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TOWN OF NORTH ANDOVER ' -^�._----
SYSTEM PUMPING RECORD 2 2001
mss-- --
DATE: 6 % --
SYSTEM OWNER & ADDRESS SYSTEM LOCATION
(example: left front of house)
7A Gi -
No AV 06 ell
DATE OF PUMPING: a7 -6 I QUANTITY PUMPED -76-0 GALLONS
CESSPOOL: NO
YE
S
SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE X_ EMERGENCY
OBSERVATIONS:
GOOD CONDITION X FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEAC
HFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER _ OTHER (EXPLAIN)
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
ADICCIUS, Robert J.
Gray Street
I hereby make application for a permit for a sewage disposal installation at
Gray Street . 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 1000 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 (Mx*jfeet 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 ZZ&016 �&
Signa&4re of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE_,d
Sigrfature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE l2 t
Signature f Inspecting OfYicer
Percolation Test 3 NiT ',� 87, J I s„„,
Garbage Grinder No
September 28, 1963
Miss Mary Sheridan k. N.
health Agf nt
Board o f Health
North Ando ver, 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 Gray Street builds ng site of Robert J. Adiconis
The land in general is high.
The subsoil'in the area was of sandy content and a'3 -minute
percolation test was conducted.
It is recommended that a 1,000 gallon concrete septic tank be
installed together vith 180 lineal feet of drain pipe.
Very truly yours,
William Driscoll
VvJD: hd
BOARD OF HEALTH
' 'TOWN OF NORTH ANDOVER, MASS.
r
4
1.
DATE
2.
ADDRESS
LOT NO, 3
TEL.
3.
NO. OF BEDROOMS
DEN
YES__ NO
4.
GARBAGE GRINDER YES
NO
5.
SHOW DIMENSIONS OF HOUSE
6.
SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
%.
SHOW DIMENSIONS OF LOT
8.
SHOW fkATION AND SIZE OF SEPTIC
TANK OR
CESSPOOL
9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10. SHOW 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.
-4141,
60C