HomeMy WebLinkAboutHealth Permit # 11/19/2003 Commonwealth of Massachusetts Map-Block-Lot
1043-0108-
-----------------------
Board Of Health Permit No
BHP-2003-0374
North Andover ------ ----------------
P.I. FEE
F.I.
$250.00
-----------------------
Disposal Works Construction Permit
Permission is hereby granted John-DiVincenzo------------------------------------------------------------------------------------
to(Repair)an Individual Sewage Disposal System.
atNo -8-1--SAW-MILL-ROAD--------------------------------------------------------------------------------------------------------------------
as shown on the application for Disposal Works Construction Permit No. BHP 2003-037--- Dated 03.
------------------------------------------------- --
Issued On:Nov-19-2003 Board Of Health
......................................................................................................
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE:--/-
' G CURRENT INSTALLER'S LICENSE#
���` �
LOCATION: S �
�,
`� C `�. � �'1, ! C. l..
LICENSED IN TA LER: G '
SIGNATURE: :%< (� � ._ . ... ..... TELEPHONE# l ..
CHECK ON
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
$
_ 00 Fee Attached? Yes No __-
Foundation As-built? Yes No
Floor plans onye?,„� � -Yes No
Appr°oval w z Date
- -