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HomeMy WebLinkAboutMiscellaneous - 700 MIDDLETON STREET 4/30/2018 (2)IF. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK POWNER TYPE OR PRINT CLEARLY CITY : _ _ I MA DATE — ( PERMIT # JOBSITE ADDRESS ®� I�i1�l,� 1 OWNER'S NAME_L ADDRESS TEL= FAX - OCCUPANCY TYPE COMMERCIAL QI EDUCATIONAL © RESIDENTIAL NEW: RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES ® N0f9 FIXTURES Z FLOOR--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM L DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM I _� (� _. I I ___ _I I DEDICATED WATER RECYCLE SYSTEM 1 1 ._.-..__I DISHWASHER _ �I ___.... _ I __ _ .._.___I ._.__. J ___- _ ,-- _.__._ ! _.__.l ----_-._.I. _-__I I _.__.__I DRINKING FOUNTAIN _f .._____� ------- _.._____I .___.._I I _____._J _.....__I ___-___ .._._.._._J .._.._.. I ------ ___-.._I ........-I FOOD DISPOSER i .-----_.1 � ( _i I ^._� ._-.___ ! -------- -___..FLOOR/AREA FLOOR/ AREADRAIN I _____(_.__ ► ____ _..___ I _....__.I ___._1 __-._..__i �.__. ..___._ _ __. .__._ I I .. _....__..I INTERCEPTOR (INTERIOR) KITCHEN SINK € __.__.I _—_...- _._- --__._,_I ------ J----.J_-_-J .-_... —_-- LAVATORY ROOF DRAIN~ --- SHOWER STALL SERVICE/ MOP SINK TOILET I [ ___.I _ _ __. ___.J ___j URINAL WASHING MACHINE CONNECTION _� TER HEATER ALL TYPES "',1-kTER PIPING ( i t f i( I I I E-J, I d -_._J i i i E_ ____I ._ i -----i --.f i )THEIR INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES X NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY D4 OTHER TYPE OF INDEMNITYE11 BOND D OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER _i AGENT 0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application ar rue and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be ino liance with Perti t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME LICENSE # SIG ATURE mp29 JP CORPORATION FJ# PARTNERSHIP®®# __ ;LLC0 COMPANY NAME Y2 _ �((� ADDRESS CITY- 1 STATE �l!►s ZIP b rQ (J'% i TEL '7 FAX ( CELL ?-�- w ��1�. AIL O O H � U a w o F] z (n O F— v1 W O W a. * Z z t a I -- U) w U) a ur co a p z U :3 CL IL LU S W I^ LL H O H H U a �7 a a O a .v ( The Commonwealth of Massa. chusetts z Department of IndustrialAccidents e 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: ?d City/State/Zip: i X d 'v- p 9t I i 'Fj Phone #: -) 91 LO --0 f-% Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ I am a employer with employees (full and/or part-time).* 7. New construction 2'Nl am a sole proprietor or partnership and have no employees working for me in 8. E] Remodeling any capacity. [No workers' comp. insurance required.] 9. ❑Demolition 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 10 ❑Building addition 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole 11. ❑ Electrical repairs or additions proprietors with no employees. 12.E] Plumbing repairs or additions 5. I am a general contractor and I have hired the sub -contractors listed on the attached sheet. ❑ 13. �] Roof repairs These sub -contractors have employees and have workers' comp. insurance.# 6.❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 14. El Other 152, § 1(4), and we have no, employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must -attached an additional sheet showing the name of the sub -contractors and state whether or not, those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees.' Below is the policy and job site information. Insurance Company Name:. Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify frrgder the pains yVd penalties of perjury that the information provided above is true and correct. Phone# Official use only. Do not write in this area, to be completed by city or town official.. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of"hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-in'sur0d companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia �- I W) VtWTI'-� North Andover Board of Health Meeting Minutes Thursday — October 27, 2015 7:00 p.m. 120 Main Street, 2"d Floor Selectmen's Meeting Room North Andover, MA 01845 Present: Thomas Trowbridge, Frank MacMillan, Larry Fixler, Edwin Pease, Susan Sawyer, Michele Grant, Lisa Hadge CALL TO ORDER The meeting was called to order at 7:04 pm. II. PLEDGE OF ALLEGIANCE III. PUBLIC HEARINGS IV. APPROVAL OF MINUTES A. Meeting minutes from September 24, 2015 were presented for signature. Motion was made by Mr. Fixler to approve the minutes, the motion was seconded by Mr. Pease, all were in favor and the minutes were approved. V. OLD BUSINESS A. 700 Middleton Street — James Morin, representing owners of 700 Middleton Road requesting: 1. Local Upgrade Approval request to reduce the setback distance from the private well to the proposed leach field of 77 feet where 100 feet is required. (3 10 CMR 15.405(1)(g) 2. Local Upgrade Approval request is required to have only one test pit in the proposed leach field area where two are required. (3 10 CMR 15.405(1)(k) 3. Variance request from the NA BOH local of setback distances of wetlands to a SAS of 51 feet where 100 feet is required. Jim Morin approached the podium. Mr. Morin stated that he is a registered sanitarian in the state of Massachusetts. A discussion ensued regarding the proposed septic system at 700 Middleton Street and the requests before the Board. Dan Ottenheimer, Mill River Consultant, reminded the Board that this request was brought before them at a previous meeting. There is a nearby well and the concern was the proposed septic system being replaced within 100 feet of a well. A representative for Mr. Morin was at the previous meeting and he was not able to answer some of the Boards questions regarding the well so he was asked to do some homework and come back to a future Board meeting. Mr. Morin stated that they hired a lab to come into the property and obtain a water sample from the kitchen sink. The well water testing results have been forwarded to the Board and the well water testing came back clean. A discussion ensued regarding the well. Mr. Morin explained that no expansions or additions to the home are proposed. The homeowners are selling the property and retiring. The home is a four bedroom and will stay a four bedroom. Mr. Morin stated that he has filed with Conservation pertaining to the wetlands and offsets. He stated that Conservation has given their verbal approval and Mr. Morin can pick up the conditions at the next Conservation meeting. A discussion ensued regarding the soil testing at the site and the 2015 North Andover Board of Health Meeting Page 1 of 6 Board of Health Members: Thomas Trowbridge, DDS, MD, Chairman; Larry Fixler, Member/Clerk; Francis P. MacMillan, Jr., M.D.; Joseph McCarthy, Member; Edwin Pease, Member Health Department Staff: Susan Sawyer, Health Director; Debra Rillahan, Public Health Nurse; Michele Grant, Public Health Inspector; Lisa Hadge, Health Department Assistant proposed placement of the septic system. Dr. MacMillan asked Mr. Ottenheimer if he had any comments or concerns regarding the second request of having only one test pit. Mr. Ottenheimer stated that he did not see any concerns. Dr. Trowbridge asked Mr. Ottenheimer that since the Board now has a baseline test of the water and the up gradient, even though there are no guarantees, can the Board accept it? Mr. Ottenheimer stated it is subjective but if the well was not contaminated with the existing system there is very little risk of contamination with the new proposed system. Motion was made by Dr. MacMillan to approve the two local upgrade approval requests as listed in the agenda as well as the variance request as printed in the agenda. Motion was seconded by Mr. Pease. All were in favor and the motion was approved. VI. NEW BUSINESS A. 440 Boston Street — Douglas Smith, representing owners of 440 Boston Street, requesting: 1. Local upgrade approval for the requirement of a 4' separation between the bottom of the soil absorption and high groundwater with a reported perc rate of 3 min per inch. This results in a 1' reduction resulting in the bed bottom being 3' above high groundwater. (3 10 CMR 15.405(h)) 2. Requesting a local upgrade approval for the requirement of a 12" separation between the inlet and outlet tees and high groundwater. A 10" separation is provided for the septic tank and a 5" separation is provided for the pump chamber. Rubber boots are provided on tank and pump penetrations. (3 10 CMR 15.4050)) Douglas Smith approached the podium. A discussion ensued regarding the proposed septic system at 440 Boston Street and the requests before the Board. Mr. Smith stated that the home does not have a full foundation but has a crawl space. He stated that the proposed system fits in well with the property and is esthetically a good situation. Mr. Smith described the layout of the property and surroundings. The driveway is about 250 feet with the house sitting sideways with no street anywhere near the system at all. He stated that the land has an unusual shape. Mr. Smith reviewed the property lines. Dr. Trowbridge asked Mr. Ottenheimer to review the inlet/outlet tees and groundwater. Mr. Ottenheimer explained that because of how the house is built they can't comply with the design standards and the code. Mr. Ottenheimer reviewed design standards and the risk of a tank sitting in the ground water table. He reviewed what the code says to prevent this risk. Mr. Ottenheimer stated that because Mr. Smith doesn't have the flexibility to change where the pipes come out of the house he can't raise up the tank to comply with the code. Dr. MacMillan asked if 12" to 10" is substantially different with regards to risk. Mr. Ottenheimer stated it was not. An explanation ensued regarding the limitations with the existing basement. Dr. MacMillan asked Mr. Ottenheimer if he had any reservations approving the two requests that were being requested. Mr. Ottenheimer stated that the Board has had questions regarding this local upgrade approval in the past to reduce the distance to the ground water. Mr. Ottenheimer reviewed what Title V addresses. This request has been granted before in the past, but there have also been times where it hasn't been granted. Dr. MacMillan asked if the property was in the Lake Cochichewick watershed. The property is not. A discussion ensued regarding the proposed system location. Mr. Ottenheimer reviewed the code with the Board. There are two options for full compliance under Title V and there is an additional option which is to request a reduction of the groundwater offset from 4' to 3'. This can be granted but the code does give two options for full compliance which would be preferred. A discussion ensued regarding the proposed septic system. Mr. Smith stated that not approving the requests before the Board could be a hardship to the current homeowners with their buyers. The homeowner asked to address the Board. She stated that she has lived there along with five other people for twenty eight years with no issues of flooding. The delay would possibly cause them to lose their buyers. Mr. Fixler asked Mr. Smith if he thought coming up with a larger system and asking for the local upgrade approval was better alternative to the two Title V options that Mr. Ottenheimer had mentioned for compliance. Ben Osgood Jr., engineer for a couple of requests on the agenda, approached the podium. Mr. Osgood discussed his thoughts as a designer for justifications on the Freduction resulting in the bed bottom being 3' above high groundwater. A discussion ensued regarding Title V and the local upgrade approval. Dr. MacMillan stated that what Mr. Smith requests, seems reasonable. Motion was made by Dr. MacMillan to approve the request, as listed in the agenda, for the requirement of a 4' separation between the bottom of the soil absorption and high groundwater with a reported perc rate of 3 min per inch. This results in a 1' reduction resulting in the bed bottom being 3' above high groundwater. Motion was seconded by Mr. Fixler. All were in favor and the motion was approved. North Andover Board of Health Meeting Minutes Thursday — October 27, 2015 7:00 p.m. 120 Main Street, 2°d Floor Selectmen's Meeting Room North Andover, MA 01845 Motion was made by Dr. MacMillan to approve the request as listed in the agenda for the requirement of a 12" separation between the inlet and outlet tees and high groundwater. A 10" separation is provided for the septic tank and a 5" separation is provided for the pump chamber. Motion was seconded Mr. Fixler. All were in favor and the motion was approved. B. 415 Winter Street —Benjamin Osgood, Jr., representing owners of 415 Winter Street, requesting: 1. Local upgrade approval to allow a reduction in the separation distance between the water table and bottom of leach stone in the leach field from 4 feet as required by Title 5 Section 15.212 to 3 feet. 2. Local variance for reduction in the offset distance between the edge of a leach field and a wetlands from 100 feet required to 55 feet. Ben Osgood Jr. approached the podium. Mr. Osgood gave information regarding the home's septic systems history. The system is a reconstruction of what was done about 10 years ago. The home is an older duplex. Mr. Osgood's firm was hired originally in 2001 to design a replacement system. The soil testing was done, permits pulled and the system was installed per the plans. He recently received a call from the owner looking for a designer and Mr. Osgood just happened to have been the designer back in 2001. Mr. Osgood gave his opinion on why the current 15 year old system failed. He stated that there had been home renovations and items i.e. paint was put down the drains that shouldn't have been. His opinion was that the system failed from abuse.. Pumping records showed it was only pumped once or twice since it was last installed. The septic plans were done and he has gone before Conservation. He is asking for same waivers that were asked for originally. Mr. Osgood reviewed his requests for approval. Dr. MacMillan asked if they planned on just excavating the sight and reinstalling the system. Mr. Osgood stated that was the case. The regulation from the last installation is still the same as before. Mr. Osgood stated that if the system was not misused, the system probably would not have failed. A discussion ensued regarding maintaining a septic system, the lifespan of a septic system and the current proposed system and an addition of a wall. Mr. Osgood would like to dig down a foot or more until good clean sand is identified. It will be replaced by another type of sand. Ms. Grant asked Mr. Osgood if he planned on removing and replacing the current sand. Using less sand could mean a good savings to the home owner, added Ms. Grant. A discussion ensued regarding replacing the sand and the type of sand. Ms. Grant added that an out of season permit can be pulled in emergency situations if time runs out. Motion was made by Mr. Fixler to approve both requests as listed in the agendas; it was seconded by Mr. Pease: -to allow a reduction in the separation distance between the water table and bottom of leach stone in the leach field from 4 feet as required by Title 5 Section 15.212 to 3 feet. 2015 North Andover Board of Health Meeting Page 3 of 6 Board of Health Members: Thomas Trowbridge, DDS, MD, Chairman; Larry Fixler, Member/Clerk; Francis P. MacMillan, Jr., M.D.; Joseph McCarthy, Member; Edwin Pease, Member Health Department Staff: Susan Sawyer, Health Director; Debra Rillahan, Public Health Nurse; Michele Grant, Public Health Inspector; Lisa Hadge, Health Department Assistant -reduction in the offset distance between the edge of a leach field and a wetlands from 100 feet required to 55 feet as written on the agenda. Chairman called for discussion. Ms. Grant had an additional item for discussion. She requested the board consider adding a requirement to test the sand to ensure compliance with Title V standards and if it does not pass, it will be replaced by C-33 sand. Larry Fixler offered the amendment to include the following; that the original sand that is in the ground below the system, is to be tested. If it doesn't pass as Title V sand, the sand will be completely removed and replaced with C-33 sand. Motion was seconded by Mr. Pease. There was a unanimous vote by the board for the amendment. The chair returned to the amendment to the motion. Frank MacMillan made the motion to approve the amended motion and Mr. Pease seconded the motion. All were in favor and the complete motion below was approved. -to allow a reduction in the separation distance between the water table and bottom of leach stone in the leach field from 4 feet as required by Title 5 Section 15.212 to 3 feet. -reduction in the offset distance between the edge of a leach field and a wetlands from 100 feet required to 55 feet as written on the agenda. - that the original sand that is in the ground below the system, is to be tested. If it doesn't pass as Title V sand, the sand will be completely removed and replaced with C-33 sand. C. 415 Boxford Street — Benjamin Osgood Jr., representing owners of 415 Boxford Street, requesting: 1. Local upgrade approval to allow a leach field to be designed in an area with only one test pit in lieu of 2 as required by Title 5 sections 15.405 (k). Mr. Osgood gave history of the property located at 415 Boxford Street. The reason for the failure was that the owner installed a water softener and the back flush went into the septic system. The water softener can cause a failure by the salts going into the tank and then the solids going out into the system. The homeowner is sold a product and does not know it could fail their septic. A discussion ensued regarding installation of water softeners. It was noted that no permits are needed to install water softeners. Ms. Grant compared it to a garbage grinder. She stated that no garbage grinder is safe for a septic system and yet, the manufacturer and sales person markets it as safe for septic systems. She also stated that homeowners may not be educated on the dos and don'ts of a septic system. The new plan will include a location for a drywell for the back flush of the water softener. Mr. Osgood discussed the proposed septic system and what was being requested by the Board. It is the same as the plan for the system currently in the ground. The designer feels that this system was properly designed and the local upgrade approval given by the board of health a decade ago was appropriate and they are still the best application for the property today. Mr. Ottenheimer did not see a problem with the local upgrade approval being requested. Motion was made by Dr. MacMillan to approve the local upgrade approval as listed in the agenda to allow a leach field to be designed in an area with only one test pit in lieu of 2 as required by Title 5 sections 15.405 (k). Motion was seconded Mr. Pease. All were in favor and the motion was approved. D. Town of North Andover Dumpster Regulations — To amend section 2.2 of the local regulation: to modify the annual expiration date for a permit to maintain a trash or refuse dumpster from the calendar year to the last day of February in order to be aligned with the food permits. To amend section 2.4 to exclude certain parties from this regulation. The amendment will take effect immediately. Motion made by Dr. MacMillan to amend the dumpster regulation by way of addition and deletion as stated in the agenda. The motion was seconded by Mr.Pease. All were in favor and motion was passed. E. Town of North Andover Regulation Concerning the Hauling and Disposal of Solid Waste — Susan Sawyer described the need to modify the regulation to eliminate conflicting phrases regarding distinction between hauling waste and traversing the town roads. This regulation oversees the movement of the trash trucks that go to Wheelabrator, TBI and Covanta solid waste facilities. Authority to set truck routes was given to the Town's Board of Health as North Andover is the host community to multiple facilities. The board felt it necessary to exercise that right. The regulation has been modified on occasion to attempt to make it more understandable and workable to the N. Andover Police Department and the Health Department. The NAPD does the enforcement on these vehicles for the Health Department. Larry Fixler commented on the process that was done to identify sections or phrases of the current regulation that North Andover Board of Health Meeting Minutes Thursday — October 27, 2015 7:00 p.m. 120 Main Street, 2"d Floor Selectmen's Meeting Room North Andover, MA 01845 conflict with other sections or phrases. The corrections proposed are all in line with the intent of the regulation as first approved. Health staff and Larry Fixler spent a number of hours going line by line to find inconsistencies. It is the intention to reduce the conflicts that arose last year. Nothing of substance or of the original intent has been changed. We also took out sections that were basically outdated and not relevant on how the regulation is applied and corrected process inconsistencies. This is a change in process. We fully expect that other items may come up from time to time that may need addressing. At that time the Board can take action on those items. It did not meet the timeline to be sent prior to the trash truck applications, but everyone who should be aware and will have to comply with the changes to be fair to all. The process is ongoing and these changes are needed to be in place for this renewal period. Larry Fixler noted that the office will notify the public via local newspaper and for the Ed Pease presents that he has reviewed and marked up the document for numerous grammatical errors and formatting errors. It is just clean up stuff, not sustentative. He noted the use of capitals; missing periods etc. Larry pointed out that Ed's capacity was not as a legal advisor for this review. These are editorial comments and Dr. Trowbridge proposed that he would be able to review and approve the final draft, but the vote can be taken now and signed at the November meeting. The final revised document will be distributed as soon as it can be signed. The final approved, but unsigned document will be distributed prior to signing to assist the applicants. Ms. Sawyer noted that these changes do not affect any permit holder or applicant to appeal any decisions made by the staff reviewing the applications. Motion made from Dr. MacMillan moved to accept the changes as presented and the Board will designate to the chairman final approval of any grammatical corrections that he deems are necessary. Larry Fixler seconded. All were in favor and the motion was passed. VII. COMMUNICATIONS, ANNOUNCEMENTS, AND DISCUSSION A. 2016 BOH Agenda — Due to renovations of Town Hall, the 2016 BOH agenda was presented with the meeting days to be held on the fourth Tuesday instead of Thursday for 2016. The Superintendent's room at 566 Main Street was suggested. The Superintendent's room is about the same size of the Selectmen's room and is wired for recording with NA CAM. Parking is convenient. There was no opposition in changing the meeting from a Thursday to a Tuesday by members present. Dr. Trowbridge asked if there was anything written anywhere in the Town Charter or By -Laws stating that the Board is to meet on a Thursday. The Health Department staff will look into whether or not it is written anywhere that the day must be the 4`h Thursday. A vote will be held off until the next BOH meeting if there is a need to address. VIII. CORRESPONDENCE / NEWSLETTERS Mrs. Sawyer gave feedback on the recent flu clinic held at North Andover High School. Over 530 vaccinations were given. The next flu clinic will be held on November 5, 2015 from 2-3pm at the Senior Center. Everyone is welcomed. There is no charge, but please bring your medical cards. 2015 North Andover Board of Health Meeting Page 5 of 6 Board of Health Members: Thomas Trowbridge, DDS, MD, Chairman; Larry Fixler, Member/Clerk; Francis P. MacMillan, Jr., M.D.; Joseph McCarthy, Member; Edwin Pease, Member Health Department Staff: Susan Sawyer, Health Director; Debra Rillahan, Public Health Nurse; Michele Grant, Public Health Inspector; Lisa Hadge, Health Department Assistant ' Ms. Rillahan, Public Health Nurse, has also been signing up people for pneumonia clinics and has been doing homebound who need flu shots. Please call the Public Health Nurse if you need a flu shot and are homebound. Merrimack College Give Back Program will be coming up on November 7th. There are over 100 volunteer students coming to clean up around the lake and Ms. Sawyer also coordinated with the NA Housing Authority to have 40 student volunteers to help beautify their community rooms and surrounding grounds. The new Fire Station's "open house" will be on the morning of November 7"'. Mrs. Sawyer stated that it is time for permit renewals. The reminder letters are set to be mailed out at the end of the week. When establishments receive their new permits, they will also receive a letter to let them know that their food and/or dumpster permits will run through the end of February 2017. Permits will then run from March I" through February 28th of each year after. IX. ADJOURNMENT MOTION made by Dr. MacMillan to adjourn the meeting. Mr. Fixler seconded the motion and all were in favor. The meeting was adjourned at 8:53 pm. Prepared by: Lisa Hadge, Health Dept. Assistant Reviewed by: All Board of Health Members & Susan Sawyer, Health Director Signed by: Larry ler, Clerk of the Boar) v Date Signed Date ....... NORTH+ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that......... :J .......... L.F-6,4.�b ............. ................... ..... .............. has permission to perform ....... R A1.44 e . ..... ................... wiring in the building of ........ ......................................... at .............................. R(A rth Andover, Mass. Fee ... Lic. No. ....... ELE CAL INSP R RI Check # 8212 Lccommonweafik of r r/addackoetb .,�.Joparttnant o� �irA �Wrvicoa BOARD OF FIRE PREVENTION REGULA71ONS Official Use Only Permit No.. gZ 17, Occupancy and Fee Checked ,[Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be. performed in accordance with the Massachusetts Electrical Code (MFC), 527 CMR 12.00 (P.L.EASE PRINT IN INK OR TYPE ALL INFORWI TION) Data: �J � E6, (? City or Town of: ® o., T, the Inspector of Wires, By this application the undersigned gives notice of his oret O to tion to perform the lectrical work described below, Location (Street & Number) /��IC � Owner or Tenant / {+ `) ell Telephone No. Owner's Address K4. iP Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building a Utility Authorization No. Existing Service Amps / _ Volts Overhead ❑ Undgrd ❑ No. of Metors Dim Se ce Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity and Mature of Proposed Electrical Completion of the following table may be waived by the Inspector of Wires. No, of Recessed LuminAlres No. of Ceil.-Susp, (Paddle) Fans No. of Transformers KVA No. of Laminalre Outlets No, of Hot Tabs Generators KVA No. of Luminaires Swimming Pool Above ❑ n-❑ nd, nd. o. o EmergencyLighting Ratto Units No. of Receptacle Outlets No. of Switches No. of Oil Burners , No. of Gas Burners FIRE ALARMS No. of Zones nw o. o InitlDet atin in Devvi . ces- No. of Ranges Ttl No. of Air Cond. Tour No. of Alerting Devices No, Of Waste Disposers p eat ump Totals: .....Uma ., ons o. 0 e ^ OAItA>ne Detection/Alerting Devices of Dishwashers Space/Area Heating KW MunicNo. Local ❑ Connection ion al Other No. of Dryers Heating Appliances IOW Security sterns:* , No. of Devices or Equivalent No. of Ater Heaters ICW No. of No. of signs Ballasts Data Wiring: No. of Devices or E ulvAlent a Bathtubs No. Hydromassage g No. of Nlotors Total HP Telecommunications r 1w Nlaquival Na. of Devices or ant OTHER: A trach additional detail if desired, or as required by the Inspector 4qf Wires. Estimated Value of Electric Work: (When required by municipal policy,) Work to Start: / Inspections to be requested in accordance witb NEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent, The undersigned certifies that such cove age is in force, and has exhibited proof of same to the permit issuing office. CHECKONE: INSURANCE BOND ❑ OTHER ❑ (Specify:} ��(V/ch rl,�Pjf"2+�ice I certt/y, under the paarts and enalti!es of perjury, that the info ation on this application is true and complete, FIRM NAME: n/, P r LIC, NO.: Licensee: SignatureLICAe , NO.;�/%% (!fapplicable, eraser "exempt" ip the license number line. Bus. Tel, Na.; 2 rF3 Address: io Alt. Tel. No.- ZUK 'Per M.G.L. c. 147, s. 57-61, 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 owner's Owner/Agent Signature _ Telephone No. _ _ PERMIT FEE: S Date.. l� 01 •otic TOWN OF NORTH ANDOVER 0 p PERMIT FOR PLUMBING This certifies that ........ .......... ........ ... . has permission to perform /?!U'- .. . plumbing in the buildings of ..... ................... at .. �... , North Andover, Mass. Fee. i�.�. Lic. No.. 3 ........... PLUfAff,1 INSPECTOR Check # D 7768 M 0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBIN( (Print or Type, J ¢ mass. Date O d g Permit Building Location�Gt6n Owner's Name 19 7a /p 83 ��`] Type of Occupancye s ident Ne Renovation . ❑ Replacement Plans Submitted: Yes -J FIXTURES nstalling Company Name Heritage Ht -g _ &Flg _ Co- Tnc _ address Pl!aasant Street Stoneham, Ma 02180 Business Telephone Name of Licensed Plumber Gordon .Switzer Check one. Certificate C$ Corporation 714 [1 Partnership Firm,rCc_ INSURANCE COVERAGE= I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Yes � No u If you have checkeC. please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity I_i Bond OWNER'S INSURANCE .WAIVER_ I am aware :hat the iicensee, does not have the insurance coverage req Chapter 142 of the Mass. Genera; Laves. and that my signature on this permit application waives this requ,rl Check one: Gwne� J� L J Sgnature of Owner or Owners Agent Agent I hereby certify thatall of the details and information t have submitted for entacedj in above application are ,cue and accurate to thi knowledge and that all plumbing work and instaliations performed under the permit issued for tris application will be in compiianc partinent provisions of the MassachU-setts State Plumbin Code a.:d Chapter 1d2 of the Generai Laws. By �0)') J, 4 a±a Title S-ignalure o: Licensed . PLTriIbe., Q YYpo J ! :cense: t�'.aster � �Ourneynan City,'Tow'n APPFiCVED ;OFFICE USE ONLY; license ^ tuber 8322 t ; z l cn 1 < O Cr7U Cr Q� �1 C x cit 1 "' 'C < cnI Q a B11i B � d J Q I'4liO{ -' -� C x �= Q t 3 3- SL'H—gSMT_ ' BASEMENT _ i l IST FLOOR 2ND FLOOR I 3RD FLOOR t S 1 I 4TH FLOOR i STH FLOOR 1 6TH FLOOR 7Th FLOOR 8TH FLOOR nstalling Company Name Heritage Ht -g _ &Flg _ Co- Tnc _ address Pl!aasant Street Stoneham, Ma 02180 Business Telephone Name of Licensed Plumber Gordon .Switzer Check one. Certificate C$ Corporation 714 [1 Partnership Firm,rCc_ INSURANCE COVERAGE= I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Yes � No u If you have checkeC. please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity I_i Bond OWNER'S INSURANCE .WAIVER_ I am aware :hat the iicensee, does not have the insurance coverage req Chapter 142 of the Mass. Genera; Laves. and that my signature on this permit application waives this requ,rl Check one: Gwne� J� L J Sgnature of Owner or Owners Agent Agent I hereby certify thatall of the details and information t have submitted for entacedj in above application are ,cue and accurate to thi knowledge and that all plumbing work and instaliations performed under the permit issued for tris application will be in compiianc partinent provisions of the MassachU-setts State Plumbin Code a.:d Chapter 1d2 of the Generai Laws. By �0)') J, 4 a±a Title S-ignalure o: Licensed . PLTriIbe., Q YYpo J ! :cense: t�'.aster � �Ourneynan City,'Tow'n APPFiCVED ;OFFICE USE ONLY; license ^ tuber 8322 Icc 0 O W F- z W a r. p a N Z O Q Z w W m Z a � Q N C7 W N N � D W W 9L 0 O a z m Y J J z a O O W N 0 O O ~ w U- 0 0 LL O 4 O LL O m z •w LL O a o ¢ O W U 4 f- CJ J w < W Q <. O J LL < z' a W U H W x N Icc 0 O F- U W a r. a N Z O Q Z w m Z � � Q C7 W � D W 9L I In Date /-:2-�. o"/**** ...... :K,. . TOWN OF NORTH ANDOVER PERMIT FOR WIRING P Thiscertifies that...................... ....................... Te ........................................... has permission to perform •........................... wiring in the building of ...... ........................................ at .:,7 ........ ) ..................................... ............ . North Mdover, Mass. Fee" ..... Lic. No.:/.?. .... e- 2�,... . .... . .......... ..................... &-ECTRICAL INSPECTOR Check # 5.407 THECOMMONWEALTHOFMASSACHUsms Office Use only DEPARTAMWOFPUBLICS4MY Permit No. BOARDOFFIREPREVETERFORONM S527CMR12 (X1 Occupancy & Fees Checked APPLICATIONFOR PERMIT ELECTRICAL, WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical Work described below. Location (Street & Number) .7(U (,� rmIIJJ 4" )ed Owner or Tenant Owner's Address SA'lr Is this permit in conjunction with a building permit: Yes Iallo (Check Appropriate Box) Purpose of Building Awe d Existing Service ���u Amps ,Volts New Service Amps f �" /'Z %Volts Overhead Overhead Utility Authorization No. dw 15-3 Underground M No. of Meters Underground EZ3 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Atier-e–ssrl ee�r- Y necelAek Sery 0 c f No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures Y �� i 'ter 7 Swimming Pool Above round1:1 Below ound ri Generators KVA KVA No. of Receptacle OutletsNo. %L+Pc,r P of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges i CvOlr 4- " 1 pis No. of Air Cond. Total 'I Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices N_ . of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other 1`1ru. of Dryers Heating Devices KW Connections ED No. of Water Heaters KW No. of No. of . Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP o.,.- f i M ..d /1 OTHER- hrnaartoeCDWrdW. RM=tDthefflquWT0VsdMmwfiuMGffna1Laws Ihaw aama>iLiability hnuranoePbliiyinchrlmgCor>plete 0 Lwd w ns Com ageor&mbstNtategtrivAq YES NO IhivesubmiWdvandpwdofsml0theOffim YES r'i� If)mfuvec rdodYESpleaseitticaethetypeofoDvUapby dnddngthe box L.�J c Il URANCELa BOND r7 MIER � (Please Spacny) )& d-/ / Af Woduostatt � Esti WdVah&dE1achicalWc&$ �'/00u •vp brspearonD*ReVmbd Rough FuW ✓ Signed underlie R3lahies of petjuty. RRMNAME `S !� Cr/►.r,_.f �[cc Itr,Yc� C U►, �va� �/ Lxa►seNo. l57S3� Goy eAw Lioatsee /� ` n" -e4uSignaltue �-- Iia�eNo 3 `✓P/a N arrl� 3'13 k��` li�tti/� S` !�'hle 6c�ro Mi 0? --)o —At Ah: Tel No. OWNER'S INSURANCEWAIVER;IamawateOudeLioewdmmthawtheir>stuar=com dWoritsaksulalegnvalergasm#odbyMassachusEmGenaallaws and that my sg naMm cn this pmyd appficMm wai" s this mgtlitemalt. (Please check one) Owner M Agent Telephone No. PERMIT FEE $�t5 Signature ot Owner or Ageflt