HomeMy WebLinkAboutMiscellaneous - 303 Johnson Street (2) 419 JOHNSON STREET t
-2101.098-A--0005--0000.0
John Willis
Lot B, Johanson St.
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPA RTW NT - NORTH ANDOVER, MSS.
I hereby make application for a permit for a sewage disposal installation at
Lot B, Johnson St. I 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%. I will install a con-
crete septic tank of 750 gal• 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 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 (24XbQ 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 1/8" 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
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 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
inspection officer, as provided below, and to incorporate any additional requirements
that may b attached to the permit. Plot Plans must be submitted with application.
AL 17 1961
DATE
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE JUL 17 1961
Si ature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DA TE _ 'Z s
w
Signature of Ins ka ting Officer
Percolation Test 4 min. Soil: Sandy-clay
Garbage Grinder No
June 24, 1961
Miss Mary Sheridan R. N.
Health Agent
Board of Health
North Andover, Mass.
Dear Miss Sheridan:
An examination was made as requested in order to determine the
suitability of the soil for the subsurface disposal of sewage on the
proposed Johnson Street building site Lot B, of John Willis.
The land in general is high.
The subsoil in the area was of sandy clay content and a 4-minute
percolation test was conducted.
It is recommended that a 750 gallon concrete septic tank be
installed together with 180 lineal feet of drain pipe.
Very truly yours,
am,
J. s oll
WJD:hd
BCARD OF HEATZH
TOWN OF NORTH ANDOVER, MASS.
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1, NAME . . . . . . .`:' . . . . . . . . . . . DATE . .
2. ADDRESS . . . . . . .. . . . . . . . LCT N0. : . TEL. .
3. NO. OF BEDROOMS . . . . . DEN YES . . . , NO. `'0 . . .
4. GARBAGE GRINDER YES . . N0.
5. SHOW DII-TENSIONS OF HOUSE
b. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIiENSIONS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. NOTE LOCATION AND DISTAI•dCE OF WELL FROM SEWERAGE SYSTEM
10. SHGW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC.
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
VIEW ENGLAND CLAIMS SERVICE, INC. .
ReplyTo ❑ Reply To ❑
P.O. BOX 345 100 CONIFER HILL DRIVE, SUITE 308 Reply P.O. BOX X 7
MANSFIELD,MA 02048 578
DANVERS,MA 01923 SHREWSBURY, MA 01545
. TEL. (508)337-8058 TEL. (978) 777-9900 TEL. (SQ8) 842-3995
FAX (508) 339-5835 FAX (978) 774-9296 FAX (508) 842-7510
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch. 139 Sec 3D
TO: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
fi0 1 W1,u, E-- S AM u--
addresses addresses
RE: . INSURED
PROPERTY ADDRESS `�19 U�)�_usv�______lw�
POLICY NO.: oy
sSG12�b
LOSS OF:
FILE OR CLAIM NO.: 315'9s
Claim has been made involving loss,damage or destruction o
� f 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 Chapter 139, Section 3D
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.
TITLE
On this date, I caused copies of this notice to be sent to the persons named above
at the addresses indicated_aboye by first class mail.
T; Uri ,-
7t�_ SIGNATURE AND DATE
cc: Fire. Dept. -
Massachusetts Water Resources Commission/Division of Water Resources
WATER WELL COMPLETION REPORT
WELL LOCATION
Address
City/Town
G.S.Quadrangle Map
Grid Location
Owner
Address
WELL USE CONSOLIDATED WELL
Domestic❑ Public ❑ Industrial❑
Type of Water-bearing Rock
Other
Water-bearing Zones
METHOD DRILLED 1) From-To-
Rotary
romToRotary(type) Cable❑ 2) From To
Other 3) From To
4) From-To-
CASING
romToCASING Depth to Bedrock
Length Diameter
Type UNCONSOLIDATED WELL
STATIC WATER LEVEL Water-bearing Materials
Feet below land surface Sand: fine❑ medium❑ coarse❑
Date measured Gravel: fine❑ medium❑ coarse❑
GRAVEL PACK WELL Screen:
Yes F1 No
Slot# length from to
❑
Split Screen(or 2nd screen)
WATER QUALITY TESTS MADE Slot# length from to
Chemical ❑ Biological ❑ Depth To Bedrock
PUMP TEST
Drawdown feet after pumping days hours at GPM.
How measured Recovery feet after hours.
LOG of FORMATIONS COMMENTS: (On well or water)
Materials From To
0
ii,
DRILLER y
Cb
Firm 0
a
Address \
City
Registration No.
Aerators Signature
Please print firmly
1 OM-8181.164843