HomeMy WebLinkAboutMiscellaneous - 825 JOHNSON STREET 4/30/2018 (2)Commonwealth of Massachusetts
City/Town of 414�" Adkv&.
System Pumping Record
Facility Information:
System Location:
Address
City/Town
System Owner:
Name:
Adress (if different from location of pump)
State
JUN 1 2014
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Zip Code
City/Town State Zip Code
Telephone Number
Pumping Record
Date of Pumping.�� Quantity Pumped �, 6bb gallons
Type of System-- N. Septic Tank Grease Trap Other (what)
System Pumped by:
Company: ROOTER -MAN 46 Portland Street Lawrence, MA 01843
Location where contents were disposed:
Signature of Hauler E -1� Date J ��
1..
r •,, t. •�( 31y '!'„y; (} 'Yrt`(+'Yla'(,"',}+^'C l'F1'Y T.
, v. I 1. �Y.,V ✓;'C+.„/..i;, .. !., 1.... �.: '': ' .. .. . , —_
/ � Y,i.;,•}y+�'f`�r,�y�1 r. '(��' a, 1 (d' I � r.t ,Yi�pi,!/�jpjp''���. I ,r,J,J{,j(�,1.�},1��1�1�y�}��fy1i�{�r�'"r1 �Vfir�('��J� "7J���w��'r•".Y7,712, 7
.7,f.�/I I r1P{ 3E75!'•li�',i'y'l:1,f'y1�,/)flS;,,r /, t7y .j� , .i't
..•..",,
n;.Y�`'t:i,Vrf °�•i.) ��,.; i �f "lY'!vl •�;,, � ,� V1'. ,7'� "ftY r ("+��
I., it
' y � j J � I'� , �1', �' T '� �%LY I`� ) ,)' .� .O �� N O•, �• � i � � I �„ l✓ OL i�.���Y R^ � i"��-'�.�.... y�' ...'�
r,N.a
hl�DKSS SYSTCM 1.0C.a:T
), �
✓. , �:41:,����tk�'•i��E''�'ji:�E°t l; t# i'v',�. 4u' y a:'i•iri�'i.`.7:�'i.\., .. ,
9"; T I T Y P U M D o
y >• �•/r, / {1' j �,,�.�;`��7..1�1��'��i,�rJkl�f�',C,I�f:�i;l1`� Y��;'r;�;� ' ,��,
„ •.,.�',,.:��"" �" ,' �.. --------- v
J I' I �j fi c 1 t r , r• i o,�
' ;'') „�?n�4'( JY .ir�Y. �11 Tj•!•6�1L �+`,rV' 6 1+ �,•I r I'
.. '
Es S E (' T I C' T A
K N 0 Y \�
�',iTUHE,OF SER`,Y,ICE;',` ROUTINE, ' EM SRO ENCY
rUytl�1�'IIQNTU coy ci�.
' • '?l'. `• r`'\ .I �'•i/'1 11,1 l,l�i'l, �,.l� �'(� 1� nA's'�jI ;,I 1I' ; ;'
V F'. F l' L 5 IN I l, A C l'
�!, DXCSS1:1,Q1'I.RS:71Fh'O;O,QED' :
H R Al N j --
• ,'•�.�, V i'r r lY
" in
l ,!
��1�(,jli�y..>)SIr�„�i�,�l.,�{1y�(��,( �yk��ri'i�N/t�
' t },r y'': ! 4 C, ',i;:l i.�'' •�'�1 (,'7V:/�l ji!��j �','1. Y� f '/I� j, Y4�1•��V t,
�, ,J'�+ { (. : QJ'• r� f'f • i (If Si •,y �” i
IY ,_II'i Yl y)'{/�IX1:•7;11. 11 •' � .._
1 � / �- JY -Y /rnl ),�r � �vl 1, lJ".A{I�� „•+
QY i .
,•, .� r.lr,t fr. i+F J�I Yr,�St ',nu ri . •�
' .:r'� i-r':':i„'':;�,•i' � v till i.)1�
t.
• tri
1 a',T ..,` I. rl yJ �;'plS: liJ,y) t.hyr�y,StiP,4 .'e„+, •.t,.Y. •-
,+, ',1' '!: ;�:” Y'1,'.µ1,1;, ;,�II{:�p,..,•,:.4...,, --
.Ab
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
FARR, GEO
Lot # 2
I hereby make application for a permit for a sewage disposal installation at
LOt # 24 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 ioQo mal 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 ( ) 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 ma� be attached to the permit Plot Plans must be submitted with application.
DATE Gj—�/
Si ature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE �;; '�/ /
Sign ture of Health Agent
I have inspected the uncovered system indicated above and find everything done
as descCr�i ed. %
DATE
91
Signature b Inspecting Officer
Percolation Test h min Soil: Sandy -gravel
Garbage Grinder No
L -' � �� 1
1
November 16, 1963
Miss Nary.,,,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 at the Corner of. Johnsonii and Mill Streets
(Lot #2) of George H. Farr.
The land in general is high.
The subsoil in the area was of sandy -gravel content and a 4 -minute
percolation test was conducted.
It is recommended that a 1,000 gallon concrete septic tank be
installed together with 180 lineal feet of drain pipe.
Very truly yours,
William J. e iscoll
uuJD: hd
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
i
U� 12-
I
370 b
voo GA u', 7'ReJ�
D icy
f
II�i .l
1. NAME l DATE
a�`��ie/ f e�c�j ►- flrr /i is c�� /V71
2. ADDRESS_,g� LOT NO. 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
7. SHOW DIMENSIONS OF LOT
/8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
JCA 9. NOTE LOCATION AND DISTANCE OF MigjL FROM SEWERAGE SYSTEM
-/'�0 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.
FORM U
TOWN OF NORTH ANDOVER
LOT RELEASE FORM
SUBDIVISION
ASSESSORS MAP
SUBDIVISION LOT(S) 5�
PERMANENT ADDRESS (ASSIGIB' BY D.P.W.
STREET 97 e— 1 1 �-/i►_ �'n n� S /
APPLICA
DATE OF APPLICATION
TOWN USE BELOW
PLANNING BOARD
IS LINE
PHONE V Y `j
DATE APPROVED
TOWN PLANNER DATE REJECTED
CONSERVATION COMMISSION
CONSERVATION ADMIN.
/BOARD�O/F�HHEEAALL
HEALTH SOI
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT
SEWER/WATER CONNECTIONS
FIRE DEPT.
RECEIVED:BY BUILDING INSPECTION
DATE
DATE APPROVED
DATE REJECTED
DA'L'E APPROVED -,57/.z
DA'Z'E REJECTED
This form shall be signed by the agents of the Planning and Health Hoards,
the Conservation Commission prior to the issuance of any building; permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
DDmz
cnTO„
D 7m
�Om-
2
D
-4 0 fr
rn -4
z�rn
-rn --
RI _=�{
�Zrc"p
l,mcn-4
33 O -nQm
m
�OZ�
i• z 0
Z '-4T.
I booby e" llrily► art
Of .atoww an
Aplips
Aft st
a w 40AVER
MOTs: THIS it A TAPS Smov"
MOT TO 99 Uf9S POA [ STA0LISMa11•
►w0P9RTT LIMES. 1190095 , O# ANY
PUOVOSa 0T11911 THAN ITS 0111014SAL 1111901
Wig PLAN WAS Dwarll POA 11110"04410
PWa "99 OSLY. am To K S9t0ASSSk
�y
MORTGAGE PLAN!
ENGINEERING SINCE 1920
ill
PLAN OF PROPERTY IN I TME #XL ���0 , 4
D1MLDIMO ! M
Too P{.AI1 is all Tw
i ''•� �
OWNED 8Y
Y
112z a ENNYt - R - GRIL—. CAIN
y o 49a to,
�OlsTE,Q'O? SCALE: 'I = �60 DATE:
sufk,4 L.G. BRACKETT CO. INC.
WINCHESTER MASS.
CO TY: — F:X _ e PLAN BY �lA�BY�•�E�R`(�
PLAN: _ _ _ DATE: OF PLAN. — —
B6-':3\ M-1 a38
f- .
SYSTEM PUMPING RECORD
��, M1� � r • A h ` t � l t,f r
E:
! TOWN OF NORTH ANDOVE
R
SYSTEM PUMPING RECORD
� l�j i r r (, '' ,, I - i ';qr r4 a •s,r „ i l,4�4� !*4i , :'t t - - -
#9� ��"�o } + at'�I� � gra• .
,
{y a
f.� �r P7t'4jn� tG,�Pr �t>af( is a:'1 a s z e
1x wl aT x1d •
t + SYS M OWNER & ADDRESS
SYSTEM LOCATION
' (CxarsPle- t1rout of house)
Rll
f"�-Z►'t � rr t ,a
n' n t
i
,ni t tiAit k1% r ,p•a :u17 t F�Tn ]� , '�6 a 1' 6n S i�, { ...
{ `k,RATE.OF PUMPING: - v� - QUANTITY PUMPED ®co GALLONS
�^z
CFSSPOOI: x0
s YE3 SEPTIC TANK: NO YE
r ,
"""TA, ATMOF SERVICE; ROUT
INE .f EMERGENCY
BV ! '
7^ 1 AFnONS.
m olllw ... ..'
GOOD'CONDII'ION
'
HEAVY GREASE
FULL TO COVER
.
` ROOTS """"'
BAFFLES IN PLACE
__,
EXCESSIVE SOLIDS
LEACIELD RUNBACK
HFFLOODED
SOLIDS CARRYOVER_,
OTHER"""--
(EXPLAIN)
Q.E,A.;
mum
N 6 yY
a , �
N•
N•S TRA�1k'ED, TO: .
� l
TOW"N'NORTH ANDOVE4
0 � I
I I A I'L SYSTE i,PIUMPINQ RECopdi)
SYSTEM 0 R & ADDRESS
AID
DATE OF PUMPING:
RECEIVED
NOV - 3 2 00'4"
IF NORTH ANDOVER
u r-Im-ARTMENT
by5-FEM LOCAT70N
14;01-u Poo
S
PUMPED:
CESSPOOL: NO_-... YES_ SOPtic 1'ank: NO
"A rURb OF SERVICE: ROUTINE---., UMERUEN('),
OBSERVATIONS:
GOOD CONDITION . FULLTO covER
HEAVY ORF -ASE BAFFLES IN PLACE
ROOTS LEACKPIELD RUNBACK
BXCESSIVE SOLIDS— FLOODED
SOLID CARRYOVER-.....—... OTHER EXPLAIN
SY&tvrn Pwnpod by LS01-
,C3raa�rr;' 177a
WNIMENTS.
'UN FEN FS 1'KANSk*bf(nD 1-0
l3r,
k
I Jill
- -- --
n�.n,lr �tGr
Lffl4 1 d 141'1 Y x Yd r f s
;.j
,''.I�rr j ri i Y-+•i{4t✓�,YS ro�Lt 'f ..
Srr
•, i" 4 �, l+<I � ,1 { 7'tit�4 ,'r• S'' I ht, i.., l l rr .. -
DEP.hai prov(ded this form'for use by local Boards of Health. The Syst �Vh,1r cord must
be submitted to the local"Board of Health or other approving autho Ity.
A. Facility Information SEP 7 2007
;Ll-tm�ortant.
i.
:j,,,.yYhen rilUng out 1::.:; System. Location; TOWN OF NORTH ANDOVER
fOrR1i On the ALTH DEPARTMENT
oornputer,
only,the tab key Address
to move your
cursor • do not
use the re MI . Clty/Tovm State
ZJp Code
1 2 System'0wner n .
-77f"'` AddressIf diff
( erent from location).- .
CttylTown State -
r oZ : � p Coda
Telephone Number
r 6: Pumping Record
vi �irr. V� .
ra • 1 Date of Pump(ng ' Da 2. Quantity Pumped:
. Ilons
3, -,Type of system ❑ Cesspooi(s) ptic Tank El Tight Tank
❑ Other (describa); •
- ��Effluent-Tee Filter present? ..❑ Ye o If es was It cleaned?
w, yes, ❑ Yes ❑No
t �
Condit(on ofSyst�m:",
t ; � r r it it ii t + r .r '•...LIV r ... _ l
f �Y 7 ! hi 1, t"��.. �� i, t:,-, ..�,�•I wl', �1�' ,
,J
3y
Pumped By, ?:' •
� � , _ -"! r J Mama \ f•'d , , ' � :..V ' .. I
.'- Ucen$e Number .
�� Y 1rr�IrM�',a�rfydt't!�t ?i' �<�
� Sig r r -wf,--"7^•y el�t+•,i � V�.,L1 tt. �'11 k'r' Up t� , a , J -
7 � rt ar ,� ✓Yr,�Xhi'fi ftW r 1 1� t716 �t. ,I _
LocaUlon where contents Were disposed;
Date
t UPJ/rv�vrv.Mas's.gov/depJwater/app rovals/t5forms,htm#Ins ect
t5forrn4.d000.08/03
System Pumping
• P g Record • Page 1 of 1
Commonwealth of Massachusetts
N City/Town of No.Andover
System Pumping Record
Form 4
�M yey`e
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they -use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
Important:
When filling out 1. System Location:
forms on the Q. n,�
computer, use /� / 5 7 .
5 11A
only the tab key Address -
to move your No.Andover Ma 01886
cursor - do not
use the return City/TownState Zip Code
key. 2. System OW r: Y
!RE ED
tab
Address (if different from location)
TOWN Or NORTH ANDOVER ,
HEALTH DEPARTMENT
City/Town State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping l Quantity Pumped: L®��
Date Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Grease Trap
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes o If yes, was it cleaned? ❑ Yes No
5. Condition of System:
6. System Pumped By: '
Name IK/
Stewart's Septic Service
Company
Vehicle License Number
7. Location where contents were disposed:
Stewart's Pre-treatment Plant, 20 So. Mill Bradford; Ma 01835
Signature of Hauler
AT—
Signature of Receiving ` cility
Date
_2Cp _l
Date
t5form4.doc• 03/06 System Pumping Record • Page 1 of 1