HomeMy WebLinkAboutHealth Permit # 1/23/1998 Town of North Andover, Massachusetts Form No.3
NORTM BOARD OF HEALTH
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DISPOSAL WORKS CONSTRUCTION PERMIT
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Applicant
NAME- ADDRESS �) TELEPHONE
Site Location 7
Permission is hereby granted to Construct ( ) or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
CHAIRMAN, BOARD OF HEALTH
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APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: / . � _ / CURRE NT INSTALLER'S Y,IC;Ii11'dSIiJ#
LOCATION:
LICENSED INSTALLER: ,�-
SIGNATURE: A/11.6 ° TELEPTTONE#
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW C:ONSTUC'TION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
$75.00 Fee Attached? Yes V/ No
Foundation As-Built? Yes No
Floor Plans? Yes No
Approval Date:
50 Haymeadow
■ 2/9/98 Phoned Mike Riley to get an update on the status of the D-Box repair
■ 2/10/98 Peter Riley returned call and stated the work had been completed
■ Please note that the permit to repair the system component was applied for,
but never picked up by Riley. Work was certified by the installer. It was not
observed by this department.
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