HomeMy WebLinkAboutSoil Testing Results - 225 OLD CART WAY 3/29/2000 Town of North Andover, Massachusetts Form No. 1
NORTH BOARD OF HEALTH /J}// f�-`g/- ���r
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4 Ew,°° APPLICATION FOR SITE TESTING/INSPECTION
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Applicant
NAME ADDRESS p TELEPHONE
Site Location �� 1��% yy
Engineer
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
t. CHAIRMAN,BOARD OF HEALTH
Fee Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
BOARD OF HEALTH TEL. 688-9540
NORTH ANDOVER, MASS. 01846
APPLICATION I TESTS
DATE:
LOCATION OF SOIL TESTS: C--,#1e7-
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Assessor's map & parcel number: I o"7 cq�fc I 10
OWNER:_ L �ec�ir1-ej TEL. N®.: 6s-7-6m-6;
ADDRESS:--z i Gil-,- G c wt r'
ENGINEER:_`UZe -°--s- 0" TEL. NO.:-el7z5 - �
CERTIFIED SOIL EVALUATOR
Intend o and: ential subdivision, single family home, commercial
Re rr test, Undeveloped lot testing
N. A. Conservation Commission Approval: __ .... - y.. C
THE FOLLOWING U T BE INCLUDED WITH THIS FO
1. Proof of land ownership (Tax bill, dead, or letter from owner permitting
tests)
2. Plot plan
3. Fee of J2Z6.0Q per lot for aM construction. This covers the minimum two deep doles
and two percolation tests required for each disposal area, Fee of JZ5,00 per lot for
re airs or u rades.
GENERAL INFORMATION
1, Only Certified Soil Evaluators may perform deep hole inspections.
2. 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,
4. Repairs require at least two deep holes and at least one percolation test, at the
discretion of the BOH representative.
5. Full payment will be required for all additional tests within two weeks of testing.
6. Within 45 days of testing, a scaled plan (no smaller than 1®•100') 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.
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