For Plumbers/Fire Sprinkler Contractors

Click Here to download the Backflow Prevention Device Design Data Sheet (Permit Application)

You do not need to print this document; you may edit the file directly from your device.

*Note: if you have difficulty downloading this file, there are physical copies available at our office. You may also email us at northchelmsfordwater@outlook.com for a digital copy.

The North Chelmsford Water District (NCWD) is committed to abiding by governing federal, state, and local regulations, including 310 CMR 22.22. As such, the NCWD and Town of Chelmsford have collaborated to implement a backflow prevention device permitting process. Effective immediately, no occupancy permits will be awarded for properties which are not in compliance with this process.

Prior to installing any testable backflow prevention devices (RPZs, DCVAs, PVBs, and SRVBs), you must abide by the following protocol:

1. Complete the “Backflow Prevention Device Design Data Sheet (Permit Application)” in its entirety.
2. Submit the application and associated schematic to northchelmsfordwater@outlook.com or by mail to/drop-off at our office located at 64 Washington St, North Chelmsford, MA 01863.
3. Pay the backflow prevention device permit review and initial test fee of $100.00.

Subject to system complexity, our decision regarding your application will typically be returned by the next business day. Once your application is approved, the NCWD will notify the Town of Chelmsford Plumbing & Gas Inspector.

Note for Fire Sprinkler Contractors: the NCWD is not responsible for contacting the Chelmsford Fire Department regarding your backflow prevention device application. It is your responsibility to ensure compliance with 310 CMR 22.22, Sections 7(a)(2) and 7(a)(5) and submit the relevant documentation along with your backflow prevention device application.

Note for Installation: the NCWD is not responsible for providing test cocks. Test cocks must be included as part of device installation. The device will be manually failed if all test cocks are not installed.

Please be advised that your application may be rejected for incompletion, tampering, failure to pay the permit review/initial test fee, failing to meet the installation requirements established by 310 CMR 22.22, or other relevant reasons per the Water Superintendent’s discretion (310 CMR 22.22, Sections 7(b) and (c)).

Thank you for your understanding and compliance with the 

North Chelmsford Water District’s Cross-Connection Control Program