HomeMy WebLinkAboutMiscellaneous - 700 SALEM STREET 4/30/2018 (2)�a
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APPLICATION FOR SEWAGE DISPOSAL INSTALIATION 2
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
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I hereby make application for a permit for a sewage disposal installation at
a. %ern S '% I will install this s ys tem in ac-
cordance with all the laws of the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 216. I will install a con-
crete septic tank of_ 7 D �d- in size. A manhole (s) permitting easy cleaning
will be provided with remo ble cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of da Fer r lineal (square) feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of'2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
the line will exceed 100 feet in length and in any case, two lines of the will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further agree not to cover any portion of this installation until approved by the
inspection officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DA TE JU,,fit r 9 G
.V GI So. I Sig a of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DA IE_,Z Y 6!:;$. / 6 l .
_9
nature of Health -c ent
I have inspected the uncovered system indicated above and find everything done
as described.
DA TE_
Signature of4specting. Officer
Percolation Test
Garbage Grinder
V L
August 19, 1961
Miss Mary Sheridan R. N.
Health Agent
Board of Health
North Andover, Mass.
Dear Miss Sheridan:
An examination was made as requested in order to determine the
suitability of the soil for the subsurface disposal of sewage on the
proposed Salem Street building site of Raymond Letourneau.
The land in general is high.
The subsoil in the area was of gravel content and a 2 -minute
percolation test was conducted.
fit is recommended that a 750 gallon concrete septic tank be
installed together with 180 lineal feet of drain pipe.
Very truly yours,
William J. iscoll
WJD:hd
BOARD OF HEALTH
TOWN OF NORTH ANDOVER,, MASS.
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30 -----�
9
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ash'
1. NAME . . . .'n:'Q : t : ``� DATE w
2. ADDRESS 4. . .. �. LOr NO. . TEL
3 NO. OF BEDROOMS . S. . . . DEN ' . N0. .
/�• GARBAGE GRINDER . . . . e NO. e s •
. SHOW DIMJ NSIONS OF HOUSE
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIIVENSIOIZ OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9, NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10, SHOW LOCATION OF BROOKS$ STREA09 DITCHES.. LEDGE OUTCROPS ETC.
11, SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROD4 HOUSE
NOTE: LOCAL REGULATIOVS SHOULD BE READ CAREFULLY.
°f NORT" 1M
O p
CHUS
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
� �
This certifies that ..rr ..... )' .. A ."-/ .....................
has permission to perform ...Rc k .V : t.... s .............. .
plumbing in the buildings of . . Y -.`.":I'.f'..f ...................
at. ! l ' ' ... ............ . North Andover, Mass.
Feel/? ...... Lic..No.. ;1��.?.�.f C'..,......`.�...'��'tom,.....
PLUMBING INSPECTOR
Check # 2
5755
44
MASSACHUSETTS UNIFORM APPLICATION�YOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
/i%� O Date 1
Building Location U Owners Name/ ' / fJ Permit # j
6 Amount /A TV
New 1:1 Renovationo
M
Replacement
Ti YVTi TR F.0
e,
Plans Submitted Yes No
(Print or type) ---' Check one: Certificate
Installing Company Name- I��r A Q t'w J /5Z H-tc 0 Corp.
F1Partner.
13 Finn/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the t e of insurance coverage by checking the appropriate box:
Liability insurance policyEy- Other type of indemnity ❑ Bond ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Agent
I hereby certify that all of the details and informa on I have su mitted (or entere in above appl' on are true and accurate to the
best of my knowledge and that all plumbing wor and installat' ns performed .t Iss f this application will be in
compliance with all pertinent provisions of the set State i o an.. h r of the General Laws.
By: ure I LiCenseu er
Type of Plumbing Li ense
Title
City/Town is nselNumDer Master Journeyman ❑
APPROVED (OFFICE USE ONLY
1
MIN
(Print or type) ---' Check one: Certificate
Installing Company Name- I��r A Q t'w J /5Z H-tc 0 Corp.
F1Partner.
13 Finn/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the t e of insurance coverage by checking the appropriate box:
Liability insurance policyEy- Other type of indemnity ❑ Bond ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Agent
I hereby certify that all of the details and informa on I have su mitted (or entere in above appl' on are true and accurate to the
best of my knowledge and that all plumbing wor and installat' ns performed .t Iss f this application will be in
compliance with all pertinent provisions of the set State i o an.. h r of the General Laws.
By: ure I LiCenseu er
Type of Plumbing Li ense
Title
City/Town is nselNumDer Master Journeyman ❑
APPROVED (OFFICE USE ONLY
1
N2 3' -' Date................ ...
62
MOM
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .... ...... sx.c ..... .................................
has permission to perform ......... ........ .................
wiring in the building of .....4. yo; A'-�<�: ee� .. ..................................
at ... 2(.). ..... 1S.. ... C.r. 4 ....... ...... ............. / North Andover, NWs,.
Fee ... 3,)..! .......... Lic. No.717 ... .............. .........
ELECTRICAL INSAECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
spa
t.rommonzoeallh of /11aSeaclnudelfi Official Use Only
cc� c�7ire Permit No.
a1.Jef�arfnlenE o�.}�eruice3
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1 t/991 ----
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electric::I CoJ (NI ), 527 CMR 12.00
(PLC.1SE PRIIVT IN INK OR TYPE :ILL I,VI'OILbi,177o/y) Date: p
City or Town of: Nnr n��t f,� To the Inspector- of p'ires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Nuniber)-OO
Owner or Tenant t 4--bDXr,\1PQ C-) Telephone No.
Owner's Address
Is this permit ill conjunction with a building pern►it?
Purpose of Building
Yes ❑ No 1/ 1 (Check Appropriate Bos)
Utility Authorization No.
Existing Service r\nips / \'ails Overhead ❑ Undgrd ❑
b
New Service. Amps / Volts Overhead ❑ Undgrd ❑
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
No. of Meters.
No. of Meters
Conmleti�nn(,IretnlL,,rinor..hto................:.....�L...r._'-.-�_-•_-- �.,.�
No. of Recessed Fixtures
- - ------ -
No. of Ceil.-Susp. (Paddle) Falls
ur L.,c uw iL-cr yr rr uZ's.
No. of i'otalw
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
Swimming Pool a bove ❑ !n- ❑
rnd. rnd.
t o. o mergence Lighting
Batte Units
No, of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of Detection and
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No, of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
t`luniber Tons
— —"-�
KAY _
- --
No. oCSelf-Contained
Detection/Alertina Devices
No. of Dishwashers
Space/Area Heating KW
Local 1luuicipal
Connection Other
No. of Dryers
Heating Appliances KW
Security Systems:
No. of Devices or uivalent
No. of Water
Heaters testi
No. of No. of
Sighs Ballasts
l;ata Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total IIP
Telecommunications Wiring:
No. of Devices or E uivalent
OTHER:
Attac/r additiozzal detail if desired, oras reytzired by the Inspector of 1Yires.
INSUR kNCE 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 coverage is iii force, and has exhibited proof of same to the permit issuine offce.
CHECK ONE: INSURANCE Z BOND ❑ 0"1-I-IER ❑ (Specify:)
fp� '(Expiration Date)
Estimated Value of Ejectrical Work: / t7 C � , v� (When required by municipal policy.)
Work to Start: 1l(101 Inspections to be requested in accordance with MEC Rule 10, and upon completion
I ccrlif under
FIRINI NAME:
Licensee: —L5C
(Ifapplicable, en,
Address:
OWNER'S IN:
required by lav
Owner/Aent
Signature` _
B\• ;Iry signature below, I hereby waive this requirement.
Telephone No.
i 11trs application is tare rd complete. ��
iC.NO.:3)'-ze- -
LiC. NO.:11-� 16
Bus.
Tel No.:t.d��
Alt. Tel. No.:
tot have the liability insurance coverage normally
I am the (check one) ❑ owner ❑ owner's agent.
Pt:R311T FEL• : S 3 j ��
`u 0SAL;I1USE 1-1-S UNIFORM APPLICATION FOR PERMIT TO D'
(Print or Type)
NORTH ANDOVER
Mass. Data / - 2 I g r
Brrrldingr < O
Location —700 Su 1 cwt T_ PermM
Owner,bo - f,i oLcf'
HARM 2 fk�rr v
NewN nenovallon U replacement p Plans Submitted: yea(-.] No ( )
FIXTURES
eck one:
Installing Company Name Fq-5i er.e\ } ro00„r✓ Zrp.
Address Mt7e,— S; O Partnership
C-4 n rr e, 4 sS U Firm/Co.
Business Telephone 1 S 0 fs- -77q-H30
Name of Licensed Plumber _ �seo� G�r�>r t Li
A
INSUnANCE COVEnA_GE: rec re
have a current Ilablllly Insurance policy or No substantial equivalent. Yes No E]
If you have checked yam, please kale Ilia type coverage by checking Ilio appropriate box.
A Ilablilty Insurance policy Other type of Wernnity U Bond U
CeltRicale
OWNER'S NSUnANCE WAIVEn: I am aware that the licensee dgQ111 not h#v.- the Insurance coverage reflulred by
Clupter7 of the Mase. General Laws, and that my signature on this permit application watves [lila requirement.
f� Check one:
ns o of or Orme[ s en
` Owner U Agent [
I hereby certify that an of the detalle and krlormatton I have eubmftlrd for entered) In
Irnowled •and that sp plumbing work and Inslallatiorre performed under the permit I
pertln•nf provlstons of the Mas:adrusells State Plumbing Code end Chapter 112 of t
By.
Title
qty/Town
Afl'rKMD (01H -E USE ONLY)
Me Wallon are true arld accurate to Urs best of my
us Uhis application will be ki compliance with all
d l�w� •
a urs o T nsad_ m e
Number �- P FTS
Type of Plumbing Ucense: Master [)
Journeyman ['1
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Address Mt7e,— S; O Partnership
C-4 n rr e, 4 sS U Firm/Co.
Business Telephone 1 S 0 fs- -77q-H30
Name of Licensed Plumber _ �seo� G�r�>r t Li
A
INSUnANCE COVEnA_GE: rec re
have a current Ilablllly Insurance policy or No substantial equivalent. Yes No E]
If you have checked yam, please kale Ilia type coverage by checking Ilio appropriate box.
A Ilablilty Insurance policy Other type of Wernnity U Bond U
CeltRicale
OWNER'S NSUnANCE WAIVEn: I am aware that the licensee dgQ111 not h#v.- the Insurance coverage reflulred by
Clupter7 of the Mase. General Laws, and that my signature on this permit application watves [lila requirement.
f� Check one:
ns o of or Orme[ s en
` Owner U Agent [
I hereby certify that an of the detalle and krlormatton I have eubmftlrd for entered) In
Irnowled •and that sp plumbing work and Inslallatiorre performed under the permit I
pertln•nf provlstons of the Mas:adrusells State Plumbing Code end Chapter 112 of t
By.
Title
qty/Town
Afl'rKMD (01H -E USE ONLY)
Me Wallon are true arld accurate to Urs best of my
us Uhis application will be ki compliance with all
d l�w� •
a urs o T nsad_ m e
Number �- P FTS
Type of Plumbing Ucense: Master [)
Journeyman ['1
A !1
RECEIVF� P
AYMEAjrTOWN OF NORTH ANDOVER
Date..............
4 19g, PERMIT FOR PLUMBING
r
ctor
This certifies that ............... ............... .
has permission to perform .....................................
plumbing in the buildings of ..................................
at .............:...................... . North Andover, Mass.
Fee. :..Lic. No .......... ..............................
PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
Location
No.
71-c �Jlqzltrn f.
Date // z
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee
,-Other Permit Fee
Sewer Connection Fee
\,,pj�W.ater Connection Fee
Q•b,i y 1 I TOTAL �$
0moo-
b/
,Y("'Building Inspector
513/ Div. Public Works
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