The URL can be used to link to this page

Home My WebLink AboutHealth Permit # 5/18/2007 Map-Block-Lot Commonwealth of Massachusetts 107.A-0116- ��,...e-- ----------------------- Board of Health Permltrro e BHP-2007-0125 ----------------------- ------ - ------------- " North Andover FEE ® P.I. $250.00 F.I. I Disposal Works C®nstructi®n Permit � Robert K. Daigle, Jr ----------------------------------- III Permission is hereby granted - --- - - - ---- g--' ---' - — - - - -- -- - ----- --- to(Repair)an Individual Sewage Disposal System. at No 93 RALEIGH TAVERN LANE ------- ------- ------ -------- --- ------- --- - ------ - ---- ------ as shown on the application for Disposal Works Construction Permit No. BHP 2007-012 j Dated._ May 18,2007 I� ___ ---- --- ------- Board of Health Issued On:May-18-2007 ------------------------------------------ 05/09/2007 10:57 98q7866884 p76 HEALTH �A E /02 A2POLcation ATE Construction Permit - TOWN OF NORTH AMDOVER, A 01845 $_?jq,90—Fuil_"e Mponent Ap fiqatioajs herptb ..........j, Whon(fli0q owl forma on the n Construct a new on-'site sewage disposal system* compotoe,im, only the tab Key Repair or relplace a" existing) on-site sewage disposal systemy M AY 1, 7 2 0 0? to Move your n Repair OT replace.,an existhng system cornponent What? rursor-do not use the(,%I,I)rn M/N(r, , key A. Facility .............. Address or Lot -7, 2,- *TYPE OF $EPT11C SYS TEM* FJFMMP 0 (Gra7iTi —ichoose one) 'llf PUMP System,attach copy Of Oectrilcw permit to application'"' Conventional System (pipe and stone system) F—VinflRrator or Wodiffuser(Grave8-Less) (Attach a copy of your certification to Install 0 3 type of system. Pressure Distfributilon S.A.S.(No D-80x) (Attach praft Maintenance Agreem Aq r', ) /--, , pressure Dosed (D-Box Presen,q S.A.S. P—wner !InformaVon Name S, dL ........... Addross J, A t CiwTomin �0 Code folo hone�'U'M'"llf"( Z') 4 Name OfCOMP,'A'ny"', 7- (2 41 7' state e 6P c 0 4. to phonp NFur'nbo-,ir(C'ell Phone poss;61e please) Namr.°t Company- L Slate A 7.ip Code Trlo p one NUM)e (BPSt#tc,Reach) Application for I)j3po, �1 Syq 1,0M Construction hermit Page 1 of 2 05/09/2007 10:57 97BGB88476 °'g T HEALTH PAGE 01/02 stem T Y'S DATE �••,•�-"'� 250,00-Full Repair �bBACNUS�K $125.00-Component PAGE 2 OF 2 A. aciiit Infer � i®n �c�lntinu�d.... S. Type pf Building; OR'esidential ®welling or®Commercial Agreement The iteerslg�e d agrees to system the construction and maintenance of the afore-described on-sire sewage disposal system in accordance with the provisions of Title 5 of the North nndover Code, as o place as the Local Subsurface Disposal Regulations for the Town of rv®rrh Andover, and not to place the system in operat;on until a Certificate of Compliance has been issued by this Board of Health. Date Application Approved y: (Board of Health Representative) Application Disapproved for the following reasons: For tffirce Use �rnl _.... __,..,... , ......._...,.... . ,,..,._.....,.. Fcc Atwcltedp s'cs� No Project rr r9"Oh,69at.rvn Form Attached.' 3, Fumty-Sy�p,�P If,Qa,Atta Na copivnf'�'t..,.m mod:� Yes 4, Fodndatipn As.Bjj,#t?(®2ew Construcgon ronl ; No_� (same scelc 95 appxovedplaJ2) Y) Yes No 5 F7oox P1ansa(hew 00hS:ruolfion ®rely): 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: (Address of septic syst6 ) For plans by ke 14 /a V I'll (Fns neer) Relative to the application of (Installe r's name) And dated Dated (Uriginal e. dat ) oc ay s c ate With revisions dated /(I l ' i ) (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 riot to performing any work on a site. I must have the approved plans and the permit 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 Tide 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 (1'� 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 OK (or e-inail to: hegItlidept a townofhorthandover.cog-_i) from the engineer must be submitted to the Board of Health, after which installer calls for an inspection time. 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 that simple excavation)and I am requited 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 operate 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 wall and other components. 6. As the installer,-.1 understand that I arn solely responsible for the installation of the system as 12er the approved plans. No instructions by the homeowner, general contractor, or an other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer: " 7 o�) " 7 (T ate / Zte (Name—Print) "e °m Commonwealth of Massachusetts Official Use Only Permit No. ;7 ' = Department of Fire vi Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) leave blank) APPLICATION I ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2 /4-1 - , City or Town of: NORTH ANDOVER To the Inspector of Wires,' By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) t 11� r) I J]2 i Owner or Tenant 1 Telephone No, Owner's Address tr- L Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building < 7. 611, Utility Authorization No, Existing Service lee e) Amps g tl J i, oVolt Overhead ❑ Undgrd No.of Meters J New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity (ollowin table may be waived by the Inspector of W Date......... ........ No. of Tota Transformers I(VA ORTH e " ° I.°, " Generators KVA '' �t ': °� 0 3 � TOWN OF NORTH ANDOVER N-5701 Emergency Lightffing ' PERMIT FOR WIRING A. ❑ Batter Units_ - FIRE ALARMS No,of Zones CHUS ...,.,,..,', No. of Detection and Initiatin Devices / r N No.of Alerting Devices This certifies that °......... .,or�!� t° .., J .,. KW No.of Sel - ontained, Detection/Alerting Devices has permission o perform .......,, t e:. :............ "'""f. Municipal . Local❑ t Other _C ne ion wiring in the b Wing of............. /� ,,, ... . I..... m Security Systems. ,.. . No.of Devices or Equivalent at .. .... ,. r r"..:. ,No_acth Andover ass. Data Wiring: _), No,of Devices or Equivalent Fee..................... Lic.No ,.t, .. r f ve, Telecommunications firing: ! 49!! No.of Devices or E uivalent ..) v <"`- ELECTRICAL INSPECTOR Check # ('r< � detail i esired, or as required by the Inspector of Wi. trG ry munici �l policy.) with MEC Rule 10 and upon completion. ? INSURANCE COVERAGE Unless waived by thie owner,no perrnior.the performance of electrical work may issue unle the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties of perjury, that the information on this application is true and complete, FIRM NAME: l, C ,,S 'J, LIC.NO.:1. Licensee. /' / - ' r7 �� /�'i�i � Signature � .,, , . LIC. NO,: S'ica.5 7 2 (If applicable, enter "exempt"in the license number line.) Bus, Tel. No.:17L.It 7t 7�L Address: rU _-O L7 7,zq�0 1 %-,n it"A 0 Alt. Tel. No.:f2 I *Per M.G.L c. 147,s. 0-61,security work requires Department of Public Safety"S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑ owner El owner's agen Owner/Agent tore PERMIT FEE: $ Signature Telephone No, V40 T� 4 TOWN OF NORTH NDOV PERMIT FOR WIRING s�cwua This certifies that ................. . ............................... has permission to perform,-,-. :: -A, wiring in the building, ......: E� at..,..... ....... ....:.: ..: ,. . :.. ?- ....,..,,.. ,North And ver,Mass. PrI .> It Feed .............. Lic.No.. ./.r4�JG ��;�........ '2:4 .SPELT., .. Check !1 R ,:� E""i 7410 NIAY mad Ph 2007 10: 50 r:RF_rtrdVE t:TUILHf.RS 3780877961 P. 1 MAY-23-07 WED 01 ,35 pn INFILTRATOR SYST FAX NO, OBOB777001 P, 02 fxxdvlicrnln p0 Mfr:nefrarMisrahwagoi,$oIlP(G'airs' Ira ��FaG�mfr s (carily rani lc te�r1 9!t&r ryr�r /r1 Ira �irar ora r<a( �r t ___,�^.._._ Tlal i, kea c;Gktify tTl�ak �� (�. , l t' � � for k'r• inat�llatit�n rif the INFILLI RATS Rm Imc;ialraGl e haamber aymer"n for arr tisltf,�rP/awewj' tear CJI r7c),I capplic,.rkia nsa lhis Laur5on is r(rtlfied kr) lll"tw 11 tire I T If T HA-1 On c,frlaaL r symerll � r01. �. �� as snl Sth by (ha rules a�:rf tlrc.__ �1��'��!� ��.__ Depari�ra�nrrt o1�dlealth. �n�� a, u�EITIkN rr�r C'F��s C;Srtilar,Latron e x 1,purrs oil a 4� � �� t � 2 ) lrt traU�r`�r(Tnatr.�re; if1flltr'aicar FTr�;4� s�rrh�.4!vn �u l��turca I`"'%I �+a i s+)' 7�I F ft�l,r"a`JE�I°�, �"�ar�raarrrt�r f1P�J�;ra 7 tTo.x'l6n 6 81151roao Pena Rod � Uld tiayGra�rak,CT HV5 m (MI WHO a Fay MCI gh7NI dvrubu.Frrfilfra�Pnr�ysf�an�.r�rra Irr,,�,Prallvr Irafcarrraatira r 0", irrtt. (print)__.,_._.. ,lob, CRY d Slaw f Zia f_rarKail _ �r Frfruraa fax i !) l� „i _.. _ _w. x J t'>ysBeMS kallfaT air"4ucar POeMgO Job 8le Q) InSlallcaklon l"yfv Stone P. fail e Infiltralnl ur•davrsl ('ri�r,hfcira __._.__.._._...,...._.._____..�._.__ "T"rarasJl f7lJ��'T� fale PricOf_F Who-re cfra YOU C)el yar+r A&and other ra ptic;rrr@lc;r'iWs frrarrl? .,..-- _ _......... ...... Would ycau like -�crust c0rrrPtark:,01)drams Wauld you&a to sdedote rasing rsrsr PrOdUCt in t('rrl fUlIV-0 a demo of our kru duet? EJ `'as t J& cr [Jos D No Calllcnr M Vi,1gA0 .11 UNAG 2