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Home My WebLink AboutComponent Repair - Dbox & Outlet Tee - Permits #56158 vp - 235 RALEIGH TAVERN LANE 10/22/2020 Date:October 5,2020 Septic Disposal System Construction Permit #56158 This is an e-permit.To learn more,scan this barcode or visit northandoverma.viewpointcloud.com/#/records/66598 � yt1il F"Ili COMMONWEALTH OF MASSACHUSETTS !j!1 TOWN OF NORTH ANDOVER BOARD OF HEALTH _ Melissa Donnelly Wind River Environmental is hereby granted a Septic Disposal System Construction Permit Repair or replace an existing system component DBox,Outlet Tee at this location 235 RALEIGH TAVERN LANE 106.C-00" 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#:800-499-1682 ` *// �C CONDITIONS: nr EXPIRATION:October 5,2021 JOSEPH W.McCARTHY BOARD OF HEALTH CHAIRMAN Septic Disposal System Construction Applicant Location Permit 235 RALEIGH TAVERN LANE Melissa Donnelly NORTH ANDOVER, MA 01845 56158 800-499-1682 ex 5871 Status:Complete @ mdonnelly@wrenvironmental.com Submitted:Oct 05,2020 General Information Application is hereby made for a permit to: What component? Repair or replace an existing system component DBox, Outlet Tee 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 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: David Starrett daves@axiomtek.com Is owner's address different from work site address?: No Installer Information Name: Company: Robert Herrick Wind River Environmental Street address: City/Town: 46 Lizotte Drive Marlboro State: Zip Code: MA 01752 Contact number: 800-499-1682 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) Attachments (2). ---- - - ; . A Gas baffle image 1 Gas baffle image 2 Oct 14,2020 Oct 14,2020 Timeline ❑ Health Department Review Status:Completed October 5th 2020, 1:46 pm Assignee: Toni Wolfenden Permit Fee Status:Paid October 5th 2020, 1:51 pm Toni Wolfenden October 5th 2020, 1:47:36 pm Payment is now due. Please pay by credit card or mail a check for$175 to: Town of North Andover,Attention Health Department, 120 Main Street North Andover, MA 01845 Health Department Approval Status:Completed October 5th 2020,2:02 pm Assignee:Stephen Casey Septic Disposal System Construction Permit Status:Issued October 5th 2020, 2:02 pm Toni Wolfenden October 5th 2020, 2:31:12 pm Permit has been issued. Please print and post. Thank you. Component Inspection Status:Completed October 14th 2020,3:31 pm Assignee:Stephen Casey Stephen Casey October 13th 2020, 10:11:57 am Was the gas baffle ever attached?Ryan said he would attach it after the inspection last week noted it was missing one. Stephen Casey October 14th 2020, 3:31:12 pm Images received. Certificate of Compliance Status:Issued October 14th 2020,3:31 pm . I �q,.: ) ♦`fix ( _ i J saa. r lei R 'o,r'r 14 S �.+i►�Su+,y, mac" ; � w. - ,'1 t. a Town of North Andover, MA $ 181 .22 Paid via Credit Card ending in 1005 Thanks for using the Online Service Center Melissa Donnelly Septic Disposal System Construction Permit #56158 October 5, 2020 Component Repair Fee $175.00 Processing Fee $6.22 Total Paid $181.22 L:J Powered by the ViewPoint Cloud platform Receipt number#23648