HomeMy WebLinkAboutSoil Testing Results - 855 WINTER STREET 5/17/2010 TOWN OF NORTH ANDOVER
Office of COMMUNITY DEVELOPMIJNT AND SERVICES
HEALTH DEPARTMENT
1600 OSGOOD STREET; BUILDING 20•4 SUITE 2-36
NO USETTS 01845
Susan Y.Sawyer,RE,IIS,RS 978.688.9540—Phone
Public Health Director MAY 1 978.688.8476--FAX
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www.townofnorthandover.com
TOWN OF NOF�TH ANDO R
HEALTH DEPARTMENT
APPLICATION FOR SUMT75r
DATE: E d MAP&PARCEL:
LOCATION OF SOIL TESTS:
OWNER: �°( V I ._ f -eO 4 vh __ Contact#:
APPLICANT:B r `
ADDRESS: L ' ! �'O ✓1 ' r'i SCb r b { / j
ENGINEER: Hb P'r v,%- Contact#: 2
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Horne Commercial
Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes No l/
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
Proof of land ownership(Tax bill,or letter from owner permitting test)
➢ 8.5"x 11"Plot plan&Location of Testing(please indicate test,pit sites on the plan)
Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades.
GENERAL INFORMATION
➢ OnIy Certified Soil Evaluators may perform deep hole inspections.
3 Only Mass.Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system disposal area.
➢ Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
➢ 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 I"-100')shall be submitted to the Board of Health
showing the location of all tests(including aborted tests).
➢ Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date:
Signature of Conservation Agent;_
Date back to Health Department:(stamp in):
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