HomeMy WebLinkAboutMiscellaneous - 501 BOXFORD STREET 4/30/2018 (3) `` - � �. `�
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Lot & Street Map/Parcel
CONSTRUCTION APPROVAL
Has plan review fee been paid: YES NO Permit
Plan Approval: Date: Approved by:
Designer: Plan Date: --
Conditions:
Water Supply: Town __. _______ _. We1L.
Well Permit: _Driller:
Well Tests: Chemical Date-Approved
Bacteria I Date-Approved
Bacteria II Date Approved
Plumbing.Sign-Off: Wiring Sign-Off-
Comments: -"
Form"U' Approval: Approval to-Issue: YES NO
Date Issued By: -
Conditions: -
Final Approval:
.All Permits Paid? YES NO
Well Construction Approval? - YES NO
Septic System Construction Approval? YES NO
Certification? YES NO
Other YES NO
Any Variance Needed? YES NO
FINAL BOARD OF HEALTH APPROVAL: ''
DATE:
APPROVED BY:
M6
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SEPTIC SYSTEM INSTALLATION
Is the installer licensed? YES NO
Type of Construction: NEW REPAIR
New Construction: Certified Plot Plan Review YES NO
-Floor Plan Review YES NO _
Conditions of Approval from Form U YES NO
_Issuance ofDWC permit: - YES NO
_.DWC Permit Paid? YES NO .
--DWC_Permit - Installer:
-.-__-- . -BegimInspection:_ - YES - NO -
_Excavation Inspection:
Needed:
Passed:. By: --
..-Construction Inspection:
Needed`.
As_Built_Plan Satisfactory:
YES:
= Approval of Back:fill: Date: By:
----Final Grading Approval: Date: By:
Final Construction Approval: Date: \ By:
Certificate of Compliance: Approval: Date:
Add ress — 8 G k t- rz 6 Title of File
Page of
Date File Open: Date We closed:
Doc Document/Action Title Date of Refer to otherPurpose of Document/Action and notes
action Document/ document/
Num. Action Department
Board of Appeals — Board of Health — Planning Board _ Conservation Commission — Building Departrnent
f Harry Shomas
Boxford St.
APPLICATION FOR SEWAGE DISPOSAL IMTALIATION
HEALTH DEPARTMENT - NORTH ANDOVER, IHSS.
I hereby make application for a permit for a sewage disposal installation at
-RoKfad 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 _ 7Ko g� 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 160 lineal (q 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
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 0 d
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE
S ature of Health Agent'
I have inspected the uncovered system indicated above and find everything done
as described.
Signature ofUnspecting Officer
Percolation Test 3 min. Soil: gravel-
Garbage Grinder N6,
J
July 8, 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 Boxford Street building site of Harry Thomas.
The land in general is high.
The subsoil in the area was of gravel content and a 3-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,
William J. Drr oll
WJD:hd
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BOARD of xE.�tTH
TOWN OFF NOIGH ANDO0ER, MASS.
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1. NAIVE . . . . . . DATES
2. ADDRESS LOr NO. j TEL.
3. NO. OF BEDROOKS DEN YES NO. is .
/�. GARBAGE GRINDER YES NO. .
�j. SHOW DIPI:ENS IONS OF HOUSE
6, SHOW DISTANCES OF HOUSE TOO ALL PROPERTY LINES
7, SHOW DILENSIOIvLS OF LOT (1311", )
$. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10, SHOW LOCATION OF BROOKSO STREAKS, DITCHES, LEDGE OUTCROP, ETC.
11, SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
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