HomeMy WebLinkAboutMiscellaneous - 390 JOHNSON STREET 4/30/2018 (2) 393 JOHNSON STREET t
-210/098A-0028-0000.0
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APPLICATION FOR SEWAGE DISPCtSAL I16TALIATION
HEALTH DEPA RTNENT - NORTH ANDOVER, ASS.
I here b ma a application for permit for a sewage disposal installation at
I will install this system in ac-
cordance wit 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 _/o" 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 rl o o lineal (she) 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/$" to 1/4'1 (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
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.
DATE 1 f M4 0
5;
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE / 'f, 12JJL
D
T ,
Siff
' ature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
Signature of pecting Officer
Percolation Test
Garbage Grinder
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November 12, 1960
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 of Margaret I Rauh.
The land in general is high.
The subsoil in the area was of clay content and a 5-minute
percolation test was conducted.
It is recommended that a 1,000 gallon concfete septic tank be
installed together with 200 lineal feet of drain pipe.
Very truly yours,
amiscoll
WJD:hd
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BOARD OF HEALTH
` TOWN OF NORTH ANDOVERp MASS.
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1. NAME * �;� /g�r � T. .�.¢ . :�. . DATE
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2. ADDRESS .� . 6 .. LOr N0. . TE(-
3.
N0, OF BEDROONS . DEN YES N0. J
4. GARBAGE GRINDER YES N0.
5. SHOW DI',ZNSIONS OF HOUSE
b. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIIVENSIORtS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
IO SHOW LOCATION OF BROOKS STREAY5.9 DITCHES
LEDGE OUTCROP) ETC
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name �� r
2. Street Address �-2
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ 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?
X yes ❑ no ❑ do not know
6. How old is your sewage disposal system? ❑ 0-5 years ,t 6-10 years ❑ 11-20 years
❑ over 20 years ❑ 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
❑ every 2-4 years ❑ every 5-10 years, ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system? ❑ yes [ , 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 dishwasher garbage disposal
dehumidifier drain sump pump toilety
roof/pavement drains shower/bathtub
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher C(U-, ��Z
clotheswasher AL G-
12. Does your property have a lawn? Eff yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre e 1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. . How often do you fertilize your lawn?
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:
4 Check here if your lawn is 5�' tained by a professional landscape contractor.
i
2. St ect Address
3. im;, many members are in your household? T
4. E type of sewage disposal system do you have? 6
cesspool
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?
f` yes ❑ no ❑ do not know
6. How old is your sewage disposal system? ❑ 0-5 years 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
r.
Has your sewage disposal system been rebuilt or repaired?
❑ yes ❑ no ❑ do not know
yE approximately how long ago? years. What was done?
S. low frequently is your sewage disposal system pumped out? ❑ annually
j every 2-4 years El every 5-10 years ❑ over 10 years El never
;.,eve you had any problems with your sewage disposal system? ❑ yes [A no
i yes, what problems?
❑ repeated pump-outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
10. : t.• many of each appliance are connected to your sewage disposal system?
t cashing machine /' dishwasher garbage disposal ..
::ehumidifier drainsump pump toilety "`
I jof/pavement drains showerlbathtub !/
11. Plepse state the brand and type (liquid or powder) of detergent you use for:
dishwasher CJZA
clotneswasher AL 4-
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre T" 1/4 acre ❑ 1/z acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. flout° often do you fertilize your lawn?
`,
_ u. of applications per year
Seasons) of the year rIF
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
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