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Home My WebLink About- Permits - 542 SALEM STREET 9/28/2018 Commonwealth of Massachusetts Map-Block-Lot 038.00004 BOARD OF HEALTH - ----------- Permit No North Andover BHP-2018-0263 FEE $350,00 DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Todd Bateson to(Construct)an Individual Sewage Disposal System. at No 542 SALEM STREET as shown on the application for Disposal Works Construction Permit No. BIIP-2018-0263 ted Sept be 18 _ ..... ry .. -- ... Issued On: Sep-04 2018 B A OF HhAI,TH �y. Application fior S:e �t�c Disposal osal System firy TOWS DATE C2pstrupfign.. Portnit - TOWN OF NORTH . A $2501 00'—Full Repair 'OVER .. MA 01845 $°t25,00-Component Application is hereby made for a permit to: 0 Corfstri e a new on-site sewage disposal system* O'kepairpr replace an existing on g P Y * p g -site sewage dis osai's stem o � ❑Repair or replace an existing system component-What? i A. Facility Information. .. � ��- 5� Address or Lot# /Ah Cityrrown 2.-*TYPE OF SEPTIC SYSTEM*: ➢ ErPump ❑Gravity.(choose one) *'*If pump system, attach copy of electrical permit to application""` ❑Conventional System (pipe and stone system) ➢ ❑Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install_this type of system.) ➢ Q Pressure Distribution S.A.S.(No D-Box) ➢ ❑Pressure Dosed(D-Box Present)S.A.S. ➢ ❑ Does the system require an effluent filter? Yes No, If yes, does plan specify make and model of filter? YES=(no further info. needed) NO=(installer must specify ,bran d of filter before DWC issuance) Whatis the Make? .� " '/` What is the Mode.lE� 2. Owner Information Name Address(if different from above) City/Town State Zip Code Cj, Telephone Number 3, installer Information Name pp m Name EWFEW 9NTERPRISCS,INC Address III Argilla Road A,S ,fi t` T Andover IAA 0181Q_____......-._. Cityrrowm State Zip Code Telephone Number(Call Phone#If posslble please) ` 4. DesignerrInformiatiorr Name Name of Company : c;1 J 001 Address I A A J Citylrown State Zi Code Telephone Number(Best#to Roach) Application for Disposal System Construction Permit•Page 1 of 2 uA . ., for S : ?1 asal: . Y T Y ieY x , $125:0p*-Comp nt FAGS 2Of2 A. Ead.ill!y":lworMation gohtirtued,... , 5, Type'of Butidt :. esldentfal.Dwel►dng ar C7�ommerclal �..Agre:ement The undersigned agrees to ensrvre:the con0ru0t1on;and rnalntenanco of the at'pre.Cfescrfbeed on-site sewage dlspasal system,in accordance with-the previsions of r/tle' of fha r Envlronrnehtal Coders well as the 4oeaT Sthsurfce 04p6sal Re,rt,rlaflans for the Town of North Andover,and hot to place,the system fri aperatlbri.unflln Certlflcate of Conip/W 66 has been kS$ue , y thls Board afNealth, Na�mu Date A plic � o Appr'v d y: (Board of Health 'epresentative) ;ei Hate Applleatl Dis ,pprove4 for the follow►ng reasons: For O-WOO.Use Only: I ''Fee Attached?: e Yes No 2.• Proctls #aget Oblg aYar Farm Attached? '�' . , •_.__ . . , Yes No .31: , b Svstcrn? HSO)Attach CQ-2y o- ..1,-crr e No 4. Fouad;d6nAs-Brrrlta(hew construe#lo►)•ronly); Yes No (S=e seal&as apptoyedptau) 5Y Floor.PZws?(hew tohstruOtlon-only rAti PQrmtt Paae 2(if 7 4 , 1• MA -'-P�LIGATIQNS JACT • ' eLafhe•N hac ve �c�3 iaitxtl rf� G trtt # the cp cay�t ►£6r.theVogalpav (Ad ofte?dr ostm� --If RtIlfwd to tht•sppltmd"of (taiwices q me Alin dated Y .• � a a a WM Mdolont elated 014st rcvircd date) I=dantand the following oFiligationa for mgnsg==t flfgjjff prgccr, ,- i. As thafnstrcller,I anat.obligatod izz obitdn aIIp itx and azd ofweakh�upnwcd.•pka pdo ` �petfosmiag atay:�arorlC�.a ' 3. A* tn1le .I t� for aad h?'c any �£ t4M60wVetContmctt ,prajactmanA8w,,orany e tet paratm nr:r b4oc&ted With my r mn ntap svAed rdc4ux and the spate n is trvtready,dli l 'Ibemt�ee•uh�il.hd. p-lu�otbIe. .. , .� .A�r t1i G ' kav,c ttxc s ry r d�pii v t ic. lieab e s Is ir�dutccl � �P k vss �R . • �.. :�x�etna�y,�+-� X.��•�! p�- ��is'�xe:t�an#,p� ckr alst d b ciaae it: ' h iartyr�i q�t#ia i�b`specdc��t dirt ai r n©t have to be prbscrit . b, o 'gib"xL C►I (os c1• t +darts+d>~ p, +r.8czt far�t6,etc. �atuGbm(iltt�irtrt;#�ic.�oiud`ofH.�+y7� ,,a$et` �; 'fr°mthe e�er�must bn p frfr th3 i�w 7. �t udag i ,-# cle t^c a k;tz�yaf M.dj and able to 'dltldd p•tib Vttarh Aup td .. C. N ` Tustsocir m,uat3+oq n`S #Cti01l'tVitl l tL r i {ej ��OCa tOt . l,�vQ#o be+onfa�tc.' .�� .. ,. •,; . �: , 4. 1 t&e ivatsrlis 'I unt3 id that only litily pi +trmr '�ot6rrt6cfr d 0' 100)a ` to aot4p�ete the�isupatian+a t e syrtt idertt is## x e o ;£�x taItationci am t fired for ,. 1�1 tht EtUICs,.Y ttftderataatszi I a'at<'�e t 3 } GC,Of th6 f • t' ! olio co�txiscion. A: �Ct1ClJtZtlIJ'ift`3�02��lA�,�t¢ ,�lGi'G�ti+�i�f��#!' liC .�r�'�►c�ar at�earche�iC ?G�.I�Q�.t+ IC�Jlittit�jEttlt Qo-m bC wed ` . � Plr�sli�,,rpcctfayby.8o�ta�.�,1'e�riftbdtorcoas �' • . - - d IA#tsrA9AAAfft*j)l-ffoj9*9#jp jrtdB4 tsar,p'tmtp +tmJScr, tef�r.�zt ct •wrrllatrtlother 1TtC� Lrti' CIC. iit1: 40 ' 4 RTN EJ 0 Town of North Andover HEALTH DEPARTMENT CHU CHECK #: . DATE: oa LOCATION: CONTRACTOR NAME: Type of Permit or License: (Check box) 0 Animal $ • Body Art Establishment $ • Body Art Practitioner $ 0 Dempster $ • Food Service-Type: $— • Funeral Directors $ 0 Massage Establishment $ 0 Massage Practice $ • Offal(Septic)Hauler $ • Recreational Camp $ • Suit tanning $- -- • Swimming Pool $ • Tobacco $ • Trash/Solid Waste Hauler $ • Well Construction $ SEPTIC Sustems: 0 Septic®Soil Testing $ 0 Septic-Design Approval $ XSeptic Disposal Works Construction(DWQ $ 3,50 Cl Septic Disposal Works Installers(DWI) $ 0 Title 5 Inspector $- 13 Title 5 Report $ 0 Other. (Indicate)- $ Health-Agent Initials White-Applicant Yellow-Health Pink-Treasurer