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- Correspondence - 50 SAW MILL ROAD 6/3/2020
North Andover Health Department Cornrmunity and Economic Development Division June 3,, 20120 Mark LaRosa heather LaRosa 50 Saw Mill, Road North Andover, MA 01 45 RE: Full `peptic Repair location 50 Sawmill Road fo whom it may concern: A Full Septic Repair for the above property was completed on September 24 2019. This prpject was done because the septic system was in Failure and a Title 5 Inspection Report to determine such, was not needed. Please find enclosed the Certificate of Compliance, the Disposal Works Construction Permit, the "peptic `system Installer Project Management Obligations, Receipt showing Payment, and the Septic Disposal System installation Certification. Il`you have., any questions please call. bear .s, frian aGrasse tkw Enclosure Page I of North Andover 1lealth Department, 120 Main Street North Anclover, MA 01 45 Phone: 97 '.688.9540 lax: 978.688. 542. �r PUBLIC HEALTH DEPARTMENT Town of North. Andover Community and Economic Development Division CERTIFICATE F COMPLIANCE s f.- September 4, 2019 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the:. Full Repair of the On-site Sewage Disposal System James Kellett At: 50 Sawmill Road Map 10�4.A Lot 86 :North Andover, MA 018,45 The Iss ec nt this ate not be construed as a guarantee that the system will function satisfactorily. Brio Laerasse Director of Public health 120 Main 51,,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.888,9542 Web www.riorthondovermo.gov Commonwealth of Massachusetts. . a i r t 04.Ar86 BOARD OF HEALTH Pemit No North Andover BHP-2019-0075 J. $35000 DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted James Kellett tt to(Construct)an Individual Sewage GDisposal System, at No 50 SAW MILL ROAD as shown on the application for Disposal Works Construction Permit No. ICI°I p 20 Issued On Apr-iti-2tl 19 BOARD I'HEALTH _.._... a. a li+c ton for Septic Disposal S stern _ T .A DAT Construction Permit -- TOWN OF $350.00-Full Repelr NORTH A �p lm YAw � `� licurtlo out �Construct��� f r� � �,� l �maW T ,raw on-site sewage disposal system* forms on the ,, ;'-dh� computer.a Repair or replace an existing on-site sewage disposal system*only 1he tab key "I move y Repair or replace an existing system component-�What? .. __ cursor w de not use the return A. Facility Information AA u Ad&eW or Lot Clty�owmrn 2.-*TYPECIF SEPTIC SYSTEM*: 0 Pump Gravity(choose one) "It"pu mp systems, Af&h copy of electrical permit to application'' E Conwentlonal Bystern (pipe and stone system) E]Infiltrator or Blodiffuser(Gravel-Less)(Attach a copy of your cert frcation to install this type of system.) Pressure DistributionS.A.S.(No D-Box) Doesthe system require an effluent filter? PWS� �. No If yes, o plaru.specify make.and model of fflterr aro further Info,needed) I'�O=flnstaller ust pecily brand of filterbefor'e DWce) 2. Owner Information ra�rmma� _ rydrtre,as,QTf dltf from above) �� Q kt u " C11tyyV""l"ou�n state ;riot+Gods t rrmall addrw rm Telephone user . Installer Information Irl Name Name of Company A Add k/ State code Telephone Number(Cell Phone ffi ffpo lblca pie 4. Designer lrtfoLm Lion te- lame Name of Company Add p � ra rm to zip C ae T leph arcs 4 rrtntaer(Best'#to Reach) Application fear Disposal System Constructfon Permit•Page 9 of 2 Application for Septic Disposal Sys em 4fiT r" DA � rE Construction Permit TOWN OF ORTH DOWEL 01845 $17 0o-Component PAGE 2 OF 2 A. Facility Information continued.... 6. Tie of Building: a loyeratlal Dwe ling or F]Corrtrnerdal B. Agreement The undersigned agrees to ensure the construction and maintenance of the afore—described on-site sewage disposal system In accordance with the provisions of 77tp6 5 of the ,Environmental Code,as well the Local a bsnrface Disposal Regulations for the, Town of fJ fir Andover. !un tan d wa tf a final Certificate to of Compliance has been Issued by riBoard of ffeettfa a Ins d s errs is not apaparoved. Date �m p" to P3 6ve and of Health Representative .µ Date Appll tlon Nei prproved for tfie following reasons: For Office Use Only: .. . eeAttached? Yew 2 ,l'toject�'Vlarx ct lalr arson,Fotru Attached? �'��� -+"lob_.._...._ w 1'xxw a K&-,x? .ffso, o— colt o �_.... AppEcantxece ed copy of ° Icctr cal. pecd .r"�"otes for Septac yst as" :�'c _.— a"�,o,.. 4. ,e 'owed,apy)aroval'l ttet,, 'pap c or -. ccfvcd ''cis:. No._ Foaseadatlon As-Bui/0(new construction only): y'csL—- NQ- (Same scale as approved plan 6 Float Plans?Mew constrictiononly): yes� No Application for UsposW System ConstrucUon Permit w Page 2 of f r .f SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the Notch Andover licensed installer for the construction for the septic system for the property at: _. - - i�o=plans by (Address of septic system) A' f (Eugsneec) Relative to the application of i+O✓'S (Installer's name) And dated 5" .Dated r-t Zb(� _ <—� Z` ZO o s. With th revisions dated (Last re 6sed date) I understand the following obligations.for management of this project: 1. As the installer,I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the peranit on site when any work being done.- ; 2. As the installer,I must call for any and all inspections. If homeowner,contractor,project manager,or any other person not associated with my company,schedules an inspection and the system is not ready,then item three shall be applicable. 3. As the installer,I am required to have the necessary work completed prior to the applicable inspect hs as indicated below. I:understand tbat re uestin an in ection without corn letion of the items in accordance with Title 5 and.the board of_Health Regulations may result in a$50.00 fine being levied against me and/or mT$m� a. Bottom of Bed—Generally, this is the first(V)inspection unless there is a retaining wall,which should be done first The installer must request the inspection but does not have to be present. b. Final Construction_Inspection—Engineer must first do their inspection for elevations,ties,etc. As-built of verbal OK(or a-mail to:-healthdept@uorthandovetma.gov) from the engineer rmust be submitted to the Board of Health,after which installer calls for an inspection time. Installer must be present for this inspection. With a pump system,all electrical work must be ready and able'to cause pump to work and alarm to function. c. Final Grade—Installer must request inspection when all grading is complete. Installer does upt s have to be on-site. 4. As the installer,I understand that only I may perform the work(otberthan shqk exeavalion)and I am required to complete the installation of the system identified in the attached application for installation. I further understand that work done b �y others unlicensed to install septic gmems in North Andover can constitute reasons for denial.Of the system and/or revocation or suspension of my license to operate in the Town of North Andover sjgwficant fines to all 12etsons involved are also possible. 5. As the installer,I understand that I must be on-site during the performance of the following construction steps: a. Determination that the proper elevation of the excavation has been reached. h. Inspection of the sand andstone to be used. c. Final inspectron by Board ofHea&b staff or consultant d. Installation of tar*D Box,pipes, stone, vent,pump charuber,retaining wall aad other. components. G. As the installer I understand that I am solely Les ponsible for the installation of the Mtem as 12er the approved plans. No instructions—by the homeowner, general contractor or any other ersons shall,absolva �e of this obligation. Undersigned Licensed Septic Installer: aruv.. IS Zo/ (Taday/s�Date} (Name notSigned) Town of North Andover HEALTH DEPARTMENT DATE- µ H/O NAME: CONTRACTOR NAME: T oaf P+erw t aar f.ic awes»(Check box) --- ! b Animal * Body Art Establishment s- Body Art Practitioner $ Daaaaapster0 Food Service- 0 Funeral Directors • Massag e Establishment • Massage Practice • Offal(Septic)Hauler • Recreational Camp © Sun tanning 0: Swimming Pool 0 Tobacco — —�- • 'PrashSolid Waste Hauler e ® Well construction st rasz • Septic-Soil Testing• d eptic—Desi, ra Approval rem )roe.,I � w Septic Disposal Works 'onstraact im(l) ) 0I Septic Disposal Works Installers itMV 0 Title 5 Inspector y E3 Title 5 Report 1 t, C' Other(Indicate) Ife",440tAgent Initials i Applicant Y 11o;y-Health E,, Treasurer u P M lay: °d e " W Saw Road Was ks%Ikd ► r'S ot'Health appmed pW,:m*palbr daW 9 1 —=41astrovift4ou 1 with a d of 440 PlImspor day. The mamiah a appmvvd 1 uw ft sy an somdam w ,the a of 3 10.CMR,15.000,T t s Boald of Hoalft w Doom t ; '?P-1 Ingi . D - n,Ilk, . Apd—ftWN,am John P,Supivanlit, P Md—1p Wt III. PE Www