HomeMy WebLinkAboutMiscellaneous - 101 ABBOTT STREET 8/25/2015 Stanley Da:Uiowski
APPLICATION FOR SEWAGE, DISPOSAL IMIALIATION I/ Arbott St.
16)
HEALTH DEPARTMNT - NORTH ANDOVER, PASS.
I hereby make application for a permit for a sewage disposal installation at
Abbott 6ts _. 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 I%o until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2%. 1 will install a con-
crete septic tank of 100CL , I
.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 lineal (wamm) 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 3A 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 1A" (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
the line will exceed 100 feet in length and in any case, two lines of the 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 a portion of roved b t
this installation until app he�L T,
inspection officer, as p rovided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DA TE
i3.g
i n Lure of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DA TE 6 '1962
0
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DA TC,
Signature nspecting Off icer,
Percolation Test 11. min.
Garbage Grinder--- No
i
i
June 2, 1962
Miss Mary Sheridan R. N.
Health Agent
Board of Health
North Andover, Mass.
e a Miss
Dear :h r.;ry:a,d.ara ro
An examination i.on was made as requested in order to determine
the suitability of the soil for the subsurface disposal of s ewage
on the proposed Abbott Street building site of Stanley D ai.ncawski.
The land a..n general is high.
`,T'.hew; subsoil in the area was of clay content and a 4-minute
p e r c o l..a t✓i.c: n t t's t was conducted.
It is recommended that ca 1 ,000 ,ea:l_::1..on concrete septic tank
be installed t ca t r,ea t h e;r with a. ::t.8 Ca lineal feet of drain pipe.
Very truly yours,
F,
William �r* r sco lMl
BOARD OF' HEAl.,rH
TOWN OINORTH ANDOVER MASS.
✓
//o u
I.
10 NAME DATE
TEL.
2. ADDRESS LOT NO.
NOo OF DEDROOTIS a DEN YES . NO.. /7'0 0 0
GARBAGE GRINDER YES
5. SHOW DIMENSIO00 OF HOUSE
6, SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIMENSIONS OF LCr
S. SHOW LOCATION AND SIZE CP SEPTIC TANK OR CESSPOOL
9, NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10, SHOW LOCATION OF IMOOKSO STREAMS DTTCl-)ESv LEDGE OUTCROP "TC-
11. SHOW DISTANCE OF SEPTIC "TAN OR CESSPOOL FROM HOUSE
hqZQ LOCAL REGULATIONS SHOULD BE READ CAIMFUTIY.
Commonwealth of Massachusetts �„°'`p� ° I E D
w City/Town of NORTH ANDOVER
System Pumping Record T(:MN�
Form 4 �
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 forms 1. System Location:
computer,on the
use only the tab ) /[)�” ��
key to move your Address
cursor-do not NORTH ANDOVER Ma
use the return City/Town State Zip Code
key.
2. System Owner:
r�
Name
iehan
Address(if different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping 2. Quantity Pumped:
Date Gallons
3. Type of system: ❑ Cesspool(s) [ Septic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other(describe): —
4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System:
'i tc q I-
M
6. System Pumped By:
Name Vehicle License Number
Stewart's Septic Service
Company
7. Location where contents were disposed:
Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835
Signature of Hauler Date
Signature of Receiving Facility Date
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