HomeMy WebLinkAboutBuilding Permit #Exception - 67 FOSTER STREET 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received 7 /112
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION
Print 4
PROPERTY OWNER %�-
Print
MAP NO: 104y PARCEL: ZONING DISTRICT: Historic District yes
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building { One family
$Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑Other
,Sept c) Well '� DFloodpla nes ®Wetlands �O�WatershedDistct
IBM _ _.; � ►► ' :zQ
DESCRIPTION OF WORK TO BE PERFORMED:
Q L"M9 v-J d eel
Identification Plose Type or Print Clearly)
OWNER: Name:. Phone: on T- 'Lsl� ZS'O D
Address: d`1 Ewa 4-t-
CONTRACTOR Name: Phone: "-,C- :-5,37j-
Address:
b 5,37 —Address: 1.'%4Z-
Supervisor's Construction License: QS3 V'I'k, Exp. Date: _.6(1-%, I
Home Improvement License: t O 0 -1 Exp. Date: 6
ARCHITECT/ENGINEER Ste_ �� Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ I-Ae, FEE:
Check No.: Receipt No.:
NOTE: Persons contractin with unregistered contractors do not have acce s to the guaranty fun
Signatiare:_ofAgent/Own r i Signature of contractor t
1aJ
Plans Submitter Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑
Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE UrSE ONLY
INTERDEPARTMENTAL SIGN OFF - U FOR
' DATE REJECTED DATE APPROVED
El
PLANNING DEVELOPMENT El
i
COMMENTS
CONSERVATION Reviewed on �S�inature l� ��vv
COMMENTS
HEALTH Reviewed on Si nature
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature&Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgoo Street
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
;COMMENTS
tPIC 0, 22-141 50 SHEETS
aewpnu 22-142 100 SHEETS
22-144 200 SHEETS
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a L 22-142 100 SHEETS
22.144 200 SHEETS
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North Andover Health Department
[ommunity Development Division
Date: July 12,2011
Matt and Pam Rinet
67 Foster Street
North Andover,MA 01845
Re: Application for 2 story addition at 67 Foster Street
Dear: Mr. and Mrs. Rinet,
�S Your application for a deck submitted on July 11, 2011 at has been reviewed by the Health
Department. Unfortunately,the application cannot be approved by the Health Department for
t following reasons found in red:
1. x Missing information - only a partial floor plan was submitted. Also note that the septic
pan used in the application was not the actual As-Built of the septic system. This can be
b found in the Health Dept. file.
L/x Passing Title 5 inspection of septic system required
3. ❑ Location of structure not acceptable
4. ❑ Undersized septic system ***need more information before determination ****
To address the Vproblem(sl:
If#1 is checked,please supply:
a. A floor plan of the existing home and proposed addition—please label all rooms
b. Draw in the project on the As-built at the Health Dept. showing house, septice
system and proposed project in scale (this can be done in the Health Dt�_
If#2 is checked:
a. Once the Health Director reviews the room count and.gives the approval, have the
septic system inspected by a certified Title 5 inspector to determine whether it is—
operating properly: A list of licensed inspectors can be found at
http://www.townofnorthandover.com/Pages/NAndoverMA Health/permitsandreg_s
�r
67 Foster Street July 11, 2011
operating properly: A list of licensed inspectors can be found at
http://www.townofnorthandover.com/PagesNAndoverMA Health/permitsandregs
b. Tie-in to municipal sewer
If#3 is checked: NO
a. Relocate the project
• If#4 is checked: Please be aware that this cannot be determined until further .
information is receive
Please feel free to call the Health Office at 978-688-9540 with any questions you may have.
Sincerely,
u Sawy
f Public Health Director
Cc: Building Department
File
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com
Commonwealth of Massachusetts R
ECEIVED
W Title 5 Official Inspection Form
11
Subsurface Sewage Disposal System Form -Not for Voluntary Assessm �' �NORTH R67Foster Street D PAR
Property Address
Matthew& Pamela Rivet /
Owner Owner's Name r� ri`
information is North Andover Ma. 01845 7-20-2011 6 ,.�
required for every - ,t
page. City/Town State Zip Code Date of Inspection 'n Qy�/
V
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
Important:When A. General Information
filling out forms i
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not F. Paul Cardone
use the return Name of Inspector
key.
Septic Compliance, Inc. _
`rdb Company Name
447 Boston Street
Company Address
Topsfield Ma. 01983
City/Town State Zip Code
978-407-1808 978-681-0726 3294
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
performed based on m training and experience in the proper function and maintenance of on site
was pe y g p
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local
Approving Authority
or's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
e regional office of the DEP. The original should be sent to the system owner
report to the ro rlat g 9 Y
p pp p
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
Rivet 67 Foster Street No.Andover 7-20-2011•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15
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AS PREPARED
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MERRIMACK ENGINEERING -
SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS
66 PARK STREET • ANDOVER, MASSACHUSETTS Ol i l0 TEL (617) 473-3533, 373-5721