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HomeMy WebLinkAboutMiscellaneous - 360 WINTER STREET 4/30/2018N NameAm-1-� W. Location f Check# Date 1-2-0 Note: RECEIPT NO 2457 WHITE: Applicant TOWN OF NORTH ANDOVER Sewer Mitigation Fee $ Sewer Connection Fee $ Water Connection Fee $ Meter Fee $ Other $ TOTAL $ 109 Div. Public Works CANARY: Department PINK: Treasurer GOLD: File �11 12/15/2016 NORTH ANDOVER Massachusi4s 360 Winter St 1 message Town of North Andover Mail - 360 Winter St Tim Willett <twillett@northandoverma.gov> To: Michele Grant <mgrant@northandoverma.gov> Michele Grant <mgrant@northandoverma.gov> Thu, Dec 15, 2016 at 2:12 PM This is no available public sewer at this location. Years ago William Bannister at 380 Winter St installed a pump and several hundred feet of private force main in the shoulder of the road to a manhole at 324 Winter St. We no longer allow this type of connection because it got out of control with all kinds of private sewer lines in our roads in numerous locations. https://mai l.google.com/mai I/ul0l?ui=2&ik=d4458df3d9&view=pt&search=i nbox&type=15903e6O8O2c7418&th=15903e6O8O2c7418&sim l=15903e6O8O2c7418 1/1 North Andover Health Department (ommunity and Economic Development Division 10/6/16 Address: 360 Winter St. All North Andover Residents with Septic Systems and Garbage Disposals Please note that due to a recent review of a Title 5 Report, your property has been identified as maintaining a working garbage disposal that is being used in conjunction with a septic system. The Health Department is concerned for the longevity of your septic system. Garbage disposals are never recommended where septic systems are used, but if they are installed, the system must be specifically designed to handle the waste from them; your system can not handle the waste as designed. Please note that continued use of this disposal could quickly cause a pre -mature failure of your septic system, resulting in a large expenditure to replace it. The North Andover Health Department recommends that you remove it from your home as soon as possible. Some information regarding regular maintenance of your septic system is attached. Please call the Health Department at 978.688.9540 if you have any questions, or e-mail your questions to: healthdept@northandoverma. goy. Thank you for taking the time to consider the impact that your current setup has on your septic system and the environment. Sincerely, Brian LaGrasse, CEHT Director of Public Health 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.northandoverma.gov 3(o0 wwrEx 5T V4P cH0Mgs q6 �- F4 1� t (� 'o t� - V)2w Owe -w thouc,4 &xvw) 6)-Owo. Tle �,c ( �uscc Std acs �- �S to ve-�Q -( 7�-,e ST�v� N Owner information is required for every page. Important: When filling out forms on the computer, use only the tab key to move your cursor -do not use the return key. Commonwealth of Massachusetts -Pk Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Owner's Na City/Town ' t'►'t 4S a ljgs- C_:�_ _/ _ 1116 State Zip Code Date of Inspection . Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A A. General Information 1. Ins ector: _ J e-11 Name of Inspect r aFny Name 6 OX C p Address Ci /Town Telephone Number B. Certification RECEIVED AUG 17 2016 HEALTH DEPARTMENT 1 o t bio State Zip Code License Number I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation b he Local Approving Authority nspector's Sig to Date The system inspector shaaub t a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 1 of 17 F` Commonwealth of Massachusetts Y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's Na information is Q� f.S� _X required for every A& 611 �'� /, page. QitylTown State Zip Code Date of Inspection B:. Certification (cont.) Inspection Summary: Check A,B,C,D or E / always complete all of Section D A) System Passes: I have not found any information which indicates that any of the failure criteria described In 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are, indicated below. Comments: �el-kdL� /J4��, C VC V\— /J c-t-tMn B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be laced or repaired. The system, upon completion of the replacement or repair, as approved by the rd of Health, will pass. Check the box fo s", "no" or "not determined" (Y, N, ND) for the following statements. If "not determined,"please ex The septic tank is metal and over ears old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced wi complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structura sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years o Ns available. ❑ Y ❑ N ❑ ND (Explain below): t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 3 (�7 0 Lk w Property Address Owner Owner's Name information is required for every page. City/Town B. Certification (cont.) State Zip Code Date of Inspection ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) Systetn Conditionally Passes (cont.): ❑ Observation of s e backup or breakout or high static water level in the distribution box due to broken or obstructe e(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with appro-VaLZf Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced El [IN F-1ND(Explain below): ❑ truction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of He ❑ Conditions exist which require further evaluation by the Board ealth in order to determine if the system is failing to protect public health, safety or the environme 1. System will pass unless Board of Health determines in accordance 'th 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will prot ublic health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Owner Owner's Na information is required for every page. City/Town B. Certification (cont.) ZA bt f-46'- State Zip Code Date of Inspection 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 fe f a surface water supply or tributary to a surface water supply. ❑ The sys has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a sep ' ank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SA more from a private water supply well" Method used to determine distance: the SAS is less than 100 feet but 50 feet or LN *' This system passes if the well water analysis, performed at a D ertified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitroge and nitrate nitrogen is eaual to or less than 5 ppm, provided that no other failure criteria are triggered. A py of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No E] clogged of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ �Z Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ry, Static liquid level in the distribution box above outlet invert due to an overloaded y or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 4 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address CS 01 /4.S Owner's -. * cis a Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ [� Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ [ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10, 000g pd. ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the questions in Section D. l� No ❑ ❑ tem is within 400 feet of a surface drinking water supply ❑ ❑ the system is withi 0 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitr n sensitive area (Interim Wellhead Protection Area — IWPA) or a mapped Zone I public water supply well If you have answered "yes" to any question in Section E the syste is considered a significant threat, or answered "yes" in Section D above the large system has failed. Th wrier or operator of any large system considered a significant threat under Section E or failed under Sec ' D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should conta a appropriate regional office of the Department. t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 5 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner's Vtryf i own C. Checklist ,Z�j4 t-41 State Zip Code Date of Inspection Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No ❑ Pumping information was provided by t owner, cupant, or Board of Health ❑ Were any of the system components pumped out in the previous two weeks? ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ Was the facility or dwelling inspected for signs of sewage back up? rm El Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address _ „ Owner O nes N_ information is required for every „1 page. CityfTown t5ins - 3l13 Q -\,c -o._ D. System Information Description: Number of current residents: KA &S & Ny State Zip Code Date of Inspection Does residence have a garbage grinder? Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) Laundry system inspected? Seasonal use? Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? Last date of occupancy: Commercial/industrial Flow Conditions: Type t: Design flow (baseee. 10 CMR 15.203): Basis of design flow (seats/persons/sq. ., Grease trap present? Industrial waste holding tank present? Non -sanitary waste discharged to the Title 5 system? Water meter readings, if available: Gallons per day (gpd) K Yes ❑ No ❑ Yes No ❑ Yes � No ❑ Yes � No ❑ Yes No Date ❑ Yes ❑ No ❑ Yes ❑ No Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 7 of 17 Commonwealth of Massachusetts x -- Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's (� information is required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other (describe below): General Information Pumping Records: j-&5 r, - 9— -0 k Source of information: Was system pumped as part of the inspection? Yes j, No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy Shared system (yes or no) if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 8 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner's Na City/Town D. System Information (cont.) bw►4,S State Zip Code Date of Inspection Approximate age of all components, date installed (if known) and source of information: /2e ,,k- 6w,eG-- � d e / 9 ?9 Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer (locate on site plan): t Depth below grade: feet 12 Material of construction: cast iron ❑ 40 PVC ❑ other (explain): Distance from private water supply well or suction line: feet Com ments (on condition of joints, ventin , evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: Material of construction: concrete ❑ metal ❑ fiberglass If tank is metal, list age: feet ❑ polyethylene ❑ other (explain) years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5X(fl— ,r Sludge depth: t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 9 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form i; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address d I" /s� Owner Owner's N information is required for every 60 page. City/Town t5ins • 3/13 D. System Information (cont.) odys, State Zip Code Date of Inspection Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle ti Scum thickness vA Distance from top of scum to top of outlet tee or baffle a Distance from bottom of scum to bottom of outlet tee or baffle 1 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ��ry I,t •t 2�C• �� 19��. ,tom �--t-� �� _ Grease Trap (locate on site plan): Depth below grade: Materia construction: ❑ concrete metal Dimensions: Scum thickness feet ❑ fiberglass ❑ polyethylene ❑ other (explain): Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address b mA Owner Owner's NawA information is /� )6 required for every l' ` a page. Cltyrrown. D. System Information (cont.) State Zip Code Date of Inspection Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid le is as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped Depth below grade: Material of construction: ❑ concrete U metal of inspection) (locate on site plan): U fiberglass Alarm in working order: Date of last pumping: Comments (condition of alarm and float switches, ❑ other (explain): * Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No l5ins - 3/13 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System - Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments b (L( -)-f Property Address Owner1 0 a information is required for every page. City/Town D. System Information (cont.) State Zip Code Date of Inspection Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump'rAl.amber (locate on site plan): Pumps in workin der: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump tuber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working ordeNexcavation Soil Absorption System (SAS) (locate on s If SAS not located, explain why: t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 12 of 17 • Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner�\� _j—�� Owner - � � information is /� required for every / 6 tr"—( page. Cityfrown D. System Information (cont.) Type: ❑ leaching pits ❑ leaching chambers ❑ leaching galleries ❑ leaching trenches leaching fields ❑ overflow cesspool ❑ innovative/alternative system r state Zip Code Date of Inspection number: number: number: number, length: number, dimension `4q-!!��� number: Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and con uration Depth - top of liquid to in nvert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 13 of 17 Commonwealth of Massachusetts M- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 13T - Property Address _ -.AO T Owner Owners h information is �-( required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids N Comments (note condition of soil, signs of hydraulic fa etc.): level of ponding, condition of vegetation, t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 14 of 17 _j Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 3 (oo Lo , Property Address 1 `,% 6)-, A-& L A07 City/ I own State ZipZipC� ode Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: '09 hand -sketch in the area below drawing attached separately -57 jZ«t- ry w ,UN t%A —33 Ski / �t t5ins • 3/13 Title 5 (ficial Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17 L Commonwealth of Massachusetts -- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1 ks Property Address �} Owner Owq'b; information is �'rN required for every page. City/Town D. System Information (cont.) Site Exam: ❑ Check Slope Surface water �U -> Check cellar iUo a ,-L� ❑ Shallow wells yyx o-JIN�5 State Zip Code 0—+/ — Date of Inspection Estimated depth to high ground water: A V feet Please indicate all methods used to determine the high ground water elevation: ❑ • Obtained from system design plans on record If checked, date of design planreviewed: r eviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) Checked with cal Board of Health - xplain* ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: �A- S5 4W e 5- 4i -.v A, R(452 -re Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 16 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 3('gL � Property Address gima Owner's (_ �` ity/Town State Zip Code E. Report Completeness Checklist CV -r-/.. Date of Inspection Inspection Summary: A, B, C, D, or E checked [ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed System Information — Estimated depth to high groundwater [� Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file /T t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17 Ae BOARD OF HEALTH TOWN OF NORTH AMOVER9 b'IASS. C o GAc ac �zo =MSU 1 r 1�. /DD 3a' 211 Ad `i 1. NAS . / //l�/y/Pf �oG1D�/�9�f/S' . DATE . ��. s: . . . . . . 2 ADDRESS ��d�//1 L✓ . 3. N0. OF BEDROOTS .` DEN YES NO.. . 4. GARBAGE GRIM, YES . . . . . NO.. . . . 5. SHOW DIT EPSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7, SHOW DIMNSIONS OF LOT S. SHOW LOCATION AMID SIZE OF SEPTIC TANK OR CESSPOOL 9, NOM LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM �Ol�/i'✓ G�T�' 10. SHOP) LOCATION CIF BROOKSt STRWVl , DITCHES9 LEDGE OUTCROP, ETC. U. SHOW DISTANCE CP SEPTIC TANK OR CESSPOOL FROM HOUSE NOTES LOCAL REGULATIONS SHOULD EE READ CAREFULLY. f._ 0 May 24, 1958 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 building site of Mr. & Mrs. Stanwood Evans at the corner of Winter and Dale Streets. The subsoil in the area was of a sandy clay content and a 5 -minute percolation test was conducted. The land in general is high. It is recommended that a 750 gallon concrete septic tank be installed together with 270 lineal feet of drain pipe. Very truly yours, e �/V CCPV William J. Dr s of A BOARD OF HEALTH 120 MAIN STREET TEL: 682-6483 y�SSACFIU`�NORTH ANDOVER, MASS. 01845 o t1 Ext. 32 or 33 COMPLAIN`i' FORM DATE: 3 1 q j q I CASE # 7 COMPLAINANT • ryk- OWNER: ADDRESS• PHONE# DATE OF INSPECTION: s U Standwood D. Evans Cor. Minter & Dale Sts. APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTPENT--NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Cor. Winter & Dale Sts. . 1 will install this system in accordance with all the lags of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Furtherp 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,a until 10 feet preceding the septic tanks where the grade shall not exceed 2%. I will install a concrete septic tank of ' 0 gall 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 /f inches in diameter and laid in a series of trenches, the bottom of which will provide a minimum of 270 lineal (qgya,;_qk 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 1/811 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 minimums 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 supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further officer, as provided belowt and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application, DAT �:r�WiiR�l lrrY15 �irii ifY 1 i r�wr Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover,9 Massachusetts. DATE _i__� % S' ature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE Signaturek a Inspecting Office Percolation Test ! 5 mirk. Garbage Grinder �- `� MADE BY: BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 TEL. 682-6400 COMPLAINT FORM �--- DATE ADDRESS: 3 1j ,Gri, a�.'I . TEL. NATURE OF COMPLAINT LOCATION: d OCCUPANT OWNER ADDRESS DO NOT WRITE BELOW THIS LINE REFERRED TO DATE OF INVESTIGATION RESULT OF INVESTIGATION RECOMMENDATIONS: ACTION TAKEN: