HomeMy WebLinkAboutDWC - Septic - Permits - 520 SHARPNERS POND ROAD 7/6/2020 Septic Disposal System Construction Applicant Location
Permit
James Boraczek 520 SHARPNERS POND ROAD
54362 9784795236 NORTH ANDOVER, MA 01845
boraczeksseptic@gmail.com
Submitted On:Jun 30,2020
General Information
Application is hereby made for a permit to: What component?
Repair or replace an existing system component Outlet T Baffle
Type of building: Type of Septic System:
Residential Dwelling Gravity
Conventional System? (pipe and stone system) Infiltrator or Biodiffuser(Gravel-less)?*Must attach copy of
Yes certification to install this type of system
No
Pressure Distribution S.A.S. (No D-Box)? Pressure Dosed (D-Box Present)S.A.S.?
Yes No
Does the system require an effluent filter?
No
Owner Information:
Name: Email:
Jon Stark NA
Is owner's address different from work site address?:
No
Installer Information
Name: Company:
James Boraczek Boraczek Septic and Drain, Inc
Street address: City/Town:
4 Hazel Dr Hampstead
State: Zip Code:
NH 03841
Contact number:
9784795236
Electronic Signature
The applicant agrees to ensure the construction and
maintenance of the afore-described on-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 Town of North Andover. I understand that
until a final Certificate of Compliance has been issued by this
Board of Health,the installed system is not approved.
true
Septic System Installer Project Management Obligations
Static Field I understand
-- true
Static Field I understand
-- true
Static Field I understand
-- true
Static Field I understand
-- true
Static Field I understand
-- true
Static Field I understand
-- true