HomeMy WebLinkAboutApplication - 97 SAW MILL ROAD 3/17/2000 Town of North Andover, Massachusetts Form No. 1
NORTH BOARD OF HEALTH /;
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7QA�RA APPLICATION FOR SITE TESTING/INSPECTION
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Applicant
NAME ADDRESS TELEPHONE
Site Location 1���� 6 'GE��r, •� i�
Engineer
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time A/le/2"/
CHAIRMAN,BOARD OF H ALTH
Fee j�EJ Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
BOARD OF HEALTH TEL. 633®9540
NORTH ANDOVER, MASS. 01846 1
APPLIgjATION FOR SOIL TESTS
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LOCATION OF S.OIL.
TESTS: � r
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Assessor's map & parcel number: f
OWNER: ,
TEL. NO.:
ADDRESS: . �� � � � L-12
ENGINEER: ° µ ::
TEL. NO.:
CERTIFIED SOIL EVALUATOR: . ..... �;
Intended use of land: idential subdivision, single family home, commercial
Repair testing Undeveloped lot testing
N. A. Conservation Commission Approval:
THE OLLOWIN MUST BE INCLUDED WITH THIS FORM:
1. Proof of land ownership (Tax bill, deed, or letter from owner permitting
tests)
2. Plot plan
3. Fee of UL6.00 per lot for OM construction. This covers the minimum two deep holes
and two percolation tests required for each disposal area. Fee of$75,00 per lot for
repairs or uggrgdes.
GENERAL INFORMATION
1. Only Certified Soil Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Engineers can design septic
plans.
3. At least two deep holes and two percolation tests are required for each septic system
disposal area.
4. Repairs require at least two deep holes and at least one percolation test, at the
discretion of the SOH representative.
5. Full payment will be required for all additional tests within two weeks of testing.
. Within 45 days of testing, a scaled plan (no smaller than V-1 shall be submitted to
the Board of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted.
PLOT PLAN
Lot # 45 Sawmill Road
North Andover, Massachusetts
Scale: 1" = 50' Buyer: Steven Leone
August 4,1980
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Pe/'e� to N.EpD. Book 1425, Paqe 239
anY Plan
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NCTE: This is not a survey and is to be
used for mortgage purposes only.
N.B.- Do not use offsets for establishing
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lot lines for the erection of fences,
walls, hedges, etc.
L hereby certify that the building on this
property is located as shown on plan and complies with
the zoning set back requirements of the Town of North
Andover.
? # NOT APPLICABLE TO FLOOD PLAIN ZONING.
QM
CYR ENGINEERING SERVICES, INC.
; 300 CANAL STREET
LAWRENCE, MASSACHUSETTS
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