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HomeMy WebLinkAboutMiscellaneous - 873 CHESTNUT STREET 4/30/2018Mark Oe Henry Lot ##2 APPLICATION FOR SEWAGE DISPOSAL INSTALLATION 873 Chestnut Street HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot # 2 .. 873 Chestnut Street (rear) . 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 _ 240 lineal (sere) 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 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 Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE October 9, 1967 ignature of Health Agent Y� I have inspected the uncovered system indicated above and find everything done as described. DATE //C/& d Signature of Inspecting Office Percolation Test 5 minutes Soil: clay Garbage Grinder yes Mark 0. Keary Lmt #2 APPLICATION FOR SEWAGE DISPOSAL INSTALLATION 873 Chestnut Street HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot # 2 - 873 Chestnut Street (rear) . 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 2100 lineal (ageem) 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 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 October 9, 1967 Si tature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE Signature of Inspecting Officer Percolation Test 5 minutes - Soil: clay Garbage Grinder yes I r�2 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Commonwealth of Massachusetts RECEIVED City/Town of MAY 2 6 2009 System Pumping Record Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 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. A. Facility Information 1. System Location: Left front, left re Z±side of house.Nlht front, right rear, right side of house. Address 3 City/Town State Zip Code 2. System Owner: Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping State&g,— – l p Code Telephone Number Date 2. Quantity Pumped: Gallons 3. Type of system: Ll Cesspool(s) Septic Tank Tight Tank Other (describe): 4. Effluent Tee Filter present? 0 YesIf yes, was it cleaned? [jYes a No 5. Condit' f System: C �� 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company � eAJ-0-A � /� +! F-,L� 7. Location where contents were disposed: Lowell Waste Water F 5821 Vehicle License Number j— rA - &—<J-? of H u r Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. m seem Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. be submitted to the local Board of Health or other approving A. Facility Information 1. Syst. I Location - r (�)� Address Cityfrow 2, System Owner: APR 2 4 2006 temF16nfping�gsco rd must t ART,ti�ENT R [A0 Zip Code Name Address (if different from location) Cdyrrown State Code. 6 a-) i � Telephone Number B. Pumping Record 1. Date of Pumping 4_10 p g Date 2. QuantityPumped 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ®—Ptd 5. Condition of System: Gallons ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No 6. SysteN Py� � d B . Name Company --- 7. Loc" where contents disposed: t..� S , Q, -�---- aignarure omauier hftp://www.mass-gov/dep/­water/approvalg/t5forms.htm#inspect t5form4.doc• 06103 Vehicle License Number Date System Pumping Record • Page 1 of 1 DATE: TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD ✓� ` `` -2 3 (example: left front of house) ��-scjecy�-- kz�u DATE OF PUMPING: 6 �y `QUANTITY PUMPED lV� �d� GALLONS CESSPOOL: NO YES NATURE OF SERVICE: ROUTINE OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED EY: COMMENTS: SEPTIC TANK: NO EMERGENCY YES FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) CONTENTS TRANSFERRED TO: 0 v J' LL 4- O N F-- f[3 W U' 0 v 4W4--'� TOWN OF v SYSTEM PUMPING RECORD r IV.ltoofoi�100 IP DATE: l 13 I SYSTEM OWNER & ADDRESS �Iuc S'�3 t6� twIA- SYSTEM LOCATION (example: left front —o -f house) 04— "A-a� v DATE OF PUMPING: C 1 QUANTITY PUMPED: GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.L.S.D Lowell Waste Commonwealth of Massachusetts b _, Massachusetts System Pumping Record System Owner Date of Pumping: Cesspool: No (.'1 Yes �..) System Location i13 CL&ct4�— Quantity Pumped: ,/ 50 U gallons Septic Tank: No U Yes I/ System Pumped by: Sitejea SnAr2 med License # Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector: .. BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. --7 1. NAME YY 1 AISK & 1 DATE O 1 6' 6j 2. ADDRESS 2-73 C h eC S LOT NO. Z TEL. Y)ly B I I l L 3. NO. OF BEDROOMS --s-- DEN YES NO 4. GARBAGE GRINDER YES 1/ NO 5. SHOW DIMENSIONS OF HOUSE 4 o' k Z 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL /(J00 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM foo Se -je 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. �10rU 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE " NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. Mqrk 0, Henry Lot ##2 APPLICATION FOR SEWAGE DISPOSAL INSTALLATION 873 Chestnut Street HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot #_2 - 873 Chestnut Street (rear) . 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 2hO lineal (squaw) 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 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 Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE October 92 1967 t ignature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. % DATE Signature f Inspecting Office Ki Percolation Test 5 minutes Soils clay Garbage Grinder yes Mgrk 0. Henry Lot #2 APPLICATION FOR SEWAGE DISPOSAL INSTALLATION 873 Chestnut Street HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot # 2 - 873 Chestnut Street (rear) . 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 2110 lineal (sq%eire) 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 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 Ootober 9, 1967 Q-. Si tature of Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE Signature of Inspecting Officer Percolation Test 5 mutes - Soils clay Garbage Grinder yes ' t n BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. POOP - is MHS zo TV lDo©pL j hue So 1, $3 1. NAME DATE U 2. ADDRESS LOT NO . 2 _ TEL . /Lr(.j .0 111-2-, 3. NO. OF BEDROOMS S DEN YES �� NO 4. GARBAGE GRINDER YES NO 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES r 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL ! o 00 "4 / 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM xid"VE, 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC..v')NF 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE October 7. 1967 NAME OF APPLICANT a,i3rk Henry LOCATION Lot 2, Chestnut St. Address of lot no. BUILDING: Dwelling X Other SYSTEM: New x Repair GENERAL DESCRIPTION OF LAND Hi6h SUBSOIL: Clay X GravelSand PERCOLATION TEST 5 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 1,000 gallon capacity. LEACH FIELD 240 lineal feet of drain pipe. William J. riscoll, Eng eer Board of H lth een D rive Evergt, Oo O J Q V Exis ting Foundotion Q � w Qv � F-9 I l � m o a� U rn Qboo 0 CIA d- 0 O 4i o 1 D N l � m o a� U 0 d- N D o� 3b �6 ° U �m�3D C ~O�Qoo Commonwealth of Massachusetts F CEIVED City/Town of DEC 1 1 2007 u,p System Pumping Record Form 4 TO, yr NORTH ANDOVER HEALTH DEPARTMENT 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. A. Facility Information Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. VQ ren Address Ilk City/Town 2. System Owner. 116,�c Name Address (if different from location) City/Town State Zip Code State p Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes a--9�0 If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: (A,_ A system Pumpe, LBy: Name ehicle License Number Company 7. Location eke ntents were c / C � Date t5form4.doc• 06/03 System Pumping Record • Page 1 of 1 b�L�'�- BOARD OF HEALTH 91 ( TOWN OF NORTH ANDOVER, MASS. �V 150.c-�0 � 1. NAME (�K & DATE C O 2. ADDRESS 3e. l &J Lf �� LOT NO. TEL . YY10 �9 1 1 11- 3. NO. OF BEDROOMS v� DEN YES !� NO 4. GARBAGE GRINDER YES 1/ NO 5. SHOW DIMENSIONS OF HOUSE 0 k --2--'g 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL / 0 0c) 741 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM `U0 SP----; e (-(",-I'P- 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. 14 0thf: 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.