HomeMy WebLinkAboutMiscellaneous - 75 WOODCREST DRIVE 4/30/2018 (2)vi
m
�Town of North Andover, -MA.
Watershed Septic Systeiri
/f? L Servicing Reportp
'Date: �S
-x MACMILLAN. Pumper ANDOVER SEPTIC PUM
Homeowner: P
Street 75 WOODCREST DR.N.A Address: P.O.BOX 4173,And.
Phone (;508) 686-7834'.Phone ; (508) 475-2593
h,Nature of Service: Routine
Emergency
T
w,. Observations Good Condition,
Full to Cover
Baffles in Place
Leachfield Runback
Excessive solids
Heavy Grease
Roots
Other (Explain)
Comments:
Please forward us as much of the following information that is possible;
1. Type of system.
2. Age f l
3. Locati6
11
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4. Maintenance records and date of last pumping out
9 %79
5. Documentation of repairs and reconstruction
av�
6. Site conditions
7. Builder of system
8. Engineer who approved%
— Site
— S-ystem
A
q Installation Procedure
1.0, Problems
2
SEPTIC SYSTEM INSPECTION FORM
ADDRESS aca- '
DATE INSPECTED '
PROPERLY FliNCTIONING? 6 N
WEATHER CONDITIONS
COMMENTS:
W.A ►'EF, aVALI T y 'T'ES I FT-,� rZ
DYE TEST PERFORMED? Y N
DATE?
SKETCH:
WASHED RESIDEN/15 QUU511UNNAIKL
'1. Name �.�'�' �=• c S (�� l� •'C� (/GL--� _ ��✓1
2. Street Address
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?
'�5, yes ❑ no ❑ do not know- •. _
6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years 11-20 years --_r=
❑ over 20 years ❑ do not know
7. lias 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
40 9. Have you had any problems with your sewage disposal system? yes ❑ no
_ If yes, hat 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
roof/pavement drains shower/bathtub
11. Please state the bra d and type (liquid or powder) of detergent you use for:
dishwasher�S C fl
clotheswasher 1 $
Does your property have a lawn? yes ❑
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre IA acre
❑ more than 1 acre (Specify) acres
How often do you fertilize your lawn?
No. of applications per year
Season(s) of the year
no
❑ 3/a acre 1 acre
Now 1. 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
Check here if your lawn is maintained by a professional landscape contractor.
.�..n..rvrw yes.++-• rrs�r�.�..•rn.s+.mwrraw �R'9TRtl+�l�T�l4�t'e'Rf4 .... _ _.. 13! _ .... .. _. _._.. .... ...._. .- r .��C
WASHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address ) G, U
0 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?
75, 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; iIas your sewage disposal system been rebuilt or repaired?
Er—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? Ae annually
- eve 5-10 ears over 10 ear
❑ every 2 4 years ❑ every y ❑ o y s ❑ never
/0 A
9. Have you had any problems with your sewage disposal system? yes ❑ no
If yes, hat 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
roof/pavement drains shower/bathtub
11. Please state the bra d and type (liquid or powder) of detergent you use for:
dishwasher CLr, r-. �jo -
clotheswasher ) 5; k
12. Does your property have a lawn? 6f'- yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre 1/2 acre ❑ 3/4 acre 1 acre
k ❑ more than 1 acre (Specify) - acres
�:"'13: How often do you fertilize your lawn?
No. of applications per year
Season(s) of the year
0,
14. Please state the brand and type (liquid or granular) of lawn fertilizery
C ou use:
C. 1 ,�.L,�.L
Check here if your'lawn is maintained by a professional landscape contractor.
2 sl
Dr. McMillen
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
y� HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
46 'Woodcrest Drive 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 200 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 1/41' (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 106 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.
1 -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
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 In pe ting Officer
Percolation Test 6 Min Soil: Olay
Garbage Grinder
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
1. NAME �� C, i �` C—
.:
S
. " `' Y� dv DATE :� �, 6Z
2. ADDRESS
LOT NO. TEL. G�-� /
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
7. SHOW DIMENSIONS OF LOT
8. SHOW LOCATION 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.
M
•..-t
BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS
NAME OF APPLICAN
LOCATION
SEWAGE DISPOSAL
DATE
BUILDING: Dwelling Other
SYSTEM: New Repair
GENERAL DESCRIPTION OF LAND
- 9 -i -a I -
SUBSOIL: Clay_ ravel Sand
PERCOLATION TEST minutes per inch.
MINIMUM INSTALLATION RECOMMENDATIONS
CONCRETE SEPTIC TANK,rrl--tj gallon capacity.
LEACH FIELD lineal feet of drain pipe.
William J. Dri c 11, Engineer
Board of Health
BOARD OF HEALTH
146 MAIN STREET
TELEPHONE# (508) 688-9540
APPLIC 4 TION FOR ABANDOjV ,fE�VT
OF SUBS[--RFACE DISPOSAL SYSTEW
(.SEPTIC SYSTEM)
Pursuant to Sectiot? 310 CMR 1.. 354
of the State Environmental Code, Title V
Name Phone
AddressIy'
Contractor hired for work:
Name_ gAMeY ceAjTZ�-A cfToe--3 Phone C-0-3-67? i
Address 33 bAY_
Date for scheduled abandonment 9=-zZ -?8
The septic system at the above address has been abandoned according to
Title V specifications.
l�
Signa ire of Contractor
Method of septic tank abandonment (check one). () removal (} sandfill
(x) crush ( ) other
Name of Offal Hauler F'90 Pl L./%,
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
TOWN OF ANDOVER
SEPTIC SYSTEM SERVICING
REPORT
Date : � - ----------- -----------
Homeowner:_
Pumper
Street
Address:22—
Phone
Phone
Routine
Nature of
S-arvice:
Emergency
Observations: Good Condition
Full to Cover
Baffles in Place
Leachfield Runback
Excessive Solids
Heavy Grease
Roots -
Other (Explain)
Description of Work::
Comments: