned about illness, wife is pregnant. Phone# I I 'OL Sent FnI 7'� 3h: Z, -7----�, 1 J- A V "Al -7 Z-'�C, -,:z e—� 4-1-<::I� -�, 1-11-Z -e:5 -70