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Home My WebLink AboutMiscellaneous - 8 Woodcrest (2)W ; $0 00 com m 0 0 BOARD OF HEALTH O 146 MAIN STREET .TELEPHONE# (508) 688-9540 Name Addre APPLICA TION FOR ABANDOAVENT OF SUBSURFACE DISPOSAL SYSTEM (SEPTIC SYSTEM) Pursuant to Section 310 CMR 13.354 of the State Environmental Code, Title V Contractor hired for work: Name lee 1 ' �j Phone .4--75 — ( Z Address 2o6 % /'AvP/ Date for scheduled abandonment The septic system at the above address has been abandoned according to Title V specifications. Signature of ontractor Method of septic tank abandonment (check one). O removal O sandfill (� crush Oother 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 HEAT TH REPRESENTATIVE'S USE ONLY. Inspecting Agent Date C 191 0 Eo J INVOICE STEWART'S SEPTIC TANK SERVICE 47 RAILROAD STREET - BRADFORD, MA 01835 TEL.: (508) 372-7471 DATE �--� 03 Cl iao YHNK YOU U N m A m n D m CID D F D 111 v 4 U v m �N-I v c 1 111 Z g � m � D A � N n P. m 1T1 1�� C Dn rn m p r 0J OD G) Ul o : O» m Z C v Ot Z v m C) I < D < O ax o z m 2 X w n m I ° m m c C) m ' C C �o L o i D y G Z N. D 31 m O a O r N 3 m 7 J N m A m n D m CID D F D 111 v 4 U v m �N-I v c 1 111 Z g � m � D A � N n P. m 1T1 1�� C Dn rn m p r 0J OD G) Ul r P*Molander Lot 59 Woodcrest Drive APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot 59 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 in size. A manhole (s) permitting easy cleaning will be provided with removable 7over (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 210 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 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 bmitted with application. DATE 5/13/68 C¢ Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE 5/1i3/68 Signat of'Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE //O (///O� all Sandy Percolation Test 4 Min Clay Soil Garbage Grinder No ail Signature of Inspecting Offic r BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. T a AA4 0 fY-Q_. 1. NAME A,7e. 0 / (+tit DATE / ` "q. -V 2. ADDRESS W Qy 4 c-), e- U f, LOT NO. TEL. 3. NO. OF BEDROOMS DEN YES N0__j( 4. GARBAGE GRINDER YES NO 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES %. SHOW DIMENSIONS OF LOT Z 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. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS NAME OF APPLICAN LOCATION SEWAGE DISPOSAL DATE Aaaress or lot no, BUILDING: Dwelling 9- Other SYSTEM: New X- Repair e GENERAL DESCRIPTION OF LAND SUBSOIL: I Clay X Gr vel Sand PERCOLATION TEST 4— minutes per inch, MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK_gallon capacity. LEACH FIELD 2 1 0 lineal feet of drain pipe, )jL'-L� r -11A illiam J. Dr'sL'� "'Pv o 1, Engineer Board of Healt SEPTIC SYSTEM INSPECTION FORM ADDRESS DATE INSPECTED �- PROPERLY FUNCTIONING? OY N WEATHER CONDITIONS COMMENTS: WA^tR QLALiTY 'T'ES tE-n 2 r E-s0LTS? DYE TEST PERFORMED? Y N DATE? . SKETCH: WATERSHED RESIDENTS QUESTIONNAIRE 1. Name 2 r f -h � 2. Street Address a / INUO C Cr'-ed4D�-` 3. How many members are in your household? 4- 4. What type of sewage disposal system do you have? ❑ cesspool [B' septic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑ do not know 5. Are the plans (drawings) for yf� ur sewage disposal system on file with the Board of Health? El yes El no LSA' do not know--,.. 6. �/ How old is your sewage disposal system? El 0-5 years El 6-10 years EP 11-20 years-- z - ❑ over 20 years ❑ do not know 7. Has your se wa disposal system been rebuilt or repaired? Ino El yes ❑ do not know If yes, approximately how long ago? years. What was done? 8. frequently is your sewage disposal system pumped out? ❑ annually ,_H_,o/w L�' every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never—/ 9. Have you had any problems with your sewage disposal system? F-1yesEF 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 1_ dehumidifier drain _ sump pump toilet— roof/pavement drains shower/bathtub 11. Please state the brand andpe ('quid or powder) of detergent you use for: dishwasher AJ/ --P& � clotheswasher ,Ad — 166 w 12. Does your property have a lawn? LIQ' yes ❑ no If yes, approximately what size? ❑ less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre acre ❑ more than 1 acre (Specify) acres 13. How often do you fertilize your lawn? No. of applications per year / OSeason(s) of the year -!57u mvrt2r 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: kQ*l &1L ICA ❑ Check here if your lawn is maintained by a professional landscape contractor.