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Home My WebLink AboutMiscellaneous - 130 LISA LANE 4/30/2018 +� ____930 LISA LANE � �- - 210/098.A-0064-0000.0 _.�_�- _._ _.. ��-------- �_� _ r ii - -- - - --- -- - �_,�__ - -- -� Town of North Andover, MA Watershed Septic System Servicing Report Date Ot p� Homeowner: Pumper p Street : l'Ctk"P Address.: (,til Phone L4 2 5-, q I C Phone Lt ? C . Nature of Service: Routine Emergency Observations: Good Condition Full to Cover �� Baffles in Place �`� Leachfield Runback - Excessive Solids Heavy Grease Roots Other (Explain) Description of Work: I 'r 1 Comments: 133 -6 L4 Please forward us as much of the folloWngt informati.,in thfit is, possible , Tvr)e of system 'A 7 oil S 3. T,oc.at i on., -3 4 . M8intenance records and date of I �jst pumping out Doctmientf-,tj on of repairs and reconstruction 6. Site conditions 7. Builder of S sem oo, 8. Engineer who approved; — Site — S-ystem 9 . Installation Procedure . Problems 1 0 y 0�,. - �an � aaeeo�e- A/ �R-�e/a� WATERSHED RESIDENTS QUESTIONNAIRE 1. Name lei i 2. Street Address 13o LISA LAN F joj 3. How many members are in your household? a � 4. What type of sewage disposal system do you have? j ❑ cesspool M septic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑ do not know 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? B yes ❑ no ❑ do not know.._ _- 6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years [A 11-20 years___. ❑ over 20 years ❑ do not know 7. Has your sewage disposal system been rebuilt or repaired? ❑ yes YJ no ❑ do not know If yes, approximately how long ago? years. What was done? • 8. How frequently is your sewage disposal system pumped out? Do annually !' ❑ every 2-4 years ❑ . every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes ® no If yes, what problems? ❑ repeated pump-outs needed ❑ system clogs, backs up, or drains slowly ❑ odors - El sewage surfaces through ground 10. How many of each appliance are connected to your sewage disposal system? washing machine dishwasher garbage disposal _L dehumidifier drain sump pump toilet roof/pavement drains shower/bathtub _ J r 11. Please state the brand and type (liquid or powder) of detergent you use for: dishwasher clotheswasher T.4,do ai cb-oa 12. Does your property have a lawn? ® yes ❑ no If yes, approximately what size? CA less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre ❑ more than 1 acre (Specify) acres 13. How often do you fertilize your lawn? No. of applications per year oSeason(s) of the year 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: ❑ Check here if your lawn is maintained by a professional landscape contractor. i. - Date NOR7M TOWN OF NORTH ANDOVER ,. PERMIT FOR WIRING 2E �,SSAcmUS� This certifies that ............... s ....... .. .................. r has permission to perform - �. , r7r, .fir t .. wiring in the building of . . t at..... :......:............:...... .,.....:......... i.t..:.... ... ,North Andover,Mass. Fee......-............ Lic.No.;E.. ,_1.......w............................................................ ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File O:iice Use Only z The Commonwealth of Massachusetts c��/ 31 N Nreit No; Department of Public Safety Occupancy b Fee BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12:00 3/90 (leave blank) `5 t APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Work to be performed in accordance With the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR E INFORMATION) Date e / 1�-� City or Town of— J/,0 the Inspector of %res: The undersigned applies for a permit to perform 91SA electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction wi h a but ng perziit: Yes No ❑ (Check Appropriate Box) Purpose of Building `�idl 1�k1• ILI Utility Authorization NO. Existing Service Amps / Volt Overhead ❑ Undgrd❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters Number of Feeders and A:pacity. Location and Nature of Proposed Electrical Work iy�1 Aled . �#24stx 1 yn �u,o T—e �// Y�� Z U YjJa t4G �hvT 9 No. of Lighting Outlets go No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures /0Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle OutletsNo. of Oil Burners No f BattervEmergency Lighting Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices Heat Total Total No. of Disposals No. of PumDs Tons KW No. of Sounding Devices No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers � Heating Devices KW Local❑ MunConnecnecpaltion❑Other No. of Water Heaters KW INo, of No. of Low Voltage Si ns Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total pHP VI�G OTHER: W L b�tO 'LO e— t hlveS M f1 If kh INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. 'YES& NO C3 I have submitted valid proof of same to this office. YES® NO If you have checked YES, please indicate the type of covgrage b checking the appropriate box. INSURANCE X BOND ❑ OTHER 17 (Please Specify) 11/ I1 Estimated Value o Electrical Work $ Expiration Date) Work to Start Inspection Date Requested: Rough 2— Final Signed under the enalties of perjury: /� FIRM r1Ai0; U A /y C T C (.n LIC. NO. 3 Licensee S' (4. �e Signature A1 LIC. N0. 14593-3 Address 16 Z- /LL- � rus. Tel. No. Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent