HomeMy WebLinkAboutMiscellaneous - 722 GREAT POND ROAD 4/30/2018Town of North Andover, MA
Watershed Septic System
Servicing Report
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Date: 5" �� �—
Homeowner : s� I�17 AL
Street :4
ay
Phone q 7 5 `1 a-7 0
Nature of Service:
Observations:
Description.of Work:
Routine
Emergency
,,4 s�
Pumper"`° ��
Address:
Phone ?�
Good Condition
aU, t \n �k,( Duse
Full to Cover
Baffles in Place
Leachfield Runback
Excessive Solids
Heavy Grease
Roots
Other (Explain)
(off
e
/I
SEPTIC SYSTEM INSPECTION FORM
ADDRESS 22 (� ,-�. -
DATE INSPECTED -7 '�
PROPERLY FUNCTIONING? Y� N
WEATHER CONDITIONS
COMMENTS:-
P OH TH
1
OFFICES OF: o Town of °� 120 Main Street
• m
AI'I'EAI_S NORTH ANDOVER North Andover,
BUILDING •�' *::o`er' g, Massachusetts O 184
CONSERVATION 9Ss,C.usE�4 DIVISION OF (617) 685-4775
HEALTH t
PI_ANNINC71. PLANNING & COMMUNITY DEVELOPMENT
Building Inspector
KAREN H.P. NELSON, DIRECTOR
August 6 1987
re= 722 Great Pond Road
Proposed addition
This Lot was inspected on August S 1987. No
Septic System problems were noted. The proposed addition of a
bedroom and study should not present a problem.
Sincerely
Sanitarian Boar ',o He -al t
RI 0 �66 ZOO5 Lot d / i13,CY,
w Fred Elias
(PLS &J ik) S MV,F1,E)
-7a ,yErreat Fond Road
"-APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMM—NORTH ANDOVER, WSS.
I hereby make application for a permit for a sewage disposal installation at
Lot A Great Pond Road . I will install this system in
dance with all the laws of the Commonwealth of Massachusetts and regulations
of the Board of Health of the Tarn of North Andover.
Plan attached
fir# I will construct the house sewer of bell and spigot pipe, the rJul
diameter being 4 inches# and will maintain a minim= grade of 1% until 10 feet
preceding the septio tank# vihers the grade shall not exceed 2,%. I will install a
concrete septic tank of 7Kn 75o g,aa, in size. A manhole (s) permitting easy
cleaning will be provide4 with rumble cover (s) of I= or concrete within 32
inches of the ground surface* I will provide subsurface disposal field with open
Jointed bell and spigot Aekron pipe at least 4 inches in diameter and laid -in a
series of trenches# the bottom of which will provide a minimum of 210 lineal
(� feet of effective absorption area. The pipee will be laiTmon a 6 inch
layer of washed gravel or crushed stone ranging in size from 3/4 to 14A inches
(dlae) and the pipes will be surrounded by similar material to a height of 2 inohss
above the cram of the pips• 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 ooureevel ar stone. The disposal field will be
Installed at a grade of 4 to 6 inches/iM feet, No single file line will exceed
100 feet in length and in any ease# two lines of the will be installed. A minimamm
of 6 feet will. be maintained between the center litres of the.diepoeal 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 supplyp 25 feet from
any stream, 20 feet from any dwelling or 10 feet from any property line• tgEMU
qj[jW, as provided beUMS and to incorporate air ada%conal xregtvremem snas
my be attached to the permit. Plot Plans most be submitted with application.
Grave and fill to be rought in fiollowing the pouriny of footing and foundation
.Vz
Kgnature Applicant
.I hereby issue the above permit for the Board of health of the Tarn of North
Andeverp Massachusettse
DATE[�,,�� %,,:�'.) c�
Si tura of Health Agent
I have inspected the uncovered system, indicated above and find ding done
as d®aer4be4
DAT$�L, 1 23
—•I "vC-dliO
Signature of bwFiting Officer ` ,
POreolation Test
i
Lot H
'-iAPPLICATION FOR SENAGE DISPOSAL INSTALLATION
HEALTH DEPARTWNT -NORTH ANDOVER t MASS.
I hereby make application for a permit for a sewage disposal installation at
__.._..... ,.tat:._R rTrP t. RaUd AQAd I will install this system in
accordance with all the laws of the Commonwealth of Massachusetts and regulations
of the Board of . Health of the Town of North Andover.
Plan attached
Fu thee# I will construct the house sewer of bell and spigot pipe, the.minimum
diameter being 4 inchesq and will. maintain a minimum grade of 2% until 10 feet
preceding the septic tank# where the grade shall not exceed 2%. I will install a
concrete septic, tank of , n-5po gg.1 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 Aakron pipe at least 4 inches in diameter and laid in a
series of trenches# the bottom of which will provide a minimum of 210 11nea1-
(sit) 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 14/2 inches
(dia.) and the pipes will be surrounded by similar material to a height of 2 inks
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 1/41F
(dia.) will be placed over the course gravel or stone. The disposal, field will be
installed at a grade of 4 to 6 inchesAO0 feet. No aingle the line will exceed
100 feet in length and in any case= two lines of the 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 In..
stellation wdil be less than 100 feet from any private water supplyp 25 feat from
any streams 20 feet from any dwelling or 10 feet from any property line. I gdha
if ,j, as provided below, and to incorporate any additional requirements that
may be attached, to the permit. Plot Plans must be submitted with application.
Gravel and fill to be brought in following the pouring of footing and foundation.
DATE
Signature of Applicant
T hereby issue the above permit for the Board of Health of the Town of North
Andovery Massachusetts.
DATE
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
~' as described.
DATE
Signature of Inspecting officer
Percolation Test
G4rbage Grinder
Lot C
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMU--NORTH ANDOVERs, MASS.
I hereby make application for a permit for a sewage disposal installation at
.....__ Late C Qzimt 2013d bar] . 0 I will install this system in
accordance with all the laws of the Commonwealth of Massachusetts and regulations
of the Board of Health of the Town of North Andover.
'Plan At e
' I will construct the house sewer of bell and spigot pipes the minirmua
diameter being 4 inaheag and will maintain a minimum grade of 2% until 10 feet
preceding the septic tank# where the grade shall not exceed 2%. I will install a
concrete septic tank of ' 0 00-� In size. A manhole (s) permitting easy
cleaning win 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
jousted bell and spigot Ackron pipe at least 4 inches in diameter and laid in a
series .of trenches, the bottom of which will provide a minimum of 210 lineal
(�) feet of effective absorption area. The pipes will be laid on a inch
layer of washed gravel or crushed stone ranging in size from'3A to 144 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 trenchp 2 inches of gravel or stone 1/8" to 1/4"
(dia.) will be placed over the coursevel or stone. The disposal field will be
Installed at a grade of 4 to 6 inches/�i0 feet. No single tile line will exceed
100 feet In length and in any case, two lines of the will be installed. A minimum
of 6 feet wiU. be maintained between the center fines 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-supplys, 25 feet from
any streams 20 feet from any dwelling or 10 feet from any property line. 2 AgIft
.X, as provided below,# and to incorporate any additional requirements that
may be attached to the permits Plot Plans must be submitted with application.
Gravel and fill to be brought in following the pouring of footing and foundation*
DATE
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Toren of North
Andoverm Massachusetts.
DATE
Signature of Hesith Agent
I have inspected the uncovered system indicated above and find everything done
as described,
DATE
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
))
r
K
`'-APPLICATION FOR SERAGE DISPOSAL INSTALLATION
HEALTH DEPARTWIT—NORTH ANDOVER, LASS.
Lot D
Great Pond Rd.
I hereby make application for a permit for a sewage disposal installation at
Lot D Great Pond Road . Iwill .install this system in
accordance with all the laws of the Commonwealth of Massachusetts and reguUtions
of the Board of Health of the Town of North Andover.
PLAN ATTAAC P
Fur p I will construct the house sewer of bell andspigot i Pei
the minimum
diameter being 4 inches: and will maintain a minimum grade of 1% until 10 feet
preceding the septic tank where the grade shall not exceed 2%. I will install a
concrete septic tank of AO -500 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 open
Jointed bell and spigot Ackron pipe at least 4 inches in diameter and laid in a
series of trenches, the bottom of which will provide a minimum of 210 lineal
( 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 simiUr 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 1/48
(dia.) will be placed over the coursevel or stone. The disposal field will be
Installed at a grade of 4 to 6 inohesAO feet. No single tile line will exceed
100 feet in length and in any cases two lines of the will be installed. A minimum
of 6 feet wi3l 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•
stallati.on will be less than 100 feet from any private water suPPI+Y: 25 feet from
any streams 20 feet from any dwelling or 10 feet from any property line. I fort r
o f� as provided belowp and,to incorporate any additional requirements tha
may be attar to the nermito Plot Plans must be submitted with application.
Gravel and Fill to be brought in following the pouring of footing and foundation.
DATE
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts,
DATE
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
Signature of Inspecting Officer
Percolation Test Yom'%
Garbage Grinder Yes
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, hWS.
.00
1. NAKIE 1J eQ�. .� � . . . . . . . . . . DATE . . . . . . . . . . . .
2. ADDRESS . . �. "III-e--l'LOT NO—T—. 90—c-1-06TEL g 2.: .
3. NO i OF BEDP�OOTf�S . ';�. DEN YES °. N0.. .
4. GARBAGE GRINDER YES .�' :''` . ' . NO.. . . . .
5. SHOW DI IICNSIONS OF HOUSE S' X
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIPIIE BIONS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9, MOTE LOCATION AND DISTAI1?CE OF WELL FROI:I SEWERAGE SYSTEM
l
10. SHOW LOCATION OF - BROOKS , STRE�`� 0. D ITC HES , LEDGE OUTCROP, ETC. 1� o d
A
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROIA HOUSE
NOTE* LOCAL REGULATIOM SHOULD EE READ CAREFULLY.
1 . %—
BOARD OF HEALTH
TOWN OF. NOR.Tii ANDOVER! MASS.
� - -----�
. _
7. SHOW DIMENSIONS OF LOT / Z J— X 17-3
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. WE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10. SHOW LOCATION OF BROOKS STREABS DITCHES LEDGE OUTCROP ETC. .��� �'
11. SHOW DISTANCE OF SEPT IC TANK OR CESSPOOL FRO14 HOUSE / O
NOTE: LOCAL REGULATION SHOULD EE READ CAREFULLY.
-,tet/+�
1.
NMJZ . . . . .
. . . . . . .
. . DATE . . . . . .
2.
ADDRESS . .
. . . LOT
NO. TEL. .
3.
NO. OF BEDROOI S . �`' . DEN YES . ` '�: .
4.
GARBAGE GRINDER YES
NO.. . .
. .
5.
SHOW DIT- ENSIOtS OF HOUSE
6
SHOW DISTANCES OF HOUSE TO ALL PROPERTY LI?3ES
/
. _
7. SHOW DIMENSIONS OF LOT / Z J— X 17-3
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. WE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10. SHOW LOCATION OF BROOKS STREABS DITCHES LEDGE OUTCROP ETC. .��� �'
11. SHOW DISTANCE OF SEPT IC TANK OR CESSPOOL FRO14 HOUSE / O
NOTE: LOCAL REGULATION SHOULD EE READ CAREFULLY.
Y3 0
BOARD OF HEALTH
• TOWN OF NORTH Al DOVER, WS.
2.
3.
4.
5.
6.
r
. . . . . . . . . DATE . . . . . .
ADDRESS j` ;J . ;" : "•. _SIM NO. . ? TEL.
N0. OF BEDROOPIsS DEIJ YES `: NO.. . . . .
GARBAGE GRINDER YES NO.. .
SHOW DIM01SIONS OF HOUSE + 7
SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES �- y
7. SHOW DIPIISN3IOM OF LCT I )— ,
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. NOTE LOCATION AND DISTANCE OF WELL FROTJ SEVMAGE SYSTEM
10. SHOW LOCATION OF BROOKS, STREAT.B.. DITCHES, I=E OUTCROP, ETC.
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROMI HOUSE
NOTE: LOCAL REGULATIORTS SHOULD HE READ CAREFULLY.
BOARD OF HEALTH
• Ta7N OF' NORTH ANDOVER, mos.
1.
NAIM '!�:%''.�. . . . .
. DATE
.. . .
. ALO"
2*
ADDRESS N0.
. . . . .TEL.
3.
NO, OF BEDROOMS .`�: DEN YES .Q.
NO.. . . . .
!t.
GARBAGE GRINDER YES NO..
.
5.
SHOW DIMPTSION?S OF HOUSE t �' �� C4Ao-q19-
17 x 3
6.
SHOW DISTANCES OF HOUSE TO ALL PROPERTY LIMES
>" 9'
7.
SHOW D17 EMIOM OF LOT Y,17 �
8.
SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL vv
9. NUPE LCCATSON AND DISTANICE OF WELL FROTA SEV7ERAGE SYSTE141
10. SHOI"J LOCATION OF BR40KS, STREAI+6, DTPCHES, LEDGE OUTCROP, ETC, /Goy
�P f
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE /o / �
NOTE: LOCAL REGULATIOIM SHOULD BE READ CAREFULLY,
m
WATERS
1. Name
D R SIDENrI QUESTIONNAIRE
2. Street Address
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
peptic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for yo sewage disposal system on file with the Board of Health?
Elyes Elno a do not know
6. How d is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years ❑ 11-20 years
over 20 years ❑ do not know
7. Has your sewage di&posal 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
O❑ 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 toilet Z
roof/pavement drains showerlbathtub -2
11. Please state the bKand and type (liquid or powder) of detergent you use for:
dishwasher11--C-c- -
clotheswasher Tj Gj 4P_
12. Does your property have a lawn?yes ❑ no
If yes, approximately what size?
❑ less than '/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your la
No. of applications per year 17?
Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
/__ta', 0
here if your lawn is maintained by a professional landscape contractor.
L01
BOARD OF HEALTH
120 MAIN STREET
NORTH ANDOVER, MASS. 01845
APPLICATION FOR ABANDONMENT
OF SUBSURFACE DISPOSAL SYSTEM
(SEPTIC SYSTEM)
PURSUANT TO SECTION 310 CMR 15.354
OF THE STATE ENVIRONMENTAL CODE, TITLE V
TEL. 682-6483
Ext23
This form must be submitted to the Board of Health no less than
five (5) days prior to date of abandonment and be accompanied with
a copy of the sewer connection permit.
NamePhone
Address
Contractor hired for work:
Name
Phone
Address
Date for scheduled abandonment : ,'�7 S ��
Method of septic tank abandonment (check one).
( ) removal
Other
( ) sandf ill crush ( ) other (describe
below)
PLEASE DO NOT WRITE IN THE SPACE BELOW
FOR HEALTH AGENT'S USE ONLY
-7
Ins n4' Agent Date
Comments
NQ 1077
APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass. 'oce 19 g�
Application by the undersigned is hereby made to connect with the town sewer main in �/ d�G l— Street,
subject to the rules and regulations of the Division of Public Works. I
The premises are known as No.
or subdivision lot no.
Owne /
Cont�tor
a
Address
Ad s
plicant's Signature
PERMIT TO CONNECT WITH SEWER MAIN
The Qivision of Public Works hereby grants permission to
to make a connection with.. the?sewer mai:; at:_�_
subject to the rules and regulations of the Division of Public Works..
By
Inspected by
Date
See back for rules and regulations
Street
Street
Division of Public Works
ATE ' I E—TIM
M L
OF
PHONE_
AF
MESSAGE
LC lam, j� It" s1�r�ia
SIGNED /Y\/nn�ry ��/1 /y--) �, � TOPS FORM4003
N0- 1006
APPLICATION FOR SEWER SERVICE CONNECTION
North Andover, Mass. 'vf2VJ 3 Q 19 L
Application by the undersigned is hereby made to connect with the town sewer main in� < Street,
subject to the rules and regulations of the Division of Public Work .
po-,�J r
The premises are known as No. 1 ,,Street
or subdivision lot no.
Owner
-Ai/ rC r
Contractor
fiZArL.X�-F
Address
Address
Applicant's Signature
PERMIT TO CONNECT WITH SEWER
The Division of Public Works hereby grants permission to
to make a connection with the sewer main at —22-2-- y ►'n, 4
subject to the rules and regulations of the Division of Public Works..
Inspected by
Date
By
See back for rules and regulations
Street
Division of Public Works