HomeMy WebLinkAboutDWC - Septic Repair D-box and Outlet Baffle Tank - Permits - 15 SULLIVAN STREET 6/14/2019 I
uornmonweal'th of Massachusetts
BOARD OF HEALTH
Perinit No
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rth Andover
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DIEIOSPOSAL W`RKS %C10,*#0'NS"r
---RUCTION
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Permission is hereby grated Dean Dynan
to(Construct)an, indl l u l Sewage Disposal System.
at No 15 SULLIVAN STREE"I"
as shown on the application,for Disposal Works t c n Permit No. B 19- � I
too
U 'u. l 1,-2 "
BOARD ,. A
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P.P.
flGation tic u1sposal §ystem
DAB
Construction Permit ,--, TOWN OIF
`50 010� it
NORTFIA' NDOVER, MA 01845 $175-00 Component
When Ring outConstruct a new -site sewage disposal m
forms on the
computer,use Repair or replace,an existlingon-site sewage disposal system*
only the tab key o nen —What? olr�l(
to moveyour
�.��r��� � exist I system
cursor-do not
use the return A. FaGifityInforma i
key, 5��1 �4a
. j
0001
Address or Lot# row
0
Cif rDwn
: . *TYPE F SEPTIC YSTEW
,'
E]"PtImp E] e
y rr
A�5vejjtlonaf System (pipe and stone system)
�> 0,Infiltrator d difft,is r(Gravel-Less) Aftach a,Gopy of rfi i o f0stall this type of s stern
[j Pressur istribution SA.S. -Box)
Ej Does the system requit-a an effluent t fter? s� +�
If es does plan specify make and model of filter? YES (too further info.needed)
N , nsi,must specify brand of i ,before DC Issuance)
Matis the MAkc?�_What'is the moew
Name mm..
Address(if different from above)
ityA At
crrowri
13tate Zip Code
AO
C4 11,64 r-k_ly.44 12
rn dry sl im Number
3. Installar InforMration
Name
Name of Company
7d-dress
let
i
Ci State, zip+bode
,
rNNN
Telephone Number(Cell Phone#1" sille
4. Designer Information J
J
Narne of Company
Name
1,
address
C Yn
State Zip Code
Telephone Number es o Reach)
Application for Di,s posal Systeari Construction Permit.Page i of 2
' y �,: oa
orSMUc� � f 1s XE_
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Construction Permit .. TOWN OF
N000GO
RT H AN1 D OV E
G
PAGE 2 OF 2
A. Fac.1flity Information continuedaw..,.
Residential Dwelling or ricommercial '
B. AgreementThe undersigned agrees to ensure the construction and.
malontenance of the sri
-site sewage disposal system in accordance with the provisions of Title 5 of the
Environmental Code as well as the Local Subsurface Disposal Regulations for the T6wn
North Andover. i understand that until a final Certificate of Compffance has been Issued
� d system i's not approved.
4thisa of
IF
Date
w
Date
Application wed for the following reasons-
For Offj'Ge Use
I FeeAaacbed? yes No
Yes No
jectMwag-et 0h_Ygafi6,nFoiYv Attachedi
ApHeeed ropy of
yfol-SepticSystem s Yes
NO
Hatidout?
4. Reviewed a " vtt � 11ppke ° + d YesSM9Z �
_.
t
5. F -Bade?(new constructiononly):
(Sa M,p,scale.a.5 app. o ve d ph p)
6: � only). Yet
��i o for Disposal'systems C.OrlStrUGHOTIPermit*Page 2 of 2
SEPTIC SYSTEM INSTALLER PROJECT MANAGEME
I T OBLIGATIONS
.As the N'orth Andover licensed n to er for the construction fort t system for die Property t
(Address of septic System) ��plans by
Relative to theapphcation
nt,,tf ' Hates) And dated 1
1
Dated 611111
With,revisions dated
ay s date)
date)revised
understand the following obligations for tnanagement of this r
. As the t le I am obligated to obtain all permits and.. ard, of Health.,approved plans pj r to
Performing any work on a site. I must have the am,)roved vlans and the oermit on-site when any work
being done_,
. As theinstaUer I must cad for and and all inspections. lfhomeowner, ,
contractor,,,project manager,,, orany
other person not associated with iny cornpany schedules, -an inspection and the system is not ready, then
ite,rn th-ree, ha applicable.
; , the M' Staller, I r =�e to have the necessary wore.completed prior to the applicable-inspections
indicated beo . I understand that r e action, widiout comoletion of the items inaccordance
t t lotions
result �0.00 �b n levied against and/or
MV ate. .,
,. Bottom.of Red ,Generally,, this is the r, (1") inspection unless there is a i,1-etai g wall,which
shoulddone &- t. The installer rnu t request the inspection
b. * , . w w
Final Construction Ins + c . .— �r� E
Engineer meat st theirinspection �tl ,; , etc.
As-b-uilt of verbal OK r e-rnail to-, ealt pt n tb ,n ov .*g -NT ftom the engineer music be
submitted to the B *d of Haab n after h c11 *installer for an inspection tune. Installer must be
resent for this, s e ti . With. a pump , stems all electrica,1,work must bercady and able to cause
pump to work andalarm to tion.
c. Final Grade—Instafler must,request nsp tion when all grading is complete. instafler does not
have to be on-site.
understand4. As the 'installer I perform the work l r dyati xi;q 'le wc m i and I am r - ~ d
1
t systemp don forinstallation. I ur ie
ut-iderstand that work done bv odiers unlicensed t instal sentic sygcmsNorth Andover can constitute
i
reasons t den.ia,l of the system d or revocation us erasion of aw licenseto overa,te in the T'own o l
North Andover SMnificant fines to all,mrsons involved are also ible. i
,
5. As the installer, I understand, that I must be -site during the performance of the following construction
steps*
a, Deterinination that theproperelevation of the excavation has been reached
. Inspection of the sand''and stone to be used
c Fin a]in n by Board of Health s taff or consultant,
d Ins talla don of tan1c Ming
p1p,es., stone, vent
pump
co,tnponents.
the installer, I understand that I am sole1vtesoonsible for the installation f the ate �the
roved l . �.. N instructionsb e homeowner, erases, contractor, r� a� other, � .� o steal e
me of this obli2atton.
f
Undersigned Licensed fit : Installerat
(N,eame Print),
�f I
O T fy
HEALTH DEPARTMENT,
01
Town 'North Andover
Of
CH,
CHECK D ftN
LOCATION-.
H/O NAMR
,CONTRACTOR NAME*
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A.6D
��.oe^ '1'lJ
i
M Permit or Laces (Check box),
m
y Art Practitioner
us
Food Service Type:
Funeral recto
I
0 Massage
Establishment
I
El Massage
i
Offal(Septic)Heeler
i
Recreational
Sun,tann'i
swinim1,11
9
Tobacco
El TrasOolid Waste Heeler
Well CIsn
SEPTIC IS so
ystem
Septic SDI n
Septic-Desivi Approval
Septic Disposal Works ic ,IW
i
Septic Disposal works Installers
Title 5 hispector
Title 5 Report
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6/11/2019 Unofficial Property Record Card
Unolifficial' Property Record Card' S, North, Andover, MA
General Property Data
Parcel Illy 107.13,0097-0000.0 Account Number MI234261932218,
Prior Parcel l
Property Owner r ISELER,DAVID,G Property Location 15, ULLIV 'l T'i T
LYNN ISELER, Property Use ONE Fri
Mailing Address 15,SULLIVAN STREET Most Recent SiateDate 5/231997 f
Legal Reference 047601- 091
City,NORTHANDOVER Grantor JEFFREY CASTALDO
Mailing State Zip 101845 Sale Price 265,000
ParcellZoning GBLanidArea 1.020 acme
Current Property Assessment
1
i
Card I' aliu Building ' lu F1001 tra Features,900 Lead Value 261,600 Total Value 540,600
Value
Building Description
Building Stylus COLONIAL Foundation Type CONCRETE, Flooring Type HARDWOOD
f Living Units,I F'r m e Type,I Basement.Floor NIA
Year Built 1 Roollf Stru.uctu.ure GABLE Hileating Type FORCED H/ ,
Building Grade V + Roof Cover ASPHALT Heating Fueil OIL
Building Condition Good Siding CLAPBOARD Air Conditioning 0%,
Finished rea SF 1872 Interior Walls TYPICAL f Bsmt Garages
Number Roams 7 #of Bedrooms 3 4 of Full Baths 2
f 314 Baths 0 # f 11213aths 11 #of Other Fixtures Oi
Cl Description
Narrative esProperty
This property contains 1.020 acres,of land mainly classified as ONE F M with err COLONIAL style building,,built about 1993,having L FEE L
le terio,r an.d ASPHALT roof c;ove r,wids 1 u nilit ,,7 room , 31 b uedruJ C ,2 bath I half bath s
Property Images
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15 SULLIVANSTREET
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Disclaimer:This information is believed to be correct but is subject to chiange and is,not warranteed.
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north and'over.,p tri tpr rties.com/'Re:cord Card. s 'lll