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Home My WebLink AboutDWC - Septic Component Repair - Permits #55831 vp - 75 GRANVILLE LANE 10/8/2020 Date:September 23,2020 Septic Disposal System Construction Permit #55831 This is an e-permit.To learn more,scan this barcode or visit northandoverma.viewpointcloud.com/#/records/66006 COMMONWEALTH OF MASSACHUSETTS • TOWN OF NORTH ANDOVER BOARD OF HEALTH I - 1 rl Todd Bateson Bateson Enterprises, Inc. is hereby granted a Septic Disposal System Construction Permit Repair or replace an existing system component Septic Tank at this location 75 GRANVILLE LANE 106.C-0053 This permit is granted in conformity with the statutes and ordinances relating thereto, and expires one year from date of issuance,unless sooner suspended or revoked. --- BUSINESS PHONE#:978-815-2703 � �e CONDITIONS: EXPIRATION:September 23,2021 JOSEPH W.McCARTHY BOARD OF HEALTH CHAIRMAN Septic Disposal System Construction Applicant Location Permit 75 GRANVILLE LANE Todd Bateson NORTH ANDOVER, MA 01845 55831 % 9788152703 Status:Complete @ bei111@comcast.net Submitted:Sep 17,2020 General Information Application is hereby made for a permit to: What component? Repair or replace an existing system component Septic Tank 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 Pressure Distribution S.A.S.(No D-Box)? Pressure Dosed(D-Box Present)S.A.S.? Does the system require an effluent filter? Owner Information: Name: Email: Mr. Darrin Manke NA Is owner's address different from work site address?: No Installer Information Name: Company: Todd Bateson Bateson Enterprises, Inc. Street address: City/Town: 111 Argilla Road Andover, MA State: Zip Code: MA 01810 Contact number: 978-815-2703 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 1.As the installer, I am obliged to obtain all permits and Board I understand of Health approved plans prior to performing any work on a site. true I must have the approved plans and the permit on site when any work is 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 applied. I understand 3.As the installer, I am required to have the necessary work true completed prior to the applicable inspections as indicated below. I understand that requesting an inspection,without completion 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 my company, a. Bottom of Bed -Generally,this is the first(1st)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 e- mail to: healthdept@northandoverma.gov)from the engineer must 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 not have to be on-site. I understand 4.As the installer, I understand that only I may perform the work true (other than simple excavation)and I am required to complete the installation of the system identified in the application for installation. I further understand that work done by others unlicensed to install septic systems 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,significant fines to all persons involved are also possible. I understand true 5.As the installer, I understand that I must be on-site during the I understand performance of the following construction steps: true a. Determination that the proper elevation of the excavation has been reached. 6.As the installer, I understand that I am solely responsible for b. Inspection of the sand and stone to be used. the installation of the system as per the approved plans. No instructions by the homeowner,_general contractor,or any other c.Final inspection by Board of Health staff or consultant. persons shall absolve me of this obligation. d. Installation of tank, D-Box,pipes,stone, vent,pump chamber, retaining wall and other components. I understand true Staff Only Conditions/Restrictions/Comments(if applicable) Timeline ElHealth Department Review Status:Completed September 21st 2020,9:52 am Assignee:Toni Wolfenden Permit Fee Status:Paid September 21st 2020, 12:09 pm Toni Wolfenden September 21st 2020, 9:53:12 am Payment is now due. Please pay by credit card or mail a check to: Town of North Andover,Attention Health Department, 120 Main Street, North Andover, MA 01845 Health Department Approval Status:Completed September 23rd 2020,8:33 am Assignee:Stephen Casey ElSeptic Disposal System Construction Permit Status:Issued September 23rd 2020,8:33 am Component Inspection Status:Completed October 2nd 2020,8:51 am Assignee:Stephen Casey Stephen Casey October 1st 2020, 10:39:09 am Tank is 9.5 feet off of the house instead of 10 due to location of original tank. ❑ Certificate of Compliance Status:Issued October 2nd 2020,8:51 am Town of North Andover, MA $ 181 .22 Paid via Credit Card ending in 2007 Thanks for using the Online Service Center Todd Bateson Septic Disposal System Construction Permit #55831 September 21, 2020 Component Repair Fee $175.00 Processing Fee $6.22 Total Paid $181.22 0 Powered by the Viewpoint Cloud platform Receipt number#23354 .�L\ Commonwealth of Massachusetts RECEIVED City/Town of OCT 0 7 2020 System Pumping Record Form 4 TOWN OF NORTH ANWVER HEALTH DEPARTMENT DEP has provided this form for use=by local Boards of Health. Other forms may be used,but the information must be substantially the same as that provided here. Before using.this form,check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of house, Left Right rear of hous. Left Tig side fa house�Left Right side of building, Left/Right front of building, Left/Right rear of bur ding, Un er eck Address cityrrown �J v State Zip Code 2. System Owner. Name Address(if different from location) CityiTown State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) D-optic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition o stem: 6. System Pumped By: Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc- Company 7. L where contents were disposed: G L S. Lowell Waste Water Sign a Haul Date t5form4.doe•06103 System Pumping Record•Page 1 of 1