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HomeMy WebLinkAboutMiscellaneous - 96 WOODCREST DRIVE 4/30/2018TO: FROM: SUBJECT: 9(o Ors. JACKSON LUMBER AND MILLWORK CO., INC. o INTER -COMPANY MEMO w c ?� DATE: LOCATION VotfP Signed BOARD OF HEALTH 120 MAIN STREET TEL. 682-6483 NORTH ANDOVER, MASS. 01845 Ext23 February 10, 1995 Dear Lake Cochichewick Watershed Resident, District #3: As a homeowner in District three (3) of the Watershed of Lake Cochichewick, you have been previously notified of the septic pumping regulations adopted in June of 1993. This required all homeowners in your district to have had your septic tanks pumped by September 3, 1994, and every three (3) years there after. our records indicate that as of this date, you are in violation of this regulation. If our records are incorrect, please submit proof of pumping to the Board of Health Office. Failure to have your septic tank pumped within thirty (30) days of this notification dan result with penalties as stated in Section 8.4 of the North Andover Board of Health Regulations. A copy of the pumping regulation is enclosed. The Town of North Andover relies on a cooperative effort to ensure a safe drinking water supply. As a watershed resident it is vital that you comply with all standards set in regards to this effort. If you have any questions, please do not hesitate to call the Board of Health Office at the number above. J T h Agent G 0110_- �C3C)1 ^ - c _ c '803721 1 Q . 0=8018 tA r. CO � "r .. ' 1' 4 +l Ta• ' �1• P ;_,P ';_. f `f L� 'c-` .iAe¢y}• ,�S °[� •'riir' fOsji ��_ in 0 .` �/• � ' 30 1320-— Y � �,JtL`6%fL''{'�0. 1°•-P �P�,. : � '� �y 6¢yE. M} �T.�4t � ' 6�a'. 0 7.M J T h Agent P 0 w N2 3780 Date. .(f ......... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...... has permission to perform...... — plumbing in the buildings of .............. at:174 ...... North Andover, Mass. Vbv - Fee /L . 1 ... Lic. No. 1� -197 . ........ PLUMBING INSPECTOR 08/06/98 09:33 15.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION /O�MIT TO DO. PLUMBING (Print or Type) f'1 dt�'U $r Mass. Date PermitAt Building Location W-66rd�lCCOSt 'Drll/�Owner's Name Al0 a y e r , /yo, 0/6 I's Type of Occupancy�PS New Renovation Replacement ❑ Plans Submitted: Yes ❑ No FIXTURES k. 'Installing Company Name __ WHITE ROCK PI-I,IMBI•NG & HT -G. Check one: Certificate j Address P.O. BOX 728 Corporation 1(o096_.. ❑ Partnership Business Telephone: 97A 975 4-2 q q ❑ l ., Name of Licensed Plumber tc Ob G r+ \b I aac [2 E 4+e i INSURANCE COVERAGE: I have a curve t liability insurance policy or its substantial equlvale•nt whN .wy, th h r.e requirements of MGL Ch. 14 2. Yes)z No O If you have checked yes, please indicate the type coverage by ehecklnjj r►w A"xnpr,aer II0I1. • A liability Insurance policy Other type of indemnity O P w%d l ; OWNER'S INSURANCE WAIVER: I am aware that the licensee does not kavv It,...,,,ulance coverage required by Chapter 142 .r ow ..,a.. General Laws, and that my signature on thispermit application waive, th1k rv-qt,I,*..x,N, i Check ,srw Signature of Owner or Owner's Agent Owner ij kgrnt 1 Iwdq fM,M IAN all a M,► dr1MI, .d -fo., ~ 1 Iu...ub,.,.,w�d for .tt1 rn M aN,..r .,d+ r.rw .w N,d , r.11aur,r„ PP' --'d u„d" ,r,► PI --I ,,,urd Ior rh, .Pol.[.,,on ...11 rr ,.. ca„P1i r ....w rl �� .,d YrWM 10 101 An,wrd.► Ind .' t.r.,...1 Iia— ^^".^' d rM Coder -.*I V � • � i •.N t,M M 1 ■■■■■■■■■■■■■■■■■■■SENSE BASEMENT ■■■■■E■ENNE■NEN■ENNEEr�E■ ..■NNN■■EEEEE■EEE■EEEEENN■ Nigel. ■NEEE■ES■E■ESNEESESNEENE FLOOR■EEEEE■EE■■■■■■■■■®SSSS■ k. 'Installing Company Name __ WHITE ROCK PI-I,IMBI•NG & HT -G. Check one: Certificate j Address P.O. BOX 728 Corporation 1(o096_.. ❑ Partnership Business Telephone: 97A 975 4-2 q q ❑ l ., Name of Licensed Plumber tc Ob G r+ \b I aac [2 E 4+e i INSURANCE COVERAGE: I have a curve t liability insurance policy or its substantial equlvale•nt whN .wy, th h r.e requirements of MGL Ch. 14 2. Yes)z No O If you have checked yes, please indicate the type coverage by ehecklnjj r►w A"xnpr,aer II0I1. • A liability Insurance policy Other type of indemnity O P w%d l ; OWNER'S INSURANCE WAIVER: I am aware that the licensee does not kavv It,...,,,ulance coverage required by Chapter 142 .r ow ..,a.. General Laws, and that my signature on thispermit application waive, th1k rv-qt,I,*..x,N, i Check ,srw Signature of Owner or Owner's Agent Owner ij kgrnt 1 Iwdq fM,M IAN all a M,► dr1MI, .d -fo., ~ 1 Iu...ub,.,.,w�d for .tt1 rn M aN,..r .,d+ r.rw .w N,d , r.11aur,r„ PP' --'d u„d" ,r,► PI --I ,,,urd Ior rh, .Pol.[.,,on ...11 rr ,.. ca„P1i r ....w rl �� .,d YrWM 10 101 An,wrd.► Ind .' t.r.,...1 Iia— ^^".^' d rM Coder -.*I V � • � i •.N t,M M 1 SEPTIC SYSTEM INSPECTION FORM ADDRESS 9( U� DATE INSPECTED PROPERLY FUNCTIONING? N WEATHER CONDITIONS COMMENTS: WA -ER aVALVTY TEs I Et, ? uesot---$� DYE TEST PERFORMED? Y N DATE? SKETCH: i WATERSHED RESIDENTS QUESTIONNAIRE 1. Name �(' 2. Street Address / ���dD�,�G s% 3. How many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool [Y' 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? 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. Has your sewage disposal system been rebuilt or repaired? m yes ❑ no ❑ do not know If yes, approximately how long ago? 2— years. What was done? ✓ U 8. How frequently is your sewage disposal system pumped out? C0/ annually ❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never O. 9. Have you had any problems with your sewage disposal system? ❑ yes Rf 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 you✓r Sewage disposal system? washing machine ✓✓ dishwasher garbage disposal dehumidifier drain - sump pump ✓ toilet roof/pavement drains showertbathtub 11. Please state the b anda�type (liquid or powder) of detergent you use for: dishwasher clotheswasher Wy 12. Does your property have a lawn? yes ❑ no If yes, approximately what size? ❑ less than 1/4 acre 5� '/4 acre ❑ 1/z acre ❑ 3/4 acre ❑ 1 acre Elmore than 1 acre (Specify) acres 13. How often do you fertilize your lawn?� No. of applications per year Seasons) of the year Q_. 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. iD4� _ �J111, v APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. hereby make application for a permit for a sewage disposal installation at 5 I40 A- e1e-e-,� . 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 -1'r7-6 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 '_� ,3,0 lineal (square) feet of effective absorption area. The pipes will be ]gi.d 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 13et'ween the center lines of the disposal field trenches and the average depth oftrench 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 Sign 'ure 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 2,6 l ignature of Insp6cing Officer Percolation Test Garbage Grinder BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. 1. NAME__ -w, 0 v cL DATE 2. ADDRESS /o a a/c e •P e LOT NO. 52 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 H. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL g. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM / or7V 6� "I' L 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 tJ BUILDING: Dwelling Other SYSTEM: New Repair GENERAL DESCRIPTION OF LAND SUBSOIL: Clay Qavel Sand PERCOLATION TEST minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK_Id-y-7 gallon capacity. LEACH FIELD lineal feet of drain pipe, )AIL William J. Dr i o , Engineer Board of Healt *1 BOARD OF HEALTH 146 MAIN STREET TELEPHONE# (508) 688-9540 A PPLICA TION FOR ABA NDOAMENT OF SUBSURFACE DISPOSAL SYSTEM (SEPTIC SYSTEM) Pursuant to Section. 310 CMR 13.354 of the State Environmental Code, Title V Name Phone Address ` elye Contractor hired for work: Name RaM[ '{ COJTKPCToeS Phone Address 33 ©PV- iso u- F -AP , M c,-- 1-4 -)e�j Date for scheduled abandonment I - Loo -9 °v The septic system at the above address has been abandoned according to Title V specifications. Siga6ure of Contractor Method of septic tank abandonment (check one). () removal () sandfill (0 crush ( ) other Name of Offal Hauler 'EC6- h This form must be returned to the North Andover Board of Health. PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH Inspecting Agent REPRESENTATIVE'S USE, ONLY. 1-/G - 7 � Date TOWN OF ANDOVER SEPTIC SYSTEM SERVICING REPORT Date: Homeowner: Pumper Street Address:� SGP Phone Phone el l Nature of S-arvice: Routine Emergency Observations:. Good Condition Full to Cover Baffles in Place Leachfield Runback Excessive solids Heavy Grease Roots Other (Explain) Description of Work: Comments: