The URL can be used to link to this page

Home My WebLink AboutHealth Permit # 4/26/2007 Commonwealth of Massachusetts Map-Block-Lot N 107.C-0052- ----------------------- Board of Health Permit No ® BHP-2007-0057 ` t North Andover 4 ` - ° P.1. FEE 9ssscwu4�41 F.I. ---- ----- 250.00-- Disposal Works Construction Permit Permission is hereby granted Todd-Bate-son to(Repair)an Individual Sewage Disposal System. at No 14-0-MARIAN DRIVE -- ------- as shown on the application for Disposal Works Construction Permit No. 13HP-2007 7005 Dated.__April 26,-2007----___ Issued On:Apr-26--2007 Board of Health II do ter ti I 9 t _ r TO S DATE — p Construction rmit .�° l , F IL.B�epair .- ..._._ 50 00 , X U5 6.00 Component Important: Application is hereby made for a permit to: When filling out ❑ Construct a new on-site sewage disposal system* forms on the computer,use epair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component cursor-do not use the return A. Facility Information key. fl rab Address or Lot# enm City own 2.-*°fYP ®F S PT IC SYS1"�IUI*: ump ❑ Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** ❑ Conventional System (pipe and stone system) ❑ Infiltrator or Biodiffuser(Gravel-Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D-Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D-Box Present) S.A.S. 2. Owner Information Name -------- --- - Address(if different from above) -- - City/Town StaState Zip Code T U Telepho a Number 3. Installer Information � -- - Name Name of Company Address City/Town State Zip Code c` - Telephone Number(Cell Phone#if possible please) 4. Designer Information Alle Name Name of Company y /w._ Addre 9 City/Town "'t6te Zip Code . 1-1173- 5 5 6 / "Telephone Number(Best#to Reach) Application for Disposal System Construction Permit•Page 1 of 2 µDrrlh ligation for Septic Disposal - ' of ,qti TODAY'S DATE -Construction er it - TOWN OF NORTH ANDOVER, MA 01845 $ 250.00-Full Repair $125.00 -Component PAGE 2OF2 A. Facility Information continued.... 5. Type of Building: Residential Dwelling or❑Commercial B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code, as well as the Local Subsurface Disposal Regulations for the Town of North Andover, and not to place the system in operation until a Certificate of Compliance has been iss by this Board of Health. Na Date Ap i lion Apprdved By (Bohr of�He�alW epresentative), _ r Name Application Disapproved for the following reasons: -or Office Use Only: 1. Fee Attacbed? Yes No 2. Project Manager Obligation Form Attacbed? Yes zp' No 3. Pump System? If so.Attacb cop of Electrical Permit Yes_ No 4. Foundation As-Built?(new construction ronly): Yes_ No (Same scale as approved plan) 5. Floor Plans?(new construction only): Yes_ No Application for Disposal System Construction Permit-Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction for the septic system for the property at: w .. (-Address of septic system) For plans by I.-t ` n 'n eer) Relative to the a pp lication of And dated( sr a eys name) 3 . raging ate Dated /o a sµ'9 gate With revisions dated (Last revised date) I understand the following obligations for management of this project: 1. As the installer, I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the pertrnit on site when any work is being done. 2. As the installer, I must call for any and all inspections. If homeowner, contractor, project manager, or any other person not associated with my company schedules an inspection and the system is not ready, then item three shall be applicable. 3. As the installer, I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection,without completion of the items in accordance with Title 5 and the Board of Health Regulations may result in a$50.00 fine being levied against me and/or my company. a. Bottom of Bed— Generally, this is the first`(V" inspection unless there is a retaining wall,which should be done first. The installer must request the inspection but does not have to be present. b. Final Construction Inspection—Engineer must first do their inspection for elevations, ties, etc. As-built of verbal OIL (or e-mail to: healthdel)t(a,townofnorthandover.com) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection tune. Installer must be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade—Installer must request inspection when all grading is complete. Installer does not have to be on-site. 4. As the installer, I understand that only I may perform the work (other than sinxjale excavation)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my license to overate in the Town of North Andover, significant fines to all persons involved are also possible 5. As the installer, I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached b, Inspection of the sand and stone to be used c. Final inspection by Board of Health staff or consultant. d. Installation of tank, D-Box,pipes, stone, vent,pump chamber, retaining waHand other components, 6. As the installer, I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner,general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer: (Today s Date) 7, " acne— Print) (Name—Signed) Official Use Only Permit No- � �4� aye 4 P-0-Sanity Occupancy&Fee Checked e BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date To the Inspector of Wires: Town of North Andover l 4 The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number �'.'v,- v Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes ❑ No$ (Check Appropriate Box) 1 — Bupgentiouao,aurj;o-UN utility Authorization No. VAN slouuaua0 ❑ P ❑ ❑ Undgmd ❑ No. of Meters dNl slauu0tsue11P'ON 1head ❑ Undgmd ❑ No. of Meters IRol I i Total Date 1 No.of Transformers KVA ......................r...... Generators INA f No.of Emergency Lighting o•'�`•' TOWN OF NORTH ANDOVER Batt Units PERMIT FOR WIRING FIRE ALARMS No.of zone No.of Detection and • �, • Initiating Devices '21 CHUS No.of Souncling Devices NoJ of Self Contained Detection/sounding Devices This certifies ❑ Municipal ❑ other tes that ry Mu"' v Local Connection ...................... i permission to perform ...::........................... �Voltage Y wiring in the building of .:•.... f j at... ................................... ... ass. . ,North Andover,Mass. Fee. .............. Lic.Nd ........1.. .......... ..... k{ ....t..:. ; . ELECTRICAL INSPECTOR; NO = Check # ' � rage by checking the appropriate box on Dane) ➢ i,> • Final I r r G LIC.NO. !' Alan asn Imoiun I �- L kensee — L_ +e iu^ • aq�.aw.o LIC.NO, 7 3 (- (� ,) Bus.Tel No. 3 .? '9 t q S`� u J f Address Y`'� �`1�+— y �k2 —` �c�y�� C�V• Aft Tel.No, F7 J� OWNER'S INSURANCE WAIVER: 1 am aware that the Licenses does not haye.the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No PERMITfEE S 7 (Signature of Owner or Agent) DelleChieie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, April 10, 2007 11:50 AM To: Murphy, Peter Cc: Sawyer, Susan; Grant, Michele Subject: 140 Marian Drive Importance: High Hi Peter, If you get an application for an electrical permit for this address, please let me knew. They are having a septic system installed. Thanks. 09f J?agszrsa(�, 'V awea Health Department Assistant Town of North Andover 160o Osgood Street Building 20, Suite 2-36 North Andover,MA o1845 978.688.9540-Phone � 978.688.8476-Fax http://www.townofnoithandover.com healthdept @townofnorthandover.corn i