HomeMy WebLinkAboutMiscellaneous - 505 GREAT POND ROAD 4/30/2018 505 GREAT POND ROAD' ^-iad
2101064.0-0017-0000.0
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SEW
8tUre of Service
Reg ASPeg.Maim
NIC .
Emergency
ANDOVER SEPTIC PUMPERS 't. Day ON.ght
D f Sery
PAY FROM THIS BILL
Customer Name: ,(
P.O. Box 4173 B Station
Service Location: !/f/ //�/�J^/f///Jn' �� Andover MA 01810
Phone: �' -X f �.L (508) 475-2593
Contact: Professional Septic & Drain
Billing Address: Locally Owned and Operated
City: zip: Emergency 24 Hr. Svc. —7 Days
Special Instructions
, l Completed
❑ Incomplete Reason:
Per:
AM/PM
Services Rendered
Vacuum Pumping Observations (® Drain Cleaning
'Septic Tank �[Y Good Condition 0 ❑ Main Line
❑ Drywell b Leechfield Runback A of Toilet Bowl
❑ Leech Pit/Overflow ❑ Riding High V� ❑ Kitchen Sink
❑ D-Box (liquid level) �� ❑ Bathtub/Shower
ElEl ��
Pump Chamber Full to Cover ❑ Vanity
❑ Grease Trap ❑ Excessive Solids./
C1 Catch
f(�1gr D Catch Basin Top/Bottom. f���� Ye�d Drain
El Portable Toilet
C3 Use No Powdered Soap O Vent
C3 Heavy Grease
F-1Other ❑ Roots ElSewer Jet
Qty: ❑ Other
Size: �r El Suggest Electric
El Under 1000 gallons f1J 1000 gallons ❑ 1500 gallons Rootering Footage:
❑ 2000 gallons ❑ 3000 gallons ❑ 4000 gallons 0 Van Called
❑ 5000 gallons ❑ other ! Others,•% . :
e
O Digging Charge El Backhoe L /I Irfspection `
11 Location �� ❑ Consultation ❑ Certification: P/F
❑ Service Call ❑ Estimate Reason:
❑ Labor ❑ Portable Toilet Rental ❑ Pump Repair
❑ Waiting Time ❑ Baffle ❑ Repair
Digging Charge Is Per Driver ❑ Chemical Treatment
Discretion ❑ Other
Description of Work
Recommendations Terms of Payment
Parts
Vacuum Pumping jl/M Drain Cleaning E 15 DY Tax
j'�
Yr. 1 Month' _ Yr. Month
I :� Discount
Term__s_ & Conditions ❑. Cash 0.. Check Credit
r: _
/i/ .. �.r'` Total
t. Clot responsible for damage teyprytl cGrb li�ie. �3. 1.5%per,month will be charged to accounts past due.
2. All Complaints shall be reoortecwiti t J %rPyrF lir. 1��-rC �'The,'purcts�r�aalees to pay all cost of collection.
I the undersigned.agree to all terms'and conditions. /J ,
Customer Signature X Serviceman
SEPTIC SYSTEM INSPECTION FORM
ADDRESS
DATE INSPECTED
PROPERLY FUNCTIONING? N
WEATHER CONDITIONS
COMMENTS:
WATER QUALITY TESTED? RESULTS?
DYE TEST PERFORMED? Y •N
DATE?
SKETCH: -
« .. ' p ��tG�vCes G• ��Kc� 7j3 � � �
rnGsa-
Please forward us as much of the following information that is possible
1, Type of system
S u l3 Scv dZ F A C E-
2 . k7 e i z `/!Z 5
3 I,o; t i oT; a F-10 2
1� . Maintenance records and date of last pumping out
D0 % x-19/- L y 77
5. Documentation of repairs and reconstruction
JJv ��c�i9 ��5 N►� c � SS/� 12y
6. Site conditions
,� f
�y 190 D b4 l <� 24 .laz y
7. I3uilder of system
/
t- 1A) /13
8. Engineer who approved,
— Site
— Sys tem U) i L L i
9 * Installation ,Procedure
1.0. Problems
WATERSHED RESID NTS QUESTIONNAIRE
1. NameI).;=Al
2. Street Address `-
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
'J9 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?
❑ 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
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes 2- no ❑ do not know
If yes, approximately how long ago? years. What was done?
I 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 x dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub
11. Please state the brand anti type (liquid or powder) of detergent you use for:
dishwasher e 'i+I isg2kf12
clotheswasher G.)/.SSC
12. Does your property have a lawn? � Yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre V11/1/2 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:
f,�:3Y YF•r X ::1,t j '!.,e'' }+"r'+:'+.
Check here if your lawn is maintained by a professional landscape contractor.
•.,.:...h..t1-w,..J F:Bi ..tia k]_. f'1 ,.. +�'. '�a ' ...,.�rr.. {,`. ..... .,,,,t.., .a:... +....Mr,. ... ,.,,.. '�f d.. .. ..., ..f,.
Dro George Fraser
k? 6'Great Pond Read
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I
herebymake application fora Per
mit for a sewage disposalosal installation at
Fi�D� 8�9Great Pond Road
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 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 lineal (square) 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 sfone.
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 �e subb ted with application.
System to be installed according to plans approve by S
DA TE v _ I _
Si atur of A licant '
I hereby issue the above permit for the Board of Health of�the Town of North
Andover, Massachusetts.
DAZE _ / U ,
ignature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as descibed.
DATELNtf6l _
.�
Signature of I ecting Officer
Percolation Test
Garbage Grinder YIN
r , 1�.,,,�•.
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T �.
VAIN
May 25,. 1961
Mr. Herbert Nilekerson, District Engineer
District Health Office
North Reading State San:.torium
North Wilmington, Plass. -
i
Duar Mr. Nickerson:
May we have your recommendations and/or approval for a sub-surface
disposal system for a single dwelling structure, proposed plans
to be submitted by, Clinton Goodwin, C.E.
25 Washington Square
Haverhill,, class.
LOCATION: 894 Great gond Road
WI ER: Dr. George Fraser
Yours very truly,
BOARD. CF HhALTH
BY
Mary F. heridan, Agent
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511 Jfi J&cdel, ModtorW August 7, 1961
WORTHEN H. TAYLOR
Director
Division of Sanitary Engineering
Board of Health RE: NORTH ANDOVER
North Andover Sewage Disposal
Massachusetts Dr. George Fraser
894 Great Pond Road
Dear Sir:
The Division of Sanitary Engineering of the Department of Public
Health, in response to a request for approval of the proposed method of
sewage disposal for 894 Great Pond Road, North Andover, dated May 25, 1961,
has reviewed the plans for sewage disposal works.
The system is designed to serve 6 persons at 100 gallons per
person per. day, yielding a design flow of 600 gallons per day. The design
consists of a 1000-gallon reinforced concrete septic tank, a distribution
box, and leaching trenches having 'a total leaching area of 516 square feet.
Percolation tests in the area were conducted on June 8, 1961, by Mr. Marshall
of the Engineer's Office. The percolation rates ranged from 6 min/inch to
8 min/inch, with an average rate of 7 min/inch. Ground water was not
encountered. The plan reviewed is titled:
"Residential Sewage System
to be installed in
North Andover, Mass.
as designed for
Dr. George Fraser
June 15, 1961"
Water supply for the private dwelling will be taken from the
North Andover municipal supply.
The Division hereby approves the plans, subject to the following
conditions:
(1) That the volume of sewage to be disposed of shall
not exceed 600 gallons per day, and
(2) That no changes be made without approval of the Division of
Sanitary Engineering, and
' + a
(3) That the Department will be advised when construction has
been completed so that a final inspection may be made of
the facilities before they are covered.
In order to expedite this inspection, please contact the
District Engineer, Mr. Herbert D. Nickerson, at Ulysses 1-7261.
Very truly yours,
Worthen H. Taylor
Director '
Division of Sanitary Engineering
T/End
#350
2.
APPLICATION FOR API....PRVAL O A � p sP(1SA sYS
�� L _ TQM
Town: North Andover
Date of Application: .tune 15, . 1961
Applicant: Dr. 'George E. Fraser
Address: 894 Great :Pond Road, North Andover, Massachusetts
Designing Engineer* Clinton F. Goodwin, Reg. Professional Engineer
025 Washington Square, 'Haverhill, Mass.
Project Name: None
Locatio,941 600' westerly of 894 Great Pond Road
Sewer; No 'down Facilities Available
Type of Establishment:. Single Family Dwelling
Population: (3' Bedrooms) maximum occupancy - 6 -
Volume of Sanitary Sewage: 6 x 100 gal. = 600 gal,. per day max.
Summary of Fac i I i'lries: ,
The system shall consist of a pre-cast concrete septic tank, pre-cast con-
crete distribution box, cast iron and vitrified clay pipe between dwelling
and septic tank, vitrified clay pipe between septic tank and distribution
box and with bituminous treated-perforated fibre pipe for the leaching
lines. All items to be sized in accordance with the plan and details.,
a) Septic tank capacity. 600 x 1.5 = 900 gal. req. 100 gal to be pro-
filed.
i
b) `Total Leaching area: req.-516 cu.yd. of trench area (see design data)
provided- 520 cu.yd. or 260 lin.ft. of 4" perforated "Orangeburg"
pipe.
29W&ATION TEST DATA*. {
No. of Tests Taken - 2
f Date of Tests June 8, 1961
Tests Supervised By -- Herbert D. Nickerson, Sanitary Engineer for the
Mass. Dept. of Public Health
Results: -
Hale #1 - Top Elev. 106.2 --- Bottom Elev. 103.7
Log of Hole .#1-O"-7" loam - 7"-2'-6" sand & clay (no ground water)
Percolation. Rates Hale #1 - 12"-9" = 16 min
9"-6" = 23 min - 7 min.40 sec.per inch
611-4" = 100 m i n
Hole 02 - Top Elev. 109.0 --- Bottom Elev. 106.2
Log of Hole #2-0"-8" loam - 711-2'-10" sand & clay (no ground water)
Percolation Rates Hale #2 - 12"-9" = 10 min
91'-6" = 17 min = 5min. 40 sec. per In.-h
6"-0" = 61 min
RESIGN DATA: 8 t 6 - 14 94, 2 - 7 min per inch average rate
7 min @ 0.86 sq, yd. per gal
600 gal x 0.86 = 516 sq.yds of trench area
51611 2' width of trench = 258 lin.ft. of tench b leaching
line required
OBSERVATION HOLE: Top elev. 107. 1 - Bottom elev.. 100.0
Log of Hole 0"-7" loam - 711-2'-6" sand & clay
216" - 7'-01' alt. layers of gravel and rotten shale
(no ground water)
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May 13, 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 building site of George E. Fraser at 891 Great Pond Road.
The land in general is high.
The subsoil in the area was of gravel and clap content and a
6-minute percolation test was conducted.
Since the policy of the Board of Health is to refer land border-
ing on Lake Cochichewick to the State Board of Health, it is requested
that it be done in this i.nstance� as it is located on the water shed.
If approved, itis recommended that a 1,040 gallon concrete septic
tank be installed together with 240 lineal feet of drain pipe.
Very truly yours,
Willsam �• 3C0
WJD:hd
., _ •_,� `� ��,,,,,�-., U�'�1' �, fit.
OP v
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(DAL,) BOARD
(DAL,) 'BOARD OF HEALTH Z ( e
i TOWN OF NORTH ANDOVERO MASS.
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1. NAME DATE
2. ADDRESS "�. `S�.V�"��. LOT NO. . T p:?. L-
3. NO, OF BEDROOMS DEN YES N0. .> .
!�. GARBAGE GRINDER YES . NO. . .
5. SHOW DIItENSIONS OF HOUSE I( -.2-
6.
b. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7, SHOW DII4tENSION[S OF LOT
$. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9, NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10, SHOUT LOCATION OF BROOKS, STREANS� DITCHES., LEDGE OUTCROPt ETC.
11, SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
(D SENDER:
o I also wish to receive the
C y • Complete items 1 and/or 2 for additional services.
I` a) • Complete items 3,and 4a&b. following services (for an extra m
• Print your name and address on the reverse of this form so that we can fee):
4) return this card to you.
m
• Attach this form to the front of the mailpiece,or on the back if space 1. El Addressee's Address N
does not permit. a.
t • Write"Return Receipt Requested"on the mailpiece below the article number. 2 ❑ RestrlCted Delivery a
• The Return Receipt will show to whom the article was delivered and the date U
c delivered. Consult postmaster for fee.
3. Article Addressed to: 4a. Article Number
Z 115 794 797
°
Mr. Doug Howe 4b. Service Type m
E °C
o El ❑ Insured
0 505 Great Pond Road �
CXCertified ❑ COD
y North And er, IVIA 01845 Return Receipt for 3
W ❑ Express Mail E] p
Merchandise `o
a 7. Date-7 D livery
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cc 5. Signatu 1 ddres e') 8. Ad res e's Address(Only if requested Y
and fee is paid)
t
cc6. Signature (Agent ~
>- PS Form 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETURN RECEIPT
N
UNITED STATES POSTAL SERA. L sS6
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Official Business
PEN"W-FTSfPIVA
E 0 USETO j�V.0 -PAYMENT---
OF PQSTA6E-$"
Print your name, address and ZIP Code here
4. ANDOVER BOARD OF HEALT'F.
120 MAIN STRLHT
M.ANDOVER, MA.01845
BOARD OF HEALTH
P146 MAIN STREET
TELEPHONE# (508) 688-9540 a
APPLICATION FOR ABANDONMENT
OF SUBSURFACE DISPOSAL SYSTEM
(SEPTIC SYSTEM)
Pursuant to Section 310 CMR 13.331
of the State Environmental Code, Title V
Name Li e__ Phone_
Address ROAD
Contractor hired for work:
Name /= F,5-izzY Phone -47S- 12:3 7
Address Zoy
Date for scheduled abandonment
The septic system at the above address has been abandoned according to
Title V specifications.
Signahire of Q00ractor
Method of septic tank abandonment (check one). ( ) removal ( ) sandfill
( ) crush (fir) other v-,eZ
Name of Offal Hauler ��
This form must be returned to the North Andover Board of Health.
PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH
REPRESENTATIVE'S USE ONLY.
Inspecting Agent Date
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