HomeMy WebLinkAboutSoil Testing Results - 191 GRANVILLE LANE 8/20/2003 NUMBER
COMMONWEALTH OF MASSACHUSETTS BHP-2003-0253
North Andover FEE
$360.00
Board Of Health
BERLIND, DAVID A
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NAME
191 GRANVILLE LANE
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ADDRESS
IS HEREBY GRANTED A PERMIT
Sod Testing
This permit is granted in conformity with the Statutes and ordinances relating thereto,and
expires-------------September-05,-2-005------_-----unless sooner suspended or revoked.
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September 05,2003 Board Of
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Health
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BOARD OF HEALTH
NORTH Air DO VFIt9 MASS. 01.845
975-6$8-9540
APPLICA'T'ION FOR S®IL TESTS
DATE: z I MAP&PARCEL:
LOCATION OF SOIL TESTS:
0WNI-R:_ LD t I—cg,�'Z.�1 }�w f? l 1�.� ,. _ TEL. NO.:
ADDRESS: li i t" P y}/l)
ENGINEER j l✓way G A-'t;L-0,'D � )f,(,t,+ �lZ(/i�' ° TEL.NO.:
CERTIFIED SOIL EVALUATOR; rc �_i 2,, ( R t t-yu> j c
Intended use of land: Residential Subdivision Single Fan7ily Home Commercial
Is This:
Repair testing Undeveloped lot testing Upgrade for addition
In the Lake Cochichewick Watershed'? yes No
THE FOLLOWING 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$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 J.36000 per lot for repairs or upgrades.
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 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°'-1.00')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.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval At),�
Date Received: Check Amount:
--Z--Check Date:
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