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Home My WebLink AboutHealth Permit # 9/24/2015 U'D I A Map-Block-Lot • Commonwealth of Massachusetts 10730046 ----------------------- BOARD OF HEALTH Permit No North Andover -BHP-2015-0393---- ------- ------- -- FEE $250.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted James Kellett------------------------------------------------------------------------------------------ to(Construct)an Individual Sewage Disposal System. atNo 1-5-5-BOSTON-STREET------------------------------------------------------------------------------------------------------------------ as shown on the application for Disposal Works Construction Permit No. BHP-2015-039, - Dated September 24,2015 ------------------------------ -------------F�--------- 77 ------------- ---------------------------- ---------------------- Issued On: Sep-24-2015 BOARD OF HEALTH - -- - ----------------- -------------------- F ti on f tic i I y t � V-D r - TOWN Construction Permit TODAY' DATE OF 250.00-Full Repit NORTH ANDOVER, MA 01845 $ ` 6.,170.-Compon 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 Repair or replace an existing on-site sewage disposal system* only the tab key to move your ❑ Repair or replace an existing system component-What? cursor-do not use the return A. Facility I arm tion key. .�° (._ ._ Address or Lot# VQ —-------- ---------- no,0,0RA City/Town 78f 2.-*TYPE OF SEPTIC SYSTEM*: ➢ ;W Pump ❑ Gravity(choose one) ***If pump system, attach copy of electrical permit to application*** Y ❑ Conventional System (pipe and stone system) Y 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) ➢ ❑ Pressure Dosed(D-Box Present)S.A.S. ❑ Does the system require an effluent filter? Yes No if yes, does plan specify make and model of filter? YES =(no further info. needed) NO=(installer must specify brand of filter before DWC issuance) frlbatis the Make? A C What is the Model? 2. Owner Information --- --------- Name .I' -- Address(if different from above) .. A c City/Town State Zip Code - g Email address Telephone Number 3. Installer Information � �� I e - — Name of Compa Na y — dress City/ own State Zip Code ..... �' , Telephone Number(Cell Phone#if possible please) 4. eslgner n ar~ma I on n .1 � k 6. Name Company� - - Name � ,,, �)P Adress AM City/ own Stat ��gg g ip Code d„� `d Tel phone Number(Best#to ch) Application for Disposal System Construction Permit-Page 1 of 2 ,r lic ti on for tic i al t q i�: TODAY'S DATE Construction Permit - TOWN F _ . .W__. tq__ 00®Full Re air NORTH A. 01845 "25:OO �cmponent PAGE 2O2 A. Facility Information continued.... 5. Type of Building: plesidentiai 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 h Andover. I understand t until a final Certificate of compliance has been issued by t s oard of Heal the alkd system is not approved. t7) Date jA cati n Approve ,B oard o Health RepresentaJve) Name U Date Application Disapproved for the following reasons: For Office Use Only: Z Fee Attached? Yes No 2, Project Manager Obligation Form Attached? Yeses No 3. Pump System? If so,Attach copy ofElectrical Permit Yes . No Applicantreceived copy of "Electrical Inspection Notes for Septic Systems" Yes No Handout? . 4. Reviewed approvalletter, all paperwork received. Yes No MissinbQ: 5. Foundation As-Built?(new construction only): Yes No (Same scale as approved plan) 6. 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: ('ta#ress of s 1 tic sysrern�) For plans by .m Relative to the application of PU y l " (7sn,�;alla,r'.;° r€t rep.) And dated �f � rlgim' date) Dated ,�w,� i �� nar s 'stitc With revisions dated (lras� 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 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'title 5 and the Board of Health.Regulations may result in a 950.00 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 OIL (or e-mail to: jEi) 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 than simple exce-wation)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 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,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 l:>at<:) airac° ... rtttC: (N atytf ...k,1 tic c: LLE P, p J September 20, 2015 MR. STEWART ALLEN 155 BOSTON STREET NORTH ANDOVER, MA 01845 508-479-4001 CELL Dear Martin: The following is a summary and detailed scope of work included under the contract agreement to install a new septic system at 155 Boston Street North Andover. Approved Plan was designed by the late Richard Tangard. Original date was July 25, 2011 and revised date of September 19, 2011. Estimate Job 155 BOSTON STREET Estimate Number 693 Estimate Amount $23,236.00 Itemized charges are shown below: Item Description Amount DIG SAFE CALLING DIG SAFE FOR UNDERGROUND NOTIFIED UTILITIES TO BE MARKED FOR EXCAVATION ERROSION PLACE SILT FENCE AND OR HAYBALES TO STOP 250.00 CONTROL ANY DEBRIS FROM ENTERING THE WETLAND BUFFER ZONE PERMIT FEE PERMIT COSTS PAID TO YOUR TOWN NORTH 250.00 ANDOVER (3 BEDROOM) TRENCH PERMIT REQUIRED BY STATE FOR ANY 100.00 PERMIT EXCAVATING PUMPING PUMPING OUT OLD SEPTIC TANK SPECIFIED BY 250.00 TANK(S) PLANS EQUIPMENT COSTS OF EXCAVATOR MOVE TO JOB SITE 250.00 MOVE BOBCAT MACHINE TO FILL IN OLD SEPTIC TANK UNDER 320.00 MACHINE DECK WITH 3/8" PEA STONE PEA STONE PROPER STONE SIZE TO FILL EXISTING TANK AS 280.00 PER TITLE V CODE EXCAVATOR MACHINE TO EXCAVATE FOR NEW SEPTIC 1,000.00 MACHINE TANK AND PUMP CHAMBER LABOR LABOR FOR JOB TO SET TANKS TO PROPER 400.00 ELEVATION STONE 3/4" CRUSHED STONE TO SET TANKS ON FOR 250.00 PROPER BASE SEPTIC TANK + APPROVED 1500 GALLON MONOLITHIC SEPTIC 1,650.00 RISERS TANK SPECIFIED BY PLANS AND STATE CODES PUMP INSTALLATION OF A 1000 GALLON MONOLITHIC 3,800.00 CHAMBER PUMP CHAMBER AS SPECIFIED BY PLANS ($650.00 STANDARD ELECTRICAL ALLOWANCE INCLUDED) RISERS SEPTIC TANK RISERS TO BRING TO WITHIN 172.00 GRADE 2 risers PLUMBING PLUMBING AS NEEDED FOR ANY CHANGE 800.00 MADE IN THE HOUSE ( ALLOWANCE ONLY) PIPE & ALL PROPER PIPE & FITTING AND D- BOX TO 550.00 FITTINGS INSTALL SEPTIC SYSTEM SPECIFIED BY PLANS EXCAVATOR MACHINE TO EXCAVATE NEW LEACH FIELD 1,000.00 MACHINE TRUCKING RENTAL TIME FOR REMOVING MATERIAL OUT 640.00 OF JOB SITE MEMBRANN RETENTION MEMBRANE INSTALLED AROUND 350.00 LEACHING FIELD AS PER PLAN LEACHING TITLE 5 APPROVED SEPTIC SAND C-33 OR 39750.00 SAND CONCRETE SAND IS NEEDED FOR NEW INFILTRATOR LEACHING FIELD ( 200 TONS C-33 SAND ALLOWANCE SET BY PLANS) EXCAVATOR MACHINE TO CAST SAND INTO NEW LEACH 800.00 MACHINE FIELD INFILTRATORS ALL INFILTRATOR UNITS WITH FRONT AND END 15100.00 CAPS LABOR LABOR FOR JOB TO SET D-BOX AND 880.00 INFILTRATORS OF NEW LEACH FIELD (SET BY ENGINEERED PLANS) EXCAVATOR MACHINE TO SET FINAL GRADE OF SEPTIC 800.00 MACHINE SAND AROUND ALL INFILTRATORS IN FIELD EXCAVATOR MACHINE TO BACK FILL AN INSPECTED 800.00 MACHINE LEACHING FIELD AND TANKS WITH CLEAN USABLE (ONSITE) MATERIAL BOBCAT MACHINE TO SET ON SITE MATERIAL TO 240.00 MACHINE ROUGH GRADE FOR LOAM LOAM LOAM FOR ALL DAMAGED AREAS TO BE 1,000.00 PREPPED FOR SEEDING (ALLOWANCE BY PLAN) BOBCAT MACHINE TO SPREAD OUT LOAM FOR SEEDING 480.00 MACHINE HYDROSEED HYDROSEEDING ALL LOAMED AREAS FOR 600.00 FASTER AND PROPER GROWTH STUMP DESTUMPING 3 STUMPS TO BE DUG OUT AND 450.00 REMOVAL REMOVED OFF PROPERTY EXTRAS ANY UNFORESEEN OR ADDITIONAL WORK WILL COMMENCE AFTER RECEIVING WRITTEN OR VERBAL CONFIRMATION OF THE EXTRA WORK REQUIRED EXTRA SAND ANY APPROVED SAND OVER ESTIMATED AMOUNTS IN PROPOSAL WILL BE BILL OUT AT $24.00 PER TON INSTALLED DUE TO INCONSISTENCY OF EXISTING C LAYER THAT MAY REQUIRE ADDITIONAL MATERIAL. DAMAGE ANY UNAVOIDABLE DAMAGED CAUSED TO FAULTY OR OLD CURBS, WALKWAYS, AND DRIVEWAYS CAUSED BY HEAVY EQUIPMENT NEEDED TO COMPLETE WORK SHALL BE TREATED AS A SEPARATE REPAIR AT HOMEOWNERS EXPENSE (PLYWOOD WILL BE USED ON TOP OF DRIVEWAY FOR EXTRA PRECAUTION) ENGINEERING ANY AND ALL EXTRA ENGINEERING FEES ACCRUED TO FEES COMPLETE JOB WILL BE AT HOMEOWNERS EXPENSE LEDGE ANY LEDGE OR ROCK OVER 1 CUBIC YARD SHALL BE FACTOR REMOVED TO INSPECTORS AND OR ENGINEERS SATISFACTION AS AN EXTRA EXPENSE TO BE DETERMINED COLLECTIONS ANY AND ALL LEGAL AND OR COLLECTION FEES DUE TO COLLECTION OF MONEY FOR WORK COMPLETED SHALL BE AT THE HOMEOWNERS EXPENSE PAYMENT 1/3 ESTIMATE AS DEPOSIT AT START OF EXCAVATION, SCHEDULE 1/3 ESTIMATE TO BE PAID UPON DELIVERY OF APPROVED SAND, FINAL PAYMENT TO BE PAID IN FULL ON DATE OF COMPLETION. ALL EXTRAS ARE TO BE PAID ON DATE OF COMPLETION OF EXTRA WORK AGREED UPON. WARRANTEE THIS SYSTEM CARRIES A TRANSFERABLE WARRANTEE FOR FIVE YEARS THAT COVERS ANY FAILURE OR DEFECT IN THE COMPONENTS OF THE ENTIRE SYSTEM. EXCLUDING ANY FAILURES CAUSED BY ABUSE OR NEGLECT SUCH AS ABSENCE OF YEARLY TANK PUMPING, HEAVY WATER OR GARBAGE DISPOSAL USAGE, OR ANY HEAVY EQUIPMENT OR VEHICLES OR SYSTEM, OR ANY OTHER ABUSE NOT PERTAINING TO THE STANDARDS USE OF THE DESIGNED SYSTEM. AGREEMENT I HAVE READ AND UNDERSTAND THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS. THEY ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO BEGIN PROJECT SPECIFIED ABOVE IN CONTRACT.(PLEASE SIGN BELOW) James R. Kellett tl,ett Excavating Date Stewart Allen HoMeowner Date