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HomeMy WebLinkAboutMiscellaneous - 85 WINDKIST FARM ROAD 4/30/2018 (2)r 4 MAP # 16 9 PARCEL # 39 LOT # �p STREET ��ruWVW� CONSTRUCTION APPROVA HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE APP. BY DESIGNER: �,�?/5 j//�—,{J�� PLAN DATE CONDITIONS COMMENTS: FORM U APPROVAL: APPROVAL TO SUE YES NO DATE ISSUED 7 BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: 3D BY:_ . r W29ER SUPPLY:WN WELL WELL PERMIT K DRILLER WELL TESTS: CHEMICAL DATE APPROVED BACTERIA I DATE APPROVED K BACTERIA II DATE APPROVED PLUMBING SIGNOFF b WIRING SIGNOFF COMMENTS: FORM U APPROVAL: APPROVAL TO SUE YES NO DATE ISSUED 7 BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID NO WELL CONSTRUCTION APPROVAL YES NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: 3D BY:_ N SEPTI_C SYSTEM INSTALLATION IS THE INSTALLER LICENSED? .(=ES NO TYPE OF CONSTRUCTION: REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW C= NO CONDITIONS OF APPROVAL YES (FROM FORM U) ISSUANCE OF DWC PERMIT ES NO DWC PERMIT PAID?%�6 DWC PERMIT N0. NO INSTALLER. e r BEGIN INSPECTION YES 0: avl(/ rivays�/ EXCAVATION INSPECTION: NEEDED: M y-5 T v M f° D u i (� Gc.� is Q4 41 r PASSED /9g BY CONSTRUCTION INSPECTION: NEEDED: r AS BUILT PLAN SATISFACTORY: YES,/ /7 APPROVAL TO BACKFILL: DATE: 1,-1- BY - ,- FINAL GRADING APPROVAL: DATE 712,r BY / v FINAL CONSTRUCTION APPROVAL: DATE: 7 3Y i El �IldOOH QGIO,L ,.-taa rwn+ba 96 /9Z I41 v- atrx Nb1d X001 j , Ql j 1 5 KWON :-aN I - -AO �i;Aci ii o 5WWJ;5NdNIM ��1Al1?� 0lld � 00.284 � uU29' ul�241 u4-.4 n0'tS n4-24 n4-tG � f1 17 T ---------r------ -----------_—_ II 4 X4 'Z1 n0.2ZI ^ w � 1. n0•�Z. �' ...09.25 .n9-ty 4b: y:. .. n9•,4 u9'201 ,' 220•.4 L ... _ _ . � � � • I . I � N I dIJOOH 660J... W11 10011 6N W1110011 'Ag IAM ldWOlJdNO)Z 51WOH:ANIJ -jo v 9 J01 5AWJ;5NdN:M Im !MIVOU ~I-I-IIAA I 11 - i - z Date: July 30, 1998 Town of North Andover, Massachusetts BOARD OF HEALTH CERTIFICATE OF COMPLIANCE E This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( X ) or repaired ( ) by Dave Maynard, at Lot #6 Windkist Farm Road, North Andover, MA 01845 has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit # 902 dated May 24, 1998. The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. '.r ,& . A, Aoard• SS/cjp Revised: 7/20/98 E 5/ P,R i G 25 , 35 OtM - T+4iS Pi,,•.r,.� ur�rl F�a�-�o,,1 S uaT gHMo "! 250, 8q- SYSTEM , TT is A E:E�orc OF r�F& La�rrb�l A N4 5I e vwnoJ of Ts4k t --o T i N,6 4Y9 m -f jismr. Sac 21+fi,97 60HfOWLWPi ,. W 1�4 P Iil 6r F: p,�-1 et,�A D AS BUILT PLAN OF SUBSURFACE DISPOSAL SYSTEM LOCATED IN AS PREPARED FOR 6VL-0Q IA L. I L;ACA DATE: SCALE: � n 1, U MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET 0 ANDOVER. MASSACHUSETTS 01810 or TEL (617) 473-3533, 973-5721 "7 /7 /-1 � TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( V cC'G=Mraed; ( ) repaired, by located at (.Of (o k-) i ND kaS"i" �+` ►ZM 1�I�Q was h%stalled in conformance witht N rth Andover Board of Health approved plan, System Design Peruout # y0 , dated �/ �� with an.approved design flow of,!�W ,gallons per day. The materials used were in conformance with those specified on the approval plan; the system was.installed in accordance with the provisions of 310 CMR 15:000, Title 5 and local regulations, and the final grading agrees subMi tialty with the approved plan: All work is -accurately represented on the As -built which has been submitted to the Board of Health. Lia 41%�� Date: la -,5T Design Engineer: 1. Date: 2- 7-11 q'f t gORT#j , O ".. 16 3?'4 '6oC O 9 It .��,SSACNUSE� Applicant_ Site Location AME j Town of North Andover, Massachusetts Form No. 3 BOARD OF HEALTH 7J Z' c1. G L 9 DISPOSAL WORKS CONSTRUCTION PERMIT a— ADD SS TELEPHONE Permission is hereby granted to Construct ("or Repa_ (�) an Individual Soil Absorption _; — _ Sewage. Disposal System -as shown on thei"I ign Approva F .S. No._ 05 CHAIRMAN, BOARD OF HEALTH 51/ Fee D.W.C. No. '�, - T` �" > �tl� -. «• v is ' as � �'S •C � . . Town of North Andover, Massachusetts Form No. 2 IAORTh BOARD OF HEALTH 1 O'tw y'�h0 lT —19 w p DESIGN APPROVAL FOR HUS Et SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. Site Location (.X -)T to UU\ Y- Reference Plans and Specs._ (' 'k ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. Fee , �4� 1 - / "' CHAIRMAN, BOARD OF HEALTH Site System Permit No. 9 6 C Town of North Andover, Massachusetts Form No. 3 NORTH BOARD OF HEALTH o 19 DISPOSAL WORKS CONSTRUCTION PERMIT 9SS�CHU5Et Applicant j // S� L--; v e,— NAME ADDRESS TELEPHONE Site Location L�-7` Permission is hereby granted to Construct �q- or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. 99CHAIR MAN, BOARD OF HEALTH N Fee D.W.C. No. �3 t APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: 6 -01,0 — 9r CURRENT INSTALLER'S LICENSE# /'/ � LOCATION: 10116 v�rS T LICENSED INSTALLER: z/,1��c'�1n-�2c✓ SIGNATURE: ,/�/—�� '�� "Gj TELEPHONE# r CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only $75.00 Fee Attached? Yes V/ No Foundation As -Built? Yes I/ No Floor Plans? Yes No Approval G. Date: Q•� 1 Q•� SEPTIC PLAN SUBMITTALS LOCATION: NEW PLANS: ( YES $60.00/Plan REVISED PLANS: YES $25.00/Plan DATE: c9 l DESIGN ENGINEER: 0 A -777:s When the submission is all in place, route to the Health Secretary